St John World (1990)

STJOHN

Badgers Cross Border

Choosing that Ambulance

Wounds and what to put on them

CONTRIBUTIONS

SUSSEX GOES SILICONE

The vital and versatile SUSSEX MANUAL RESUSCITATOR in both Basic and Universal models, is now offered with a compact, high-volume, translucent SILICONE Bag.

SUBSCRIPTIONS

Choosing that Ambulance

STEEDRIVE AMBULANCES

and options from which to choose

When the target of a new ambulance s beyond the reach of even the most ambitious fundraisingscheme , then itistimetothinkof a secondhand ambulance Of course , you need to be careful when buying secondhand , as you may have a heavier'repair bill , but overall they can be a very good buy

How to find a second hand ambulance

There are only a few sources of secondhand ambulances In the UK most ambulances are operated by Health Authorities who sell them direct to St John divisions , by tendering or by auction Alternatively, ambulances can be found in private ambulance services or other voluntary organisations , but these are often ex-health authority vehicles moving on to yet another life Occas onally m anufacturers dispose of demonstration ambulances which is the only source of nearly-new ambulances Such an ambulance will have covered only a few thousand miles on demonstrations Sometimes demonstration vehicles are sold because change in specification has outdated them

by BR IAN ROCKEll

Director St John Supplies

These veh i cles can be an excellent buy, but they are few and far between and the saving on the new price might be only a few thousand pounds , and st ill beyond the reach of many divis ons

Secondhand ambulances can sometimes be found at commercial veh cle traders , but they are often stripped of expensive equipment such as lights , s igns , stretchers , etc In recent years a number of compan ies have been formed which refurb sh old ambulances to offer for sale to voluntary organ isations such as St John The extent of such refurbishment varies considerably but of course it needs to be more than cosmet ic to be effective With the exception of demonstration veh icles , all secondhand ambulances will have completed at least 100,000 miles , and some tw ce that m leage Most people would be very wary about buy i ng a car with such a high m leage , so the purchase of an ambulance, with the extra publ c responsibil ty, needs even more caut on

(Left) The latest Ford Transit van convers ion with GRP top added to give headroom (Right) A VW van conversion which is not likely to be available second hand for a while yet

What to check in a s econdha n d ambul ance

Essent al po i nts to check are :

1 Braking system The brakes will have had a demanding life and although able to pass an MOT test they are unlikely to be up to new performance unless master and wheel cylinders and flu ids have been replaced

2 Look out for worn pedal rubbers , floor mats and tread steps Rusti ng of the cab floor or step i s a l ikely problem

3 Heavy wear (and heavy handed use) will have weakened door h nges , catches and w i ndow mechan isms There may be water leakage through skylights , windows or via the ambulance sign

4 The stretchers (if fitted) may not work through the full range of movements and cont inued overleaf

9

S

7

6

5

11

12.Some

13 The

Almost

DARTFORD LEICESTERSHIRE

STJOHN

W €O RLD

Choosing t hat Ambulance (cont.)

cheap but they are unlikely to have any records and will usually be stripped of essential ambulance equipment. It can be very costly to replace the equipment removed! Auctions give little opportunity for inspection and buying is very risky except for the most skilful and technically qualified General commercial vehicle dealers, such as those who advertise nationally, often buy at auctions.

Specialist dealers are likely to have bought at auction or direct from Health Authorities and will have solved the problem of missing parts. Buying from specialist dealers can be a costly way of buying and it is essential that you make sure that the refurbishment is not just to improve the look of the ambulance. A new front end and a respray does not make a new ambulance underneath can still be a high mileage chassis. Brigade Orders require that all potential purchases are submitted to a vehicle test by one of the motoring organisations , such as RAC, AA or Crown Suppliers. The modest cost is M M

very worthwhile and a full vehicle report will spot potential problems. Better to be put off

massive bills after purchase!

Inevitably, a vehicle report will pin-point faults , so before buying calculate the cost of repairs and whether the selling price is value for money A list of faults (even minor) can sometimes be used to negotiate a price reduction. But sadly, many vehicles will be beyond economic repair, so don't let enthusiasm rush you into making a bad buy All ambulances should come with a current MOT certificate, but this is no guarantee of

roadworthiness Remember too that ambulances have to have a

when they are one yearold (unlike cars , which start at three years). There are some savings to be made , as the purchase of an ambulance, repairs and inspection are all VAT zero rates , provided that the correct declaration is made to the supplier Full details of VAT relief are available from St John Supplies C o nclusi o n If you buy carefully, have the vehicle inspected

Add to this the average cost of a new ambulance vehicle and the figure normally quoted for a fully equipped ambulance is between £25,000 and £28,000

These items, along with the smaller ones such as replaCing the contents of public duty first aid kits, can all be identified and priced as separate items for a fundraising appeal. There

A

The sponsor of a piece of equipment

be acknowledged on the outside of the ambulance, eg " The equipment (or single item) inside this ambulance is sponsored by " ; and a presentation ceremony can be arranged. (If you have a main sponsor of the vehicle, be sure to give their logo slightly more prominence on the side of the ambulance!)

You may find that a wealthy individual or small group of supporters will be much more interested in contributing to yourfunds for a specific item rather than a long term appeal for a new ambulance.

Sponsorship of this kind does not have to stop at the medical contents of the ambulance It can be related to sponsorship of each tyre, or the radio set. Smaller companies mayfind this idea rather novel. Your local tyre fitting garage may sponsor the tyres, the local petrol station give a contribution towards your petrol costs - all to en-

sure your custom in the future and their name on your ambulance as a moving advertisement!

So the next time you need a new ambulance or a new piece of equipment try to think of ways in which smaller contributions could be accepted and acknowledged This will widen the idea of sponsorship to many more people in your community, and not just to big businesses

The local press may also like to help launch a 'progressive appeal' For instance, every time a certain amount is reached , another piece of equipment or part of the ambulance is able to be bought, until you achieve the final goal of a new, fully equipped ambulance But you need a realistic time table for the final amount to add impetus to the fundraising

Remember, the more the general public know about what things cost you to provide the first aid cover, the more they will appreciate what you do - and hopefully give bigger contributions next time you re fundraising!

ASTRA HO LDINGS PLC

Found in a Devon farmyard

Resuscitating a Ford 'A'

M

ice had been nesting in the engine of what is believed to be the oldest surviving St John ambulance when it was rediscovered lying forgotten and overgrown with weeds in a corner of a Devon farmer ' s field. The Ford Model A', which originally cost £250 had started life back in 1929 with St John in Sid mouth where it was known as the Sympathy Ambulance

Later it was used by St John in Honiton , but in 1946 its ambulance days ended and it was sold to a farmer near Axminster and reregistered as an agricultual goods vehicle

Nothing more was heard of it by the Brigade for more than 40 years But thanks to some smart detective work , fortunate coincidences and a lot of good will, it will not now end its days as a pile of scrap It will soon be in pristine condition, ready to go back on St John duty

The miracle transformation is being carried out free of charge by apprentices at Astra Defence Systems' high precision engineering works in Grantham , lincolnshire.

"When the work is completed the veh icle will not sit in a museum. It will be used to

JOHN 5T JOHN

rtunate coincidences Leyland (Phil) ings is group financial accountant of Holdings pic and honorary treasurer of rderof Stjohn Musical Society, run by ia Lady Wilkinson

She told him about the plan to restore the hicle, that the Cork Charitable Trust was nancing the first £5 ,000 of the work, and at they were looking for suitable comnies to do the restoration * and sought the support of Bill ught, managing director of BMARCAstra Defence Systems - who saw it as ideal project for the company's apprentices

,

"From a training standpoint, the project requires the exercise of a great many practical engineering skills and the final product will be a useful vehicle in which those involved can take pride," he said

The ambulance project has received great support from John Anderson , a director of the parent company, Astra Holdings pic

"We have a very good apprentice training centre at Grantham and we usually take on one project a year that's both useful training and good forthe community," he explained

Next step was for a small team to go down to Philip Snell's farm and bring back the remains of the Sympathy Ambulance

When it arrived at Grantham those inved in the renovation were taken aback "It was a right mess ," said John Cheeseman , senior training supervisor in harge of the apprentices . " Everything was sty and covered with green mould and ine the engine there were little bits of paper and straw where mice had been living! " The

wooden body was riddled with woodworm

DAVID McDINE GOES and apparently had every disease known to TO SEE A 1929 John s initial reaction? " We'll never do

AMBULANCE REBUIU Training instructor Don Brandom was

(Right) Remnants of the body ready to be rebuilt and reassembled (Below) The chassis has been checked , cleaned and treated - and the wooden subframe is built over it

going back to

Back in May 1929, the ambulance, registration number DV 654, was collected from London by Elliot Breach and John Till , of Sid mouth St John Ambulance Assoc iation.lt was dedicated on June 18 at a special service followed by a dinner and dance Its comprehensive insurance had cost a princely nine guineas (£9.45) and the rules drawn up for its use stipulated that it had to be available at any time - night or day '. The rules also prohibited the carriage of infectious cases and corpses, although it is not recorded what the crew were expected to do if a patient died in transit!

Taxi Hodge

The ambulance was kept at Hodge's Garage and the owner, known locally as 'Taxi Hodge', shared the driving with Elliot Breach and Arthur Irish From the start it did sterling

8 raise money for the Order," said Robin Salmon, who heads the restoration committee. He is appealing for anyone who has contemporary items of ambulance equipment to donate them so that it will be kitted out authentically

asked to go and have a look at it but couldn t work, attending ten accidents and ferrying find it. " That's because I was looking for an invalids to hospital in the first few month! ambul ance but all I could see was a rusty Its distinguished career apparently a rotten body and a box of odd when it was sold at Honiton to farmer Willi aparts! he recalls Rutter in 1946 Over the next nine years The first task was to do extensive research was a workhorse around Ashe Farm ne on the type of vehicle and take the remains Axminster, but then it blew a gasket an d wc apart , noting each abandoned in a field - its useful life We even watched TheWaltons parently over teleVision r:nost of the vehicles in Philip Snell, from the neighbouring far r It are Model As, said Then w?rk remembers discovering what he the chaSSIS and engine as an old Ford van overgrown with nett lE and finding Dozens of when he was a boy in the early 60people both inSide and company Fascinated by it , he eventually asked tt helpe d Model A Be,lcher, Rutter family if he could have it. "They didr who lives near DISS, donated a new conattach any value to it and said 'Have it ifyc motor Former really want it!' It was thator let the scrap mE Clem Vale came out of have it" recalls Philip retirement to bUild a new body out of ash "I it to my land I wanted to restorwood and an apprentice 'sfa:her is providing it but realised the costs involved we Continued on page 21 beyond my means at the time." Then til * years ago members of the Sidmouth Oil ':- committee been formed sion did some detective work tracked dOli With Robin Salmon as chairman , Alderman the Sympathetic Ambulance to Philip 's fiel( Roger and the long saga that led to its restorat io SylVia John Mills , began How it ended up in the Astra works i Dlrector?f Public Affairs , and Montagu Grantham is just one of an amazing series { of Beaulieu agreed to be preSident.

The bodywork being rebuilt - from front of cab

and Alan Mcilroy, 7, are seen here with Glen Michael , presenter of Scottish TV's Cartoon Cavalcade programme on which the Badgers appeared.

Twenty Badger leaders have been trained and the first Badger set has been established at Bellshill , the new Safeway headquarters for Scotland Even the large inflatable Badger has been fitted with an

happenings .

80-year-old volunteer retires

Dame Anne Bryans , aged 80, a tireless voluntary worker since the Second World War, retired as chairman of the Service Hospitals Welfare Department of the Order of St John and British Red Cross Society at the end of October

Dame Anne, here sharing a large 60lb cake specially made and decorated to commemorate her years of service with Chelsea Pensionersatthe Royal Hospital in London , where she still mans the tea bar every Tuesday afternoon. Some of the pensioners

Dame Anne helps are younger than she is!

Dame Anne has been involved with vol untarywork for the Joint Committee of Stjohn and the Red Cross since the beginning of the Second World War Since then she has been

Seventy SJA presidents and vice presidents from NO 6 Region met at Aylesbury on October 28 for an all day conference The Region covers Dorset, Isle of Wight, Hants , Oxon, Berks and Bucks.

Chaired by Sir Philip DuncombeCounty President of the hosts , Bucks - the meeting began with a showing of the video "For all the right reasons"; about half the audience had not seen it before Bucks PRO John Williams then presented thoughts on how presidents can get involved with divisions in recruitment and publicity

The Chief President, Mrs Harold Phillips then gave a stimulating talk "Let's be Positive," reflecting on the success of St John recently - Badgers, Cadet Action Pack and now the Energy Programme She encouraged all presidents to be " working presidents" , as they could playa vital role in supporting divisions. She confirmed that she was investigating an award of Service Medal to Presidents.

After lunch the guest speaker Chief Superintendent David Lindley, head of operations of Thames Valley Police, spoke on 'The Lessons Learnt', focusing on the problems of public safety and order at major events On soccer stadiums, he said, research indicated that organised hooligan gangs, although a minority were not a tiny minority and they could rely on the tacit support of a large number of 'uncommitted' terrace spectators who had little respect for uniform, police or St John. The problem of fencing, which prevented rapid evacuation but also prevented potential mass violence, was reviewed; and he said it was difficult for anyone to contend with 'sheer irrational sudden movement.' Chief Supt Lindley then looked at the public safety at pop festivals and the recent phenomena of 'Acid House' parties - of which Bucks had the record for attendance, 20,000 at Aston Clinton.

Next, a welcome return to Buckinghamshire of Jeanne Mercer, now Chief Welfare Officer. Jeanne showed the new video on the

STJOHN W 0 RL -

Dame Anne still mans the tea bar every Thursday at London s Royal Hosp i tal

continually concerned with the welfare of servicemen and women

She became the first Director of the St John and Red Cross Service Hosp tal Welfare Department in 1946 and as such travelled widely in the Far East monitoring

PRESIDENTS MEET

" Energy Programme " and concentrated on the " new and exciting challenge " of Community Care and Welfare in St John Ambulance She said that a special train ng package for community care at divisional level is being i ntroduced , coupled with guidelines to community care co-ordinators

She reflected that the value of the Energy Programme was its flexibility - disabled people could undertake presidential duties or participate in communication centres

She then showed a new video on the Badgers and concluded that recent action would take the Brigade into the 2000s with confidence

The Management of Property is a key area for the involvement of presidents , said Bucks Commander, Lt Col. Bob Payne. He reviewed the new Brigade regulations on property

St John World County and Division News

Even b i gger!

Lifestlye promotion

Have you been collecting BP Lifestyle vouchers to help boost your income or pay for a particular piece of equipment?

Mrs Judith Wingar, County Secretary for Suffolk St John, has organised a central collection scheme which has collected 1,290 vouchers, enough to pay for a four-drawer filing cabinet for their county office. A further 800 were then collected which will help buy a piece of equipment.

casualty evacuat on of serv ice pat en during the Korean War In 1957, Dame Anr was awarded the DBE and , follow i ng death of Lady Edwina Mountbatten , she tex over her current role as cha i rman of the Se v ce Hosp tals Welfare Department.

and said tha t h s ideal management com m tee cons isted of : DiVISional PreSident in the chair

Div Su pt.lOfflcer adult diVis on Dlv Supt IOfflcer, cade t diviSion

Com m ander's representative

Hon SoliCi or Hon Surveyor A N O ther P lus an ex-offiCIO secre tary and treasurer - da roles for presidents

He commented on finance and insuran o matters and encouraged all pres i dents an vice presidents to become nvolved w i th th management of local St John property

Sir Ph i lip then chaired a quest ion an answer session One interesting idea ca m the Rev D etr ich who sa i d t he S u pe r S u p e rs In Germany every dnver had to underg eight hours first aid training before obta inin a driving licence He suggested that eve r body wrote to their MPs press i ng them take up this idea

Thanks were g iven to Bucks Coun Secretary, Pat Chesterton , for her hard war i n the conference

How did they achieve this? Their Publicity Officer sent information to various Suffolk newspapers asking them to feature St John Ambulance and the BP promotion , and asking the general public to collect the vouchers on behalf of St John. He even managed to get newspapers to mention the Energy Programme (tying in nicely with oil and BP!) The public response was tre· mendous.

Both Mrs Judith Wingar and I are eagerto hear of other counties or divisions who have had similar success. The BP promotion finished at the end of December, bul remember the Gulf Oil promotion, which is very similar, runs until March 31 1990. SO KEEP COLLECTING!

For information on the two promotions, please contact: Elizabeth Ganney, Mar· keting Department, St John Ambulance HO, 1 Grosvenor Crescent, London SW1X 7EF,

Anything you can do, we can do says SJA Leics , whose Centre Shield measures 461hins high and 33ins wide, larger than Sedgley's (see this page August '89 issue).

First competed for in 1892, the Centre Shield has been won for the last four years by British Gas East Midlands team. With this year's winning team is David Atkinson, British Gas Regional Chairman, who received the shield from Mrs K. Burdett, Assistant County Director.

Hailsham Badger Set has a record 18 Super Badgers , the highest number n East Sussex s more than 40 Badger Sets Ordare we ask - is it the highest of any set in the country?

Badger Leader Sharion Bourn and Badger Assistant Michael Hamilton are greeted by a bevy of Badgers from Bishopston Set , Bristol , as they leave church as Mr & Mrs Hamilton Sharion is now Area Badger Leader.

Bath City Division s team (front row) who were winners of the Avon Ambulance Challenge Day, with runners-up

lwyd

Penycae Badgers present blankets they made to residents of Maelor Hospital, Wrexham (Photo : Wrexham Evening Leader)

AROUND THE DIVISIONS AROUND

Cefn Mawr Division, 7 miles from Wrexham, has been awarded £150 from the Shell Better Britain Campaign to buy an acces fire door for its HQ.

The Division, which has 20 adults, 80 cadets and 40 badgers, is completing the fire-proofing of its 100-year-old building (stairs, roof and walls) at a cost of £10,000. Most of the work has been carried out by the cadets u nder the direction of their 0/0, Stephen Jones.

The

Hampsh ire

Coventry

O ffi

of the Order. Be rn ard Browning, 6 4, said r e cently: 'Three we e ks after pa SSing my

c o urs e th ere was a car crash n ear my home w th six people inside th e o verturned vehicle. One of them could n ot be saved, but I managed to get the others to hospital where they later recove red It was so me introduction to my

Hereford and Worcester

Newa rk

THE DIVISIONS

training to incompany' locations and to extend the range of first aid training in more distant areas of the county

The cost of the vehicle has been funded by the efforts of part -time instructors in profitable FAW courses in recent years.

King's Lynn

Sir Harry Secombe entertaining some of 0 girls on duty at the local golf course recentl)

Leeds

At the annual inspection of the Newark Di vis ion s the town's Mayor CUr Roy Bird pre sented Essential of Firs t Aid certificates to 22 nur ing cadets and the Southern Area deputy co mmi ss ioner Frank Shields presented honorary member 's badges to Frank and Anne Martin who founded the Cadet Parents Association 10 1979 Mr and Mrs Martin are only the 9th and 10th honorary

k members of the divi s ion since It foundatIOn 10

1912

A warrant of appointment wa s pre ented to the Vice -President of the Nursing Cadet Di v s ion. Mr P Dalby Corporal A E Well s received hi Long Service Medal

Oxford

NurSing 8gt Debbie Cousins (left) and Cadet Cpl Karen Brown , of Oxford City Quad Division , attend a runner in the Town and Gown fun run with nappy rash!

Victoria Cadets presiderl Mrs Annie Thom!> son and vice · president Jac* Alderson out flae sellin g have a West Oxford Division recently bought two portcombined age (j able radios and accessories. thanks to grants from 158 years the Oxford City Council and the National Westminster Bank, plus their own fund rai ing

Salisbury

Salisbury Division were rewarded for many years of service to Wylye Horse Trials when the Bathampton Equestrian Centre and Wylye Horse Trials presented them with a new ambulance

The presentation was made by the Hon Suzanah Maitland-Robinson, and the keys were received by ASO Glyn Reeve, who until recently wa superintendent of Salisbury Division

There were three ambulances on duty, plus a

The photo (above next column) shows Badger of the Year 9-year-old Joanne Mitchell demonstrating to parents and friends how to place volunteer Tony Grimes into the recovery position Joanne was awarded the John Cook Shield for gaining the highest marks in first aid and nursing. , . . f Neath Division's new HQ was opened during September by the Princess Royal, who chatted with cadets and (here) watched a first aid and nursing display

Suzanah Maitland-Robinson hands over the ambulance to ASO Glyn Reeve for Salisbury Division. (Photo: David Merritt)

mob!le

Sheppey

During October Howletts Zoo Canterbury wa s invaded by 25 Isle of Sheppy Badgers complete with camera s and picnic bags on their annual outing (Photo above)

All the animal s were out to greet them (or was it the bags of eaL ) : tigers. monkey exotic bird gonlla s. and even the Honey Badgers were awake to ay hello! The fir t

Solihull

OF YEAR

Michelle King from Thrapston, Northamptonshire, is the Cadet leader of the Year having won the annual competition held at Kidderminster over the weekend of 8 to 10 December. Joint runners-up were Nigel White from Richmond in North Yorkshire and Catherine O'Leary from Oxford. Thirty-three cadets representing counties all over the country, took part in an intensive but enjoyable weekend.

CHALLENGE

The 'Challenge', a scheme initiated during discussions with HRH The Princess Royal who is Commandant in Chief of Cadets, is to be launched on 7 February Anneka Ricerenowned for tackling challenges of all sorts - is to launch the new youth initiative aimed at young people aged 15 to 25

PALACE VISIT FOR GRAND PRIOR'S CADETS

Over one hundred lucky Grand Prior's cadets - three from each county - are to be invited to attend a reception at Buckingham Palace on Wednesday 7 February. This is the third consecutive year that the Palace have hosted the reception.

16

NEW THREE CROSS AWARD VIDEO

A new video for the St john Ambulance Three Cross Award Scheme has been made thanks to sponsorship by BP and will be launched on 18 January 1989 TV presenter Phillip Schofield , who appears in the v deo will be at the launch

The winner of the BP award for school children who have performed meritor ious acts of first aid will also be announced

TRAINING COURSES

Don't forget to apply for courses you are interested in The Course 1990 leaflet is available from your county office or the National HQ training department. ClOSing dates for the following courses are coming up very soon!

Making presentations - 23 to 25 March

1990 (closing date - 26 January

Youth Leader Training - 16 to 18 March

1990 (closing date - 19 January)

Cadet Proficiency Subjects - 9 to 11

March 1990 (closing date - 12 January)

Links Workshop -3 March 1990 (closing date - 2 February)

The Challenge Workshop - 10 March

1990 (closing date - 9 February)

For more details telephone , Carol Dwyer, Training and Development Officer on 01-235 5231.

topic of interest among firstalders, pharmaceutical suppliers and, perhaps to a smaller extent, the public , is what is the best thing to put on a wound. Any attempt to provide an answer should start with a brief account of how wounds heal and then of studies of how this remarkable process can be influenced for good or ill.

Healing is essentially a process whereby a labour force is brought to a site where repair is needed and then sets to work The labour force is made up of cells in the injured part. Some of these cells clear up debris, some bind together the wounded surfaces, some multiply in order to make good the loss of tissue and some fight any germs that get into the wound In ideal conditions the raw surfaces of a simple clean cut by a sharp knife or by glass can be brought snugly together (fig. 1); this makes the process of repair simple and quick. Once it has been tlosed, the surface of such a wound is a very narrow strip and it is quickly sealed against germs when any oozing from it dries and forms a crust. This sort of healing is known as healing by first intention, in which the process of repair proceeds unhampered and has no need of assistance There is no swelling, redness or discharge.

Harder task

Other wounds leave a gap because tissue has been cut or scraped off or has been gouged out or badly crushed or torn Now the reparative cells have a much harder task because there is more or less of a gap that has to be filled (fig. 2) Ideally, a surgeon will be able to tidy up and fashion the damaged area with his knife and scissors so that he can bring the nice clean (from a surgeon's point of view) surfaces together and allow healing to occur by first intention.

In olden times wounds had to heal as best they could, often in spite of dreadful things that were done to them - such as applying cow dung or burning with hot irons or, well within living memory, pouring in tincture of iodine. It is remarkable what the healing process could achieve in spite of these adverse influences although it often took a very long time and left severe scarring Perhaps the wisest words on this subject were those of a French military surgeon in the 16th century - Ambroise Pare - who said that he dressed the wounds but that God healed them He learned a very valuable lesson when the scalding oil that was then used to counteract the supposed poisoning of gunshot wounds ran out. He used instead a preparation including raw eggs and oil of roses, which was the best he had. To his astonishment and relief Pare found that the wounds treated with his 'digestive' were much less painful and made much better progress than the ones that had been treated with boiling oil. This showed him that wounds could be harmed and the process of repair greatly delayed by some methods of treatment.

Man has for so long been in the habit of

WOUNDS and what to put on

by P. S. LONDON, MBE, CStJ,

in the short time that is likely to elapse before a doctor or a nurse sees the patient the dressing will not stick to the raw surface Any cream , ointment , paste or powder that is

h applied to a wound may damage the cells in

FRCS, MFOM

Member of the SJA Medical Board

applying substances to wounds in the belief that they had a beneficial effect that he still finds it strange when , at least as a first-aider, he is told not to (reference 1) First-aiders may well ask why this should be when so many antiseptics antibiotics and other substances that kill germs now exist and some of them are readily available to the public. A short answer is that what kills germs in a test tube may also kill the cells that attack germs and those that heal wounds , which are made of similar substances. This is not always the case but the conditions in which antiseptics and antibiotics and other substances that are harmful to germs have been applied to wounds and have been shown to have been of benefit are conditions that exist in hospitals (ref 2-8) Antiseptics have been used to treat existing infections but they were abandoned (ref. 9) This has nothing to do with first aid but it is worth mentioning because it reinforces the case against the indiscriminate use of antiseptic and similar substances

A clear distinction needs to be drawn between the use of antibacterial substances on intact skin and their use on raw surfaces

Fig 1

Living, healthy surfaces have been brought snugly together by stitches and the healing process can quickly join them Infection is unlikely

Scar

A gaping wound. This will heal on its own but is has to be filled by cells that are responsible for repair. In spite of natural shrinkage of the wound in the early stages of healing, healing may take a very long time and germs are likely to become established in the wound.

.w the raw surface ; it can all to easily carry • I I germs intothewound and it may be painful. Furthermore, such application may obscure appearances and thereby hamper diagnosis Do these objections apply to antibiot cs as well as antiseptics? The answer is yes as far as first aid is concerned This is not because antib iotics cannot do anything to

it , but they are much more effective when they

Healthy skin swarms With but It h, reach the tissues by way of the blood stream good natural protection against them (ft (which is the natural route of supply) than Some of these germs come from res ( when they are applied directly to the surface vOlrs In the nose , throat and other rn a places not all of them are harmful b among those that are are the germs

First-aider's rules spores of tetanus and gas gangrene , wh l( Disappointing tho ugh it may b e, the r ules can be found in the crutch and for so r for first-aiders remain few and simple : distance around it. Thorough washing w 1 Apply a simple , and whenever possible soap and water removes most of the ger n dressing with sufficient and sufthat are living on the surface but not th o! flclent pressure to stop any bleeding that are living in its nooks and crann es SU( 2 If a cleansing agent , with or without an asthe hair pits and the sweat glands Alco h antiseptic in it , is ava ilable it should be use? is a very successful k iller of germs on the Sl on Iy to wash away dirt or blood stains but It face but on Iy ina concentration of 70% (r£ must be kept out of wou nd 11) Its effect is slightly enhanced by the a 3 No sort of should be dition of iodine and certain other substan cf applied to the wound Itself but if it is applied to moist skin the alcohol It may be asked if these rules apply to the diluted and the antiseptic effect is m uc everyday cuts scrapes that do not nee d reduced (ref 12) It must be emphasiz e medical attention In general the a nswe r IS however, that when such disinfectants a' yes They need no help to heal and Infection applied to the raw surfaces of wounds th E

can do serious damage to the cells that cor bat bacteria and promote healing (rei' 13-17) In the case of cetrimide the an bacterial effects are abol ished when comes into contact with the t issue juices (re 18)

Special skill

Although it has been shown that certa substances help to reduce infection wounds when they are applied as spra y creams or on tulle gras (a coarse sort · gauze impregnated with vaseline) (re 2,4,6,7,8 ,17) these methods are not suitab for first-aiders This is partly because they n quire special skill equipment and mater ia and partly because they need to be prE ceded by careful cleaning of the skin, wh ic is not something that can be done with rna! first aid kits

Those that still feel that there must sure be something that they can put on a wou n in order to reduce the risk of infection an promote healing may be assured that livi n: tissues have a remarkable ability to deal wil' germs and to heal (ref 19) This ability is m paired by the presence of dead tissue an foreign matter, both of which may harbou germs and also by drying The best way o dealing with the first two is by removin ( them, which is a surgeon's job, and the bes way of preventing drying is to apply a simpl! dressing such as plain dry gauze; it is soor moistened by blood or other discharge ant

is unlikely but they benefit from protection and if there s more than a little ooz i ng the dressing should be large enough to absorb it without being soaked through Dirt and blood should be carefully washed away ; absorbent paper can be used to dry the skin before applying the dressing Ant septic preparations are not necessary ; they may do no harm but they certainly do no good , except to the shareholders in the manufacturing company. Even s mpler is to suck a superficial wound until it stops ooz ng and then forget about it; th is method has worked well for mill ons of years w th man as well as other animals

References

Waler rescue Service launched

An ambulance rescue unit to operate on inland waterways has been launched by the St John Ambulance Brigade in the Cotswold Water Park near Cirencester, Gloucestershire, courtesy of Texaco

The unit, which is one of only a handful in the UK, will watch over thousands of people who visit the Park's 150 lakes each year for numerous water spons including, swimming, water skiing, sailing , wind surfing and even triathlon.

Its first vessel has been named 'Texaco Magnum', in recognition of the oil company's financial support of the new venture

Presenting a cheque for £1,000 to help fund the unit, Texaco's distribution manager, Peter Roberts, said : "The St John Ambulance Brigade is renowned for the voluntary caring service it provides and we are convinced that this latest initiative will add a valuable contribution to the safe pursuit of leisure on the water."

Texaco's donation will be used to buy an outboard motor an oxygen resuscitation

Glos County Commissioner Mrs Carolyn Elwes, with (centre) Bob Bennett (/IC transport) and Dave Savin (IIC division) , after receiving cheque from Texaco for boat support equipment.

unit , first-aid equipment and fuel for both the boat and the volunteers' road ambulance.

Dave Savin, the St John Ambulance divisional officer behind the project, said that his team had already dealt with several minor casualties, including heat stroke, as well as possibly preventing more serious occurrences by dissuading visitors from

"

'

SJA Flower Fund

Interesting project in Derbyshire

T

he Flower Fund was proposed by the Council of the Order of St John for Derbyshire in 1982 with two obj ects. 1. To provide a record and memoriam of members and friends. And 2, to encourage people to make donations to our worthy cause. The names of those remembered in this way are inscribed in a Book of Remembrance and an In Me mo riam' card is sent to the relatives

The Boo k w hich gives details of the donation s can be seen at any arranged time. With no state support, the Order is dependent upon donations and subscriptions It is hoped that the Flower Fund w ll become wid e ly known and consequently play a gre a e r pa rt not only in helping to meet ever incre as ing costs but n supplying improved tr a inin g facilities for personal and specialised e qui p ment for the care and comfort of tho se in need.

Don ati o ns of not less than £10 should be s e nt to th e Council Secretary at the following addr e ss: Alma Hou se Derby Road , Chesterfield , Derbysh ire S40 2ED Deta ils required: Full name of deceased (stat e Mr, Mrs, Mis s). Date of death. Part icu-

lars of St John service or c onnection Message for relatives

S pecimen Rules

To be operated through the St John Counc il for Derbysh re

1 The Book of Remembrance will be held at County HQ and will be available for inspection a during normal office hours ; b at other times by arrangement ; c. at specific functions away from the County HQ

2 The Book will give name of deceased and date of death only, and there w ill be three names on each page

3 There will also be an Index Book which will show name and any other deta ls of deceased , including St John Ambulance involvement.

4 The minimum fee for each entry i s £10

5 Requests for entry to be made by letter or by a pro forma/card (These w ll be produced at County HQ)

6 When notification s rece ived , the followi ng action will be taken : Pnn ted card o f acknowle d gemen t

a Acknowledge to sender by mean s( pr nted ca rd

b Send card to Next of K n as nd ic ate by dono r wh ic h may i n c l ud e message of sympat hy

c Ensure approp ri ate entr ies m ad e I both books

CHILDREN IN NEED

Tn the SJA marquee (Above) deliberation over FA quiz and (r ght) queuing for casualty make-up

• ast year, a Newcastle upon Tyne company announced that they were going to organise a massive children s party as a thank-y o u to those who raised £10 or more forthe Freeman Hospital's Children's Heart Unit

St J o hn in Northumbria thought that as they were trying to take 'our' party record , the least we could do was put on a good show, so things were set in motion

A large tent was ordered and HQ was

20

Resuscitating a

Threat to SJ party recorm

asked for different displays We put together a representative display of the sort of things we had had in Hydepark , along with photographs of the Big Day itself We also ran a video of our ' party and tapes of the Badgers, Energy and For All the Right Reasons There was a first aid competition and lots of Bertie Badgers to colour And most popular of all - casualty make - up Afterwards , there must have been hun -

dreds of children running around the To w! Moor w ith var ous cuts and bruises I ca n imagine what their mothers thought! The f! were lots of activities and even a Lambt or Worm

I have to report that this great party attrac· ted 103,000 people on the Sunday, anC 24 ,000 on the Monday, but raised £260 ,OO i plus for the Heart Un it , which will finan e! further research

wheels , but refused to take any money " as it's for St John ".

Gradually the ambulance is being put back together and there was a moment of triumph in Novemberwhen mechanic Dave Nix successfully started the engine - the first time it had turned over in 34 years Services and maintenance manager Steve Topley has also been heavily involved

throughout , nclud ng spending a lot of his own t ime on it. " Everyone in the works has become very nterested in the progress of the ambulance and the apprent ices are really enjoy ng working in it ," he sa i d

Among the ten apprent ices who have been work i ng on the veh cle is 19-year-old Chris Hardcastle , who s n the third year of a four year craft technic ian engineer ing apprent i cesh i p " It's taught me a lot about engines and I think the exper i ence is go i ng to be useful n my career although there were t imes when we thought we would never be able to put it together again ," he sa d

The vehicle s choke was crumbling so second year apprent ceship Carol New, 18, made a new one , faithfully copying the original. " It's nice to th i nk you are doing someth ing that's go ng to last ," she sa d

Personne l d i rector John Varney commented : " It ' s a good pro ect for the apprent ices because there ' s a def n ite end result , it's required team work and they have found solut ions to a lot of d iff icult problems under the gu idance of sk i lled nstructors It w i ll stand them n good stead all the r work ing ves ." Leyland R d i ngs , who made the St John /Astra nk , summed it up l ke th is : " It's a l ive and work ng veh icle wh ch is go i ng to be a test mon al to the sk i lls of the people who have worked on the restorat ion as well as being someth i ng tangible to earn funds for the Order in the future

" The work of StJohn saswell known here as it is all over the country and our people feel that it's a worthwh ile cause and are happy to be assoc ated w th t. "

mascot B lly Ba dger.

Cadet Help and Information Pa 9 e

Courses It certainly more for them to do so An expert In communications is far more likely to come along to a group of

twenty Cadets than to two or three from one Division Why not suggest this at your next Area Cadet Officers ' Meeting and see what happens?

C*H*I*P*S Comment

Hello and Welcome to the first birthday of C*H*I*P*S. Yes, we first appeared in Sf John World in January 1989, replacing Cadet Chat which had been running for about five years. We hope to continue with our lighthearted, informative column which has attracted some nice comments over the past 12 months.

Human relations

First, let us kick off 1990 with a free gift from C*H*I*P*S A cut-out-and-keep chart to keep you going in the coming year :

The six most important words: "I admit I made a mistake.'

The five most important words: 'You did a good job.'

The four most important words: 'What is your opinion?'

The three most important words: 'If you please.'

The two most important words: 'Thank you.'

The most important word: 'We'.

The least important word: 'I'.

So the Nineties are here We made it ! Looking to the future , what will the Nineties hold in store for Cadets? Steady growth? Rapid expansion? Perhaps neither, but "'I!J instead a stable level , topped up with a

regular supply of new recruits throughout the years Perhaps decline? Extinction - never! All this brings me to a fundamental question What aims , what objectives do we as a Division have for the Nineties? To continue as we have for the past few years? We have been pretty successful , I suppose

Of course many cadets and the i r Leaders may well be thinking that there is little that

Kingsbridge, Devon, Cadet Sgt Heidi Diepold (right) , 16, and Leader Rebecca Luscombe, 15, celebrated gaining thell Grand Prior Awards by a sponsored squat al the top of the local fire brigade s training tower. They stayed up there (as in picture) fOf nine hours, raising £200., half of which is to go to the Fire Brigade 's benevolent fund , hall for the i r division Rebecca represented the county at the Princess Royal's reception

The best Division in the area

You know the one The lot down the road with their own headquarters, a six-wheel base minibus and six canoes They seem to have as many Officers as Cadets and they have five Badger Sets. Yes, every Area has one and you have got to do something about it! Take them away from all that equipment and are they still that good? Maybe not. Look at their uniforms. Do they wear training shoes? Do they wear the correct badges?

The best Cadet Divisions are those that wear their uniforms with pride Correct uniform , headwear, polished shoes and badges

Proficiency badges are not difficult to gain They take organisation on the part of the Officer and effort - real effort - on the part of the Cadet. Is this the real sign of a good Cadet Division?

Cadets like getting badges but the Proficiency Scheme is underused Officers

and Leaders have enough to do running weekly programme The Act ion Pack al associated Fi rst Aid/N ursi ng Cou rse work keep all but the super- human cadet w( occupied These concepts keep us all bU with plenty of programme ideas but we a not stretching our more able Cadets Thel young people sometimes get bored and dr off - the Proficiency Scheme could kef their interest.

Perhaps it is the Area s job to run Badf Part of London District's float (a sports stadium) in the 1989 Lord Mayor s Show Sponsored by TSB with a lorry and crew supplied by W J. Simms, N0:th London's Barnet Division designed and bUilt the float and together with other counties manned it The theme? Serving the Nation

53 cadets from Sussex on a training weekend at Lodge Hill, Pulborough which included activities such as canoeing as well as first aid and nursing The new County President Lady Bartelot and new County VicePresident Mrs Susan Cheney (centre, left and right) spent a day with the cadets

edited by andy bull

they can do directly to influence the direction of the Division How wrong they are An immediate way for members to start attempting to influence the course of St John Cadets is surely to look at the objectives and aims of their very own Divisions , to ask questions , prompt discussion and thought. Is the Division really doing anything positive towards developing SI John Ambulance in the area in which it exists? Or is t simply t icking over from week to week , month to month , year to year?

We are at the beginning of a new decade A decade that prom i ses i ncredible development and change n the soc iety n which we live We must all keep pace with that development and change And if we do , St John Cadets can only get better, grow stronger and become truly great.

Com i ng back down to earth , Happy New Year to you all ! I w sh your Divis ion every success in 1990 and for the remainder of the decade

Showing the flag

(Right) Cadets - Stephanie Duce, Scott Cutts and Rachel Burgin - led Rotherham Area s inspection parade (Below) Mark Pearce , 14 presented £105 raised on a sponsored cycle ride to his Mum and Dad's division s (Brinsworth) Supt Rowena Clarkson

The 1990 C*H*I*P*S challenge

Th is year, throughout our twelve ed t ons , I would ke to launch a challenge

C "' H T P*S s challeng ng Div s ions to recru it at least ten members from outside the movement.

I will be offering a pr i ze to the D v is ion , wh ich th is t ime next year has recu ted those ten young people and retained them i n the r Div is ion

I w ill be report ng on your progress throughout the year, and w ll welcome any i nv itat ions to attend your D iv s ional events , to record your successes

During the next few months I shall nclude deas and suggest ions , that may help you in meeting the C * H * I* P* S CHALLENGE

Therefore , I declare THE 1990 C*H*I*P*S CHALLENGE well and truly open I look forward to seeing and hear ing your progress reports , and w ll report them n the magaz ine GOOD LUCK

And finally...

Two things. My thanks, over the past year to all the contributors to C*H*I*P*S and also to our magazine editor Frank Driscoll (for being so patient), Jim Bond and his gang (for ideas and inspirations), Alan Herbert and Dave Wheatley (for their abuse), and to Jill for her support (I will always wear it). We sometimes get serious in C*H*I*P*S , and try to challenge the norm Here are some lines which might be well known to some, but I have never heard them before They are beautiful : I looked for God; But God I could not see ; I searched for faith ; But faith eluded me

I sought my brother; And I found al/ three .' Think about it. See you in February

CHIPS , St John World , Wood Cottage, High Corner, Sutley, Woodbridge, Suffolk , IP123QF.

Where is Energy taking us?

It seems that the new Energy Pack is becoming the talk of the St John Ambulan ce, if not its major controversy. As yet I have not seen opinion expressed in these columns upon the issue by a Welsh Unit and feel it might be time to correct the deficiency

It must be admitted that with our semiautonomous status here in Wales , much that affects the Brigade in England does not affect us immediately, but sooner or later the chickens come home to roost and we fall into line with English practice. In the present circumstances I am very concerned that we should not fall into line, since am far from convinced that the Energy Programme is the solution to our recruitment problems , rather in the case of many Welsh Divisions 'Energy' will spell our doom

Paused recently sent for the Energy Programme information pack , read it and paused to consider what I had learnt. It may be that I am stupid, but I fail to see how taking reexaminations in first aid every three years , instead of every year, can possibly constitute a raiSing of standards. I also fail to see what is really so 'new' about the programme in the first place. All of the areas of training proposed by the programme are already available to Brigade members, subject to the proviso that they hold a valid First Aid Certificate, and herein lies the problem that gives me most cause for concern

It is the proposal of the Energy Programme that in future the St John Ambulance Brigade uniform will NOT denote a qualified and fully trained first-aider. It may do so, but there will be no way of determining this from a distance At present, the man in the street correctly associates the St John uniform with first aid , rightly assuming that its wearer is fully qualified to administer first aid. In future, such a view would be highly unwise; he might be looking at someone who was fully qualified in transport management, but knew very little first aid. I fail to see how such a situation can be classed as a raising of standards, since it devalues the uniform and undermines public confidence in the Brigade. Ultimately, this has to result in fewer people joining the Brigade not more.

To refer to the excellent article by John Shortland regarding the Hillsborough tragedy, the public are entitled to their "product expectation", which entitlement seems bound to be undermined if their confidence in the uniform is damaged; as it must be if the same uniform can stand for a number of things.

But supposing the Energy Programme were successful in attracting new members to the Division, what then? I do not know how things are for divisions in the South East of England but I certainly know about our

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.

finances here in one of the impoverished South Wales valleys (by the way, I am an English immigrant). Last year our net income (discounting the carry forward from the previous year) amounted to £701.36 total.

To translate that into Energy Programme terms , that is just a little more than the cost of two St John radios in a whole year. People joining under the auspices of the Energy Programme are quite reasonably going to expect to be able to train in radio communications and/or transport What will become of those divisions which are too poor to be able to afford the expensive equipment required? I will tell you. People will vote with their feet. Very soon there will be no divisions in places like Bargoed , because the divisions that were there couldn't afford the Energy Programme costs and went out of business as a result. The divisions in South Wales are having a hard enough time surviving as it is, without having additional burdens thrust upon us. To give an example, in the Rhymney Valley there were once 20 St John Divisions There are now 10, and of these 10, two at least are in a very uncertain state of health and are in no condition to face further financial pressure

Financial problems

Our financial problems are not assisted by the extraordinary cost of Association certificates. Under the Energy Programme scheme , a qualified first-aider will hold no less than four certificates, ie £8.00 per member. This may not sound like a great deal, but when you multiply it by 12 members it becomes a very nasty burden on already limited resources. If money has to be spent on certificates, other areas will naturally suffer The first area will almost certainly be first aid equipment. Such prioritising of divisional spending may be foreign to many, but , as Divisional Treasurer, I can assure you that it is our enforced standard practice We in South Wales simply cannot afford anything other than essential expenditure and the Energy Programme looks set to lay upon us an intolerable burden

John Fenton B Sc ., Divisional Treasurer, Bargoed St John Ambulance Brigade

National Headquarters replies

I have read with some interest the commen1s

from the Divisional Treasurer of Barg (} • Division and offer the following comme l'j

Hig h profile

The membership of St John Ambula n has been declining for many years

need ed

show that if the same trend continues SO r counties would lose their adult memberst with in the next five years St John Am t l must reply to John Mills , Director of Public lance has succeeded in attracting thO Relations (Oct Letters), to show that for once ands of new members through the Bad g! Cornwall is in front also agree with Mr and halted the downward trend of Cadi Hargreaves that St John needs a high profile through the Act ion Pack The Energy Pwhen its members are out and about. gramme is the third stage in the regenera For the past 2112 years our small division of the Brigade and will take the organisal has been increasing its members and funds into the 1990s and beyond by doing exactly what Mr Hargreaves

Before The Energy Programme was inl suggests. At all events where a PA system duced it was discussed at every natioris used we ask for a short but effective conference and sixty eight presentati oannouncement to be read out to the public were made within fourteen weeks to We also have a display board with posters counties press cuttings , photos, etc ., which we use

Already over 3,000 enquiries have bewherever we go. received nationwide and we approxim , The short announcement says : that by the end of 1989 we will have secur 'Just a short announcement for the unbetween 600 and 800 new members thro u sung volunteers of St John Ambulance, the induction course By broadening I without whom we couldn t hold these spectrum of talent we really are attract events. Their members give up their free people with different managerial, technll time to continually train and cover duties and administrative skills, each using his without any payment All their equipment her own personal energy and talents wi tt

the organisation Also , for the first time rent members have a choice in their future the organisation, many already specialis , in such fundamental areas as fundrais and care in the community

Guarantee

The new regulations governing Energy Programme guarantee that for I first time all personnel in uniform will have duction course training They will therefc be able to deal with an accident or em gency, knowing what to do and , proba more importantly, what not to do. Mr Fen l seems to have overlooked the fact that many years we have had a great many pe pie in uniform (for example, commande and presidents) who have had no tra in l whatsoever

The Welsh representatives for the An m Conference in Blackpool will, I am sure , ha passed on the materials and advice issu by our fund raising department. Indee there was even an offer of help from our house professionals ' for divisions with pre lems The Chairman of Safeway also offert financial help with the registration of so r Association courses

It is very sad that at this stage St Joh n Wales is not actively involved in the Ene r Programme However, as Mr Fenton me tions in his letter, 's ooner or later we i into line with English practice .' T Energy Programme is the future of St Jar Ambulance As it says in the literature be a challenge for us all.'

I am sure that when the people in Wa l· receive their presentation on the Energy P gramme and take advantage of the we that has already been done in this are membership and resources will go fre strength to strength.

TCombined

Division 's exhibition display - from the hall they train in , ambulance, petrol, right down to the last sticking plaster - is paid for out of their own funds which are raised by their members who do these duties, by collecting , by bingo, sponsored rides , etc

They ask for no praise, but they do desperately need more members. And when they come round on the blanket collection - theyask that you help as much as you can

Year of good news

he year 1989 was the most extraordinary that I can remember in terms of good news, and so much of it. Other years have stood out in the way of tumultuous events In 1955, for example, there was both the crushing ofthe uprising in Hungary and the Anglo-French invasion of Suez In 1968 there were student demonstrations all over Europe, most notably in Paris , and there was the Soviet suppression of the demands for freedom in Czechoslovakia And in 1973 there was both a Middle East war and the threat of a prolonged world energy shortage because the Middle East oil producers were up the price as well as limiting supplies. Do not forget how serious that seemed at the time.

But in terms of news, the year 1989 won on two counts Not only was there more news; there was better news

To start at the less sensational end of the scale : George Bush is turning out to be an impressive President of the United States He is different from President Reagan, under Whom he served as Vice-President for eight years. He does not go in for rhetoric, but when he acts he seems sensible and concil iatory, trying to carry out his campaign promise of presiding over a "kinder, gentler nation". There is much less antiAmericanism around the world than there

used to be

In South Africa too, there has been a change of leadership. The new President Mr F W de Klerk, has not solved all his country's problems overnight. Nobody could do that.

But at least the approach and the atmosphere are diHerent. It has become conceivable that apartheid may end neither in a bloodbath nor a revolution, but by a peacefully negotiated settlement. That is a fundamental shift.

But , of course, the biggest changes of all have been in Eastern Europe Who at the beginning of the year would have predicted that the Berlin Wall would be pulled down before 1989 was out? Not only that: other dictatorships in Eastern Europe have dissolved themselves as well. Czechoslovakia had one of the hardest line regimes of all , yet it began to crumble when the people went onto the streets to say that they did not support it and it became clear that the Soviet Union would no longer shore it up Even Bulgaria , which had the longest serving Communist dictator of the lot in Todor Zhivkov, suddenly found that it was possible to get rid of him.

And we now know that not only did the Communist regimes produce bad government ; they were also corrupt on a scale not previously realised In East Germany, where the press was perhaps more servile to the

regime than in any Communist country, the newspapers are now reporting stories about hunting lodges and wine cellars reserved for the Party leaders that were vastly more lavish than anyone suspected. All that s now out in the open

There was bad news as well to be sure : espec ally from China. Yet even there it was possible to be hopeful. When the students started demonstrating in Tianamen Square in Peking , it was some weeks before the authorities decided to stop them by force That suggests that there was a considerable int ernal debate within the regime. The old men won and the troops went in But my own view is that next time - and there will be a next time , just as there was in Hungary and Czechoslovakia - the demands for greater freedom will prevail. China at present is the odd man out , and a big one at that , but one doubts that it will want to stay that way. Look around the world and you can still say, if you want to , that huge problems remain. Rumania is a tiddler of an odd man out, but still immensely repressive. Small wars go on , particularly in Central America , and they are not so small if you are there on the ground There has not been much movement towards peace in the Middle East. Then there is the politicians or diplomatists argument that all the changes that have taken place only create new problems At least during the cold war and the division of Europe people knew where they were , a conservative argument goes Freedom is all very well, but where will it lead?

For my part, I prefer the Berlin Wall down to the Berlin Wall up 1989 was a very good year and, if we recognise that , we should be capable of dealing with the consequences in 1990 © 1989 Malcolm Rutherford

Malcolm Rutherford on

News from Scotland

Residents Managers

• Disposable head bag, making cleaning unnecessary and eliminating the risk of cross-i nfection between students.

• Un ique, patented personal face mask also reducing potent ial for crOSS-Infection

• Breath ing is done in lifelike fashion , through nose and mouth , not through another part of the body.

• Chest rises and falls , stiffness adjustment simulates chest compliance rang in g from a young child to an adult.

• Lifelike stomach expands if insufflation technique is wrong

• Soph isticated instrumentation monitors insufflation techniques , pressure and hand positions as well as air volume Display can be read from both sides, proVIding convenient instructor/student interaction An offer this

, turning n your tired , outmoded

for

The Specialist Vehicle Builders

CONGRATULATIONS TO THE BLYTH POWER STATION

CONTRIBUTIONS

SUBSCRIPTIONS

(Left) The cover of the new Three Cross Award video, wh ich has a runningtimeof42m nutes 1t costs £1125 including VAT from The Supplies Oept

irst Aid in Schools

More than 100,000 children have received

i_ ore and more frequently, we read IW. stories in the newspapers of children, ften very young , whose knowledge of mergency first aid has helped them to save life

More than 100,000 children have received ertificates so far in the St John Ambulance ssociation's Three Cross Award Scheme )r schools, and that number is continually rowing.

Tracy Corby, 13, is just one such pupil who as undertaken the scheme and, for her, it as already proved a lifesaver Tracy, from Mowbray, carried out emergency first id when her brother Martin , six, fell ownstairs and became unconscious racy's cool and efficient actions have CrossAward ViJ arned her praise from her headmaster, Mr Jamle Slmpson aged 15 waspresentedwllh ohn Broad , who was 'delighted' that she magnificent BP Three Cross Award Trophy fc " speedy and deter d t h lad been able to use the training she had mine ac Ions w en appl emergency a d ," from TV presente r. Precelved at school.

Schofield Jam e, a pupil of Edensor High SCi There are cou ntless sim liar stones of Just valuable the Three Cross Award Cross Award Scheme , gallantly attempted to ;cheme has proved to be in the five years mouth to mouth resuscilat i on and car(· ince its inception massage to a ne ghbour who had a heart aNi The scheme was started in 1984 when the it John Ambulance director general , Mr 10bert Balchin , himself a headmaster, ealised the great need for emergency first lid to be taught in schools

The launch of the first Three Cross video lelped teachers to teach first aid to their lupils in three simple stages

The One Cross proves the child can dial 199 and speak properly, knows how to make person comfortable , making sure they can lreathe, and knows what not to do

The Two Cross is awarded once the child las learned how to help a person who canlot breathe, and how to treat choking and leart attack

And the Three Cross is awarded to a child vho can deal with such emergencies as

Association certificates

by CLAUDIA COOKE

burns , bleeding and poisons

In each case , the teacher teaches and assesses a child s sk ll. And St John highly recommends that teachers themselves have a minimum of four hours training in emergency first aid

Now the Association has launched a second video featuring children's TV presenter Phillip Schofield which demonstrates the most up-to-date techniques

The video has been sponsored by BP, which has an established relationship with St John , having sponsored the Brigade s centenary video For All The Right Reasons ' in 1987

BP s assistant in donations , Tessa Murray, says : " We are delighted to continue that partnership with the v i deo for the Three Cross Award Scheme The better the education in emergency first a d for young people , the more benefit there is to the community. Therefore we approve of the aims of the award ."

From the v deo - A mother gives treatment for a scald

And

The only real casualty, reports Anne , was the kitchen sink used in the scalding scene - it was chipped from having the saucepan flung into it so many times. But the choking scene proved easy : " The local chip shop continued overleaf

kept us supplied with plenty of sausages and chips - we used sausages because they looked much better than fish when chewed up and spat out." Yes, well.

The video, produced by Boyd Catling of Original Film, is42minutes long, divided into three sections for the Three Crosses The first is 13112 minutes, the second 16 and the final 121/2 minutes. The video is on sale at £17.25p including VAT, and certificates and badges can also be bought for pupils completing one or more sections of the scheme

A total of 27,000 schools in England are eligible to take part in the Three Cross Award Scheme, and 3,000 of those already use the first video, which sold 5,000 copies.

The scheme is aimed at children between the ages of nine and 17 or 18 although it is proving increasingly popular with vocational training schemes, too , such as YTS.

In addition , two prisons have also bought the video to teach emergency first aid to inmates And a number of special schools have invested in the scheme Students who complete the scheme can also buy a special Three Cross Award refresher book.

Children are fascinated by first aid , and they are also highly competitive To give it maximum appeal , St John Ambulance aimed to combine these characteristics in the Three Cross Award Scheme

The colourful badges and impressive cerfficates, carefully graded to standards to suit school children of all ages , provide an excellent incentive to learn more about emergency first aid

And the scheme is clearly filling a gap in our education system ; a recent survey by St John Ambulance revealed that a startling 40 per cent of schools had no staff member with a statutory first aid qualification It also revealed that one in five schools is without a member of staff with even the most basic first aid training.

And all this when in the year to March 1988, there were 8,000 major injuries to pupils in schools, some of them fatal.

Robert Balchin said at the time: "I have not the slightest doubt that lives could be saved if more teachers attended a short first aid course."

And it is clear that, by equipping school children with a knowledge of emergency first aid, the Three Cross Award Scheme could prove invaluable in Britain's schools.

Many teachers fit the scheme neatly into the curriculum under health education, citizenship or as part of a wider project. And it is being used extensively in Personal Social Education within the new national curriculum.

In Surrey, all schools have been give a Three Cross video through the generosity of the county's Friends of St John Ambulance. And other counties throughout the UK are negotiating sponsorship deals to supply their schools with a copy of the video.

The Fedefation of Master Builders and the International Thomson Organisation have both kindly sponsored special certificates for 4

BP Three Cross The SI John Ball

Over £50,000

raised

for the Order Award P os ter

The StJohn Ball held on December 6 at the Hotel Inter-Continental,

l".IChl'r', ,iJ:!Il,llllr,' LKh ,1"'01 10 ing dat e

are some who believe that the voluntary sector has no place in a odern welfare state To defend it is to \.-\dl h)r\\clrJ l. n ril h "'l J""'Ihn t\mhul.lnll ,n L,IOJlln. 11 .1 II 1.1\" f' ,1,\ I Ih Il)'), lfend an outdated Victorian attitude An 4 Thl" Ift_lll, 'Ill I''',nt'': lhelu,lglllg,,,III,hll,1Lcn l) 12,11,,111 It 1' It 31" lon.l"" rill 'e(,,,,,1 \lnl ,I )peal to the volu ntary sector, It IS )llhl')l)l Th",':\\llIbconc JOllcl')\)lJl1llh"\\lIl11l'fS'\l111- des an uncaring and mean-spIrited \\1111l,'r "lid 1\\" r,lIner UI 11,'1\11,'.1 thruugh dl,'\[ I )vernment unwilling to loosen the purseItOIl\ l' .,h .,1 JIll' l·l1.1 "I PI'} -ings. It is no more than an excuse to let the 5 :\11 ,'111 lie, \\ 11I1I:1·\.l1l1 TI ra; \I 1111 lie eille ., H w to nt r Puptl, ,hulIi-I ,1I1ll ,11""1,·, J"pl(tll1g In\ .1 ret r ,II \ Ald. tlw r,,' A\\.l[d ur the

They argue that a modern society should )t have to depend on volunteers or larities. They believe that the unpa id nateur is a thing of the past. And they insist at it is the duty of government and Ireaucracies to rush in where the voluntary ctor still dares to tread I cannot agree These arguments ignore 9 enormous and irreplaceable contr ibun that the voluntary organisat ions make to r national well-being , And they fail to take r io usly the satisfact ion and the sense of Ifilment of the volunteers themselves , If government is held to be respons ible for erything, the individual will feel respon)ility for nothing Central responsibility :lkes more and more of the important ')\' ')\' ')\' P",t" " ,"\((Il', ngs of life the sole preserve of governthe individual s sense of tiative and personal responsibility is Ished out.

(BI),( f-nenJI\ ('1,lIlt)

The Three Cross Award poster competition which closes n May

The state could never fill the gap left by a youngsters for her ' screen appeal '. lclining v?lunta,ry sector - for four good the Association to be given to schools when a certain number of pupils have achieved either one or all three stages of the Three Cross Award Scheme

The new video , which includes child actors as well as children from a school near the filming location at Westerham, provides a clear and palatable way of learning

A dramatic bicycle accident allows demonstration of the recovery position This section of the video alone took five hours to film. This is followed by a drowning incident, shot at the lakeside on Squerrys Estate

Then there are scenes of choking, burning and other accidents.

The film is presented by Phillip Schofield and features St John Ambulance instructor Anne Cable, who was chosen by a panel of

As an adjunct to the new video , Bpasons : It would never be able to also generously sponsored a Three the flexibility of the Award poster competition for that eXist the UK today which the closing date is May charItles are tYPically ahead of are ten prizes, with a total value of time In the needs that they address £3,000 They include an engraved cUf lirdly, they are really appreciated by full bodied Resusci Anne , The aim cos e benefit from them, These are competition is to find a bright eye catc ten minority groups whose interests would and memorable poster for a n'ational ar overl?oked by unwieldy bureaucracy tising campaign to bring home to youn gS preCisely the Vigilance and the concern pie the importance of knowing what 10 the vo.lunt arY ,sector that ensures that an emergency ese minOrity Interests are taken into The posters will be judged by carti count. And fou rthly, the charitable instinct Bill Asprey. Further details and an enlr)',!requent ly an instinct. It is an are available from St John seeks to Influence and reform Association 1 Grosvenor Crescent Lo; habits and values of the society around it. SW1X 7EF. Good Luck with ideas! In short , the charity is an integral part of

The R ght Honou r able M ichael Heselt ne MP With the D rector - General Robert Balch n , and his w fe (centre) , and Mervyn Malcolm , Deputy D rectorGen.eral, and h is wi fe at the Assoc ation Di nne r. a free soc i ety -a society in which people come together to pursue their own freelychosen purposes , Voluntary care is about ind ividuals acknowledg ng civic responsibil ities that no bureaucrat has imposed upon them

Volunteers enrich their own lives and the lives of those they help But they also complement the work of the public serv ices

They allow the professional to concentrate on the more compl cated and techn i cally demanding tasks Every day thousands of people give up the r own t i me to do voluntary work And every hour put in by volunteers is a hour saved by the public services

In truth , the pub li c services depend on the voluntary sector, Without t they could never meet the increasing demands being placed upon them Indeed , the question s not whether a voluntary sector can work alongside a statutory sector, but whether a statutory sector could manage on its own

Wherever large numbers of people are gathered together, there also s the St John Ambulance Where would the police or the fire services be without this vast networkof 80,000 volunteers and 1,000 vehicles?

Every first division football match depends upon them How would the police cope with that scale of commitment without the Brigade? The answer is simple : by diverting yet more resources from the r crime-fighting responsibilities , Who would prov de our school children with first aid training? Who would have trained the 200,000 St John Ambulance First Aid certificate holders? Who would take care of the 800 casualties that St John Ambulance deal with on an average day?

How would the Health Service manage without the thousands of volunteers who happily drive the elderly and infi r m to

hosp tal and provide tens of thousands of meals-on-wheels? How would our social workers cope w ithout the thousands of volunteers who v is it the lonely and the house-bound?

The answer to all these questions is not the public serv ces , for the simple reason that they could not manage if the voluntary sector were to disappear : they do not have the cash And if they did they would still be unable to provide so economic , so flex i ble , and so personal a serv ice

The Government recogn ses th s For ten years t has sought to encourage , not stifle , voluntary work and the spirit of initiative that moves i t. The Government has made it poss ble for voluntary organisations to sit on joint consultative committees of health and soc al services They have helped boost charitable giving by provid ing tax incentives on company and payroll donations Tax relief on char table donat ons amounts to some £400 mill on a year, The Government itself has ncreased its own grants to char t ies by 75 % in real terms since 1979 Today provides over £250 million a year to these important causes

The British publ c are giving more to char ties today then ever before - nearly £1 billion a year And they are g iving not only their money but many thousands of hours of their t me as well.

In a country where the state takes all the dec is ons we know very little about the people themselves Onlywhere individuals are able to exercise a freedom of choice can they be judged as ndividuals Some criticise a society which welcomes the discretion and cho ice that low taxes make possible , I welcome it. St John Ambulance reflects what people do with that cho ice And the nation thanks you for it , 5

ST JOHN

Grand Prior ' Competition

Dauphine Casualty Simulation Make-up

"It is quite difficult to simulate pain and terror! Such compell In 1988 the Post Office Ambulance Centre

a

are terrific value in promoting the usefulness of first aid ." He ad fulfil a need forvisual aids which was identified during instructor " It's very good to have this sort of experience - and the COrt re-assessments This video was made by a profess onal director tions are good for first-aiders ." using Post Off ce First Aiders and premises

The competition , held for the first time at the English Riviera There are six separate sequences vary ing in length from 3 '/2 tre of Torquay, attracted 35 teams who were already to 9 minutes covering , in turn , Asphyxia and Mouth to Mouth within their own industry resuscitation , the Circulation and Heart Attacks , Wounds and

As always , the teams and individuals fought a tough conl e: Bleeding , Fractures , Burns and Scalds , and Shock and Recovery the coveted trophies Summing up judges' comments , Dr Position Molloy, Deputy Chief Medical Officer for the Assoc ation , rema

Each part is made up of dramatic sequences , animation and on the high standard of competitors performance in the Ind lv still photographs , aimed at causes, effects and recognition , of tests First Aid conditions

At the end of the afternoon , The Duke of Gloucester presen te Th s video is priced at only £25 which ncludes a presenters prizes to the winning teams , and Robert Balchin , SJA's Dire brief. Copies can be obtained from : General , who chaired the presentation ceremony, thanked a THE FIRST AID ADVISER , PO/OHS ROOM 94 , who had worked behind-the-scenes to ensure the compe lll ___3_3_G_R_O_S_V_E_N_O_R_P_L_A_C_E_,_L_O_N_D_O_N_S_W_1_X_1P_X___----' success and the Mayor of Torbay, Councillor Eileen Salloway,Ie warm welcome received in Devon

Results

Men s Pairs - Championship trophy : Electricity Supply Ind (Blyth Power Station) Runners-up Police (Gloucestershire stabulary) Third : National Dock Labour Board (Hull) scoring men : NO 2 : Mr V. Dennet (Brit. Telecom , Leicester).'

Mr D Todd (Blyth Power Station) Champion reserve : Mr J. (Blyth Power Station)

Women's Pairs - Championship trophy : St John Amb ul Brigade (Glynneath Combined Division) Runners - up : P (Durham Constabulary) Third : British Telecom (She ff Highest scoring women NO 1: Mrs J Pankhurst (South Ea:

Gas) Champion reserve : Ms M Boyd (SJAB Gly nn Combined Div.)

Pairs - Championship trophy : Coach & Bus F.A. Assn don Busses Ltd) Runners-up : Police (Sussex Police) Th ird Post Office (Bristol POAC) Highest scoring man NO 2: Casper (London Buses Ltd) Highest scoring women : No.2

Bullimore (Bristol POAC) Champion reserve : Mr B Ma (London Buses Ltd)

New Year Honours

A J Glass (Berkshire)

D L Harris FSCA (Av

J W Soanes (Suffolk )

W Tucker (London)

K Morgan (Gwent)

Cadet leader of the Year

Michelle King of Thrapston Combined Divis on , (centre, above) Northamptonshire , is the new Cadet Leader of the Year She beat some fierce competition from 32 other cadet leaders during an intensive weekend in December to achieve the title. Michelle received a portable hi-fi system from John Kinch , company secretary of Safeway pic , who sponsored the competition Of her win Michelle said : " I thoroughly enjoyed the weekend Winn i ng is just a bonus I made lots of friends and would certainly recommend other cadet leaders to enter next year."

Nigel White , from North Yorkshire , (above, r ight) and Cather ne 0 Leary, from Oxfordshire , (left) were joint runners up Nigel of Richmond Quadrilateral Division , and Catherine , from Oxford City Division , both received a portable television , also given by Safeway Among the cadets tasks in the competition were preparing a project , giv ng a 5-minute talk and attending a panel interview. But it was certainly not all hard work There was a d isco on the Saturday n i ght.

All the cadet leaders felt the weekend was well worthwhile " I think this kind of competition helps to develop leadership skills and gives you more confidence ," said Cather i ne O Leary Clare Scott , from Nottinghamshire , added " The competition was much more fun than I expected It's been great to meet so many cadets from other counties ."

Grand Prior's Trophy First Aid Competition

in the Grand Priory .Church

(Left) Gwen Thomas, a retired Westminster Hospital nurse from Dagenham , who has been made a Serving Sister of the Order. Gwen has been a member of the Brigade for 37 years. (Photo: Barking & Dagenham Post).

Order ' Investiture

by the Lord Prior, Dec 7

(Right) Reg Perrin, Superintendent of Malton and Norton DiviSIOn , N Yorks, becomes a Serving Brother after 32 years with St John (Photo : Ryedale Mercury)

Chaplain

The Very Reverend Thomas Eric Evans MA (London)

Commander

John Ha rry Edmund Baker

TD MD BSc MRCP DMJ (SJA HO)

Mollie Christine, Miss Lambert

SRN RFN SCM ONS HV (Norfolk)

Lt Comdr John Edgecombe Hammond

SRN DCR DHSA LAHM (SJA HO)

Pamela , Mrs Wallis (Bucks)

Eric Harold Smith (Wilts)

Maureen Rozella Mrs Weston (Wilts)

Officer

CD M Drew MA MB BChir MRCS MRCP (London)

Roger William Jacob (Devon)

Freder ick Harold Smith (Wilts)

Kenneth George Smith (London)

Dor is Rose Mrs Dalby SRN OHNC (Nolls)

Geoffrey Robert Welch (Herts)

Kenneth Leslie Wheadon (Somerset)

Anton Charles Turner (Met Police)

John Henry Boughton aBE (Bucks)

Jean Mrs Mardon (Leics)

Russe ll Brereton Marshall (Salop)

Colonel Andrew Henry Parker Bowles aBE (London)

Ian Voase Askew MC DL (Sussex)

Douglas Anthony Chamberlain

CBE MD MA MB BChir FRCP (Sussex)

Peggy Doreen , Mrs Julian (Cornwall)

John Mertyn Hywell Lloyd-Parry

MA MB BCh ir BObstRCOG (Bucks)

John Bo il eau Sorapure

MB BS LRCP MRSC DObstRCOG (Dorset)

John Peterson (London)

John Telford Beasley CBE (London Transport)

Lucille Mrs Langley Williams MRSH (Cornwall)

James Winton Junor MB ChB MRCGP (SJA HO)

Alan William Young LLB (Met Police)

Associate Officer

Ronald Louis Hersov (Bailiff of Egle)

Michael David Abrahams MBE (Bailiff of Egle)

Serving Brother or Sister

Margaret Elspeth Mrs Thomas BScEcon (Cambs)

Ann ie Brodie , Mrs Ba in (Herts)

Pamela , Mrs Barrell (Norfolk)

Michael Davis Boll

MB BS MRCS LRCP MRGP DObst RGOC DTM&H

8

DCH (Isle of Wight)

Susan Mary Mrs DaVIS SRN SCM ADM PCCAE (Glos

Cynthia Louvaine, Mrs Dalmond (Hfd & Worcs)

Staff Sergeant John David Denial (RAMC)

Sergeant Peter Willoughby (RAF)

Sergeant Robert Fredenck Sanderson (RAF)

Derek Edmund Guest JP (NOIIS)

Kenneth Lockyer (London Transport)

Josephine Jean Mrs Hinds (Norfolk)

Arthur Aston (S&W Yorks)

James Samuel Harvey Lodge

MB BChir DCH (S&W Yorks)

Mic hael Edwin Balman (Devon)

Fredie Douglas Bowden (axon)

Beryl Evelyn , Mrs Bevill (axon)

Valene Audrey, Mrs Longford (axon)

Joy Muriel Mrs Moreby (axon)

Peter Albert Charman (Sussex)

Annie Kathleen , Mrs Bennett (Sussex)

Sidney John Coleman (Warwicks)

Cynthia Caroline Mrs Howells RGN (Warwicks)

Jean Ann Mrs Moore (Warwicks)

Vivienne ,Mrs Moore (Warwicks)

Jane Ann , Mrs Jones (Warwlcks)

Helen , Mrs Cheek (Warwicks)

Harry Coxon (Leics)

Gertrude Vera Mrs Gillman (Leics)

Margaret Carol Mrs Pepper (Leics)

John Derbyshire (Dorset)

Barry Douglas Doul (Avon)

Clarice Myrtle, Miss Stone (Avon)

Ann Elizabeth Mrs Sullon (Avon)

Derek Ian Dykes (Bucks)

Dion John Etheridge (Gtr Manchester)

Irene Joy Mrs Bromley (Gtr Manchester)

Frances Helena Mrs Handley (Hants)

William Ronald Frewin SEN (London)

Winifred May, Mrs Barnes (London)

Gladys, Mrs Shewry (London)

Gillian Beryl, Mrs Smith (London)

Ursula Barbara Miss Starega (London)

Gertrude Gwendoline, Miss Thomas (London)

Edward John Green (Hants)

Ruth Mrs Lake (Herts)

Margaret Emily, Mrs Lathwell (Beds)

William Aneurin Greenaway (Warwicks)

W lliam Douglas Gregory (Staffs)

Margaret , Mrs Rock (Staffs)

Elsie, Mrs Cornbill (Staffs)

Juozas Grublys (Notts)

John Frederick Halley (Berks)

Paul Hudson (Nolls)

cky Rowen , of Safeway staff training hands over e keys of the new vehicle to riffiths, while cadets Laura and Katie Bennett Just IJn't resist cleaning the Division 's new posseson (Photo Express and Star, Wolverhampton)

Olive Mrs Molesworth (Lincs)

Maureen Courtney, Mrs Prout (Cornwall)

Thomas Johnson (Lancs)

George Wilfred Jordan (Lancs)

Mary Brenda Mrs Green (Lancs) rhe Safeway store in Sedgley (WolverDoreen , MISS Milins MB Chb DCH MRCGP (1.4 hampton area) and the village ' s SJA

Doreen , Mrs Shires (Lancs) Jad Division have developed a wonderful Harnet , Mrs Smith (Lancs)

John Kenneth McCu tcheon (Warwlcks) latlonshlp of mutual help and support

Colonel DouglasJohn McClelland CBE TO DL Jring St John Awareness Week, Sedgley (London) ised more money than any other division

David James Mills (Avon ) the country and Safeway did everything

Reginald Stuart Moyle (Somerset) Id t h Joyce Chnstlne Mrs Secker (West Midlands) ey cou 0 e p. Raymond Nichols (Dorset) The store provided high-pressure hoses

Gordon William Nonsh (Devon) Id an area in the car park for members to Hugh O'Neill GIFireE (Merseyside) ean shoppers cars A Save-A-Life

John ThomasCaryle Parnaby (N Yorks) arathon was also run in the car park And Reginald Pernn (N Yorks)

Molly MISS Farnsworth (N Yorks) , wei! completing 12- hours non - stop

Frank Joseph Phill ps (Wilts) suscitation, many dozens of shoppers

Phyll is Mary, Mrs Chilcot (Wilts) taught the life-saving technique

Susan Ann Mrs Mulhal (Wilts) Inside the store Safeway produced a

Arthur Frank William W illis (Gtr Manchester) .

David Michael Shewan BA MB ChB FFARCS (l mderful cake, Iced With the St John Cross , Major James Osmund McGill (London) lich with a food hamper were raffled

Esquire

Brigade members of all ages packed groceries for the public , helped carry to cars and made themselves useful. On Saturday the store staff came to work in fancy dress as doctors nurses and 'casualties' and on Sunday the car-park was transformed into a giant car-boot sale

The money raised by this tremendous effort from Safeway and St John has helped the Division to buy a minibus It is planned to have it converted so that not only will it transport members on duties but also serve as a first-aid station Thedivision is paying for materials but the conversion work is being done free of charge by local young people employed on apprenticeship schemes in design , upholstery and joinery.

Safeway

an electronic keyboard to cheer shoppers and hardworking staff during this busiest week of the year

STJOHN training '. ..' .' ,.{ W 8 R

Th is new course is designed to help cadets develop leadership abilities and self-confidence to PARTICIPATE in the running of their organisation , to understand the wider nature of St John Ambulance , and to teach them how to instruct and plan divisional meetings

The instruction was carried out by a team of two adult NCOs , two officers and two nonuniformed adults with strong St John connections. These instructors felt that the course went well and with only a few minor changes , next year s courses will run with the same programme.

You may be interested to know what some of the cadets thought of the course. Natalie Bloy and Katherine Chamberlain , both of Norfolk s King's Lynn Quadrilateral Division , said: " The course was well organised , the schedule was packed and we were always doing some kind of activity Even when learning some element of fun was included."

Praise indeed from two cadets who , at the start of the course were unhappy at the level of discipline required

Victoria Ratcliffe , Derbyshire's representative in the Cadet Leader of the Year competition, also enjoyed the course However, she did express her disappointment at one

New course for Cadet NCOs

Matlock, Oct 13·15

Lee Gwinnell gives his group s views on the duties of NCOs section of the course " I felt that the ' Games and How to Run Them ' section went on a little bit too long, without enough explanation as to the potential applications of the games we were playing when we returned to our divisions."

However, Victoria is using the Programme Planning section of the course to good effect. Following the instruction of the course director, Ms Susan Yau , the cadets are able to plan a divisional programme well into the future and that is just what Victoria is doing

Malcolm Rutherford on . . .

Immigration

from

lines of foreign

I wonder who is right - Mr Norman Tebbit, the former chairman of the Conservative party, who is threatening to vote against the Government ' s plans to grant British passports to 50,000 or so citizens of Hong Kong and their families, or the liberal newspapers like The Economist and The Financial Times, which write that such immigration - and more - will be a very good thing for the country? Perhaps both sides have some explaining to do. Let me say at once that I am opposed to M r Tebbit. think that his views sound mean. It is especially ungenerous not to admit that Britain has some responsibility to the people of Hong Kong He reminds me of Mr Enoch Powell, who is against practically all coloured immigration of any kind and who wanted to keep Britain white Mr Powell used to predict some years ago that the widespread admission of coloured people would lead to violence "I see the Tiber foaming with much blood ," he said in a famous speech That has not happened; nor anything like it.

On the other hand, it has to be admitted that those who favour immigration do so largely for economic reasons. It may be that we should put our case better.

One ofthe reasons for the grudging , rather apologetic approach to immigration is that we only realise afterwards the benefits it

brings Each new wave of immigrants is supposed to be the last. They are admitted reluctantly; then a few years later it is easy to forget how great was the fuss at the time By now we should be ready to try and demonstrate , I think, that immigration has been good for us.

Take the first great wave of immigration from the Caribbean in the 1950s when Mr Powell, incidentally, was Minister of Health and welcomed the newcomers as ancillary workers in the hospitals Contrary to some expectations, the wave did not go on rolling for ever But , without those immigrants, it would have been very difficult to staff some of Britain 's essential social and public services: not only the hospitals, but the buses and the London Underground That is a strong economic reason in favour of immigration.

Then take the Asian immigrants They have transformed the way we shop for dayto-day goods. Their establishments stay open very late and at weekends , and they offer choice. The Asians have also added variety to restaurants: not expensive restaurants, but those within the regular reach of ordinary people Curry has become almost as popular as fish and chips, and indeed you can have curried fish and chips

Again that is an economic reason for ap-

The last word from the cadets comes If( Emma lIiffe , also from Derbysh re : " Itwa : very enjoyable weekend , wh ich succe M i n ts purpose , and I hope that the Co ur cont nues successfully in the yea rs come ."

Emma s wish is to be granted There c two courses planned for 1990, on weekends of October 19 -21 and Novemb 23-25 For more deta ls , please Susan Yau , Cadet and Tra in i ng Departme at National Headquarters on 01 - 235-52 ext 216

proving of immigrat on , but it begins to impinge on the social. Immigration opens new frontiers - whether of food , or dress or music There is also sport Look at the way that the sons of Caribbean immigrants have contributed to English soccer, and the sons and daughters to athletics No English side is complete without them

The immigrants from Hong Kong would be in yet another category : mostly skilled civil servants and administrators, receiving the r reward , in the form of a British passport , for keeping the Colony going until it reverts to China. The Economist once suggested that as many Hong Kong people who wish should be allowed to move to the Isle of Wight. They would then set up an entrepreneurial economy that would be a spur to mainland Britain Going too far perhaps , but certainly the people from Hong Kong could add some vitality to British economic and social life

In practice, some of those offered British passports may choose not to come They may prefer the US , Canada or Australia , believing that they are more dynamic societies But that will be our loss, not theirs.

I wonder if those who oppose immigration realise how drab our society would be without it. I am also much more struck by the degree of tolerance between the immigrants and the indigenous British (and vice-versa) than the degree of intolerance Finally, it is not true that it only happens to us. France has quite as many immigrants as we have, if from different places. West Germany is getting them The US is the most sought-after country of all, and always has been Immigration is a compliment. We should learn to appreciate it.

Aylesbury

AROUND THE DIVISIONS

of the Porta We tfalica on October 25 -26. All Division except two were represented and peaker included an honoured gue t from Ash Vale Divi ion, UK, Mrs Mary Bolland (photo below) who preented the Commissioner, Dr Manche, with a ouvenir plaque The Commissioner expressed the gratitude of the whole county for Mr Bolland' vi it and hoped that more vi itor from the UK would make the effort to contact him.

Hertfordsh ire

Thank to a generous donation from the Ayle bury Ladies Benevolent A ociation, the AyJe bury Divi ion was able to receive a new ambulance to replace their old vehicle.

At the presentation at the County HQ dunng October, Divisional President Laurence Godfrey handed over the ambulance' key to DIS Alan Price, and the vehicle was dedicated by the Rev. Canon Francis Robert. The County Commiioner. Col. R J Thomas, and other county staff were present, together with members of the Diviion and Mesdames McArthur, Robert, Peberdy and Godfrey of the Aylesbury Ladie Benevolent As ociation.

8ath

HRH The Duke of Gloucester, the Grand Prior, is shown divisional photographs dating back to 1900 by the City of Bath Division's Supt Eric Ashman during an evening visit (and supper) with the Division as a closing event of centenary celebrations.

Germany

Ash Vale's Mrs Mary Bolland presents plaque to Dr Manche.

Twenty two officers attended a training weekend

On a cold and damp morning 10 October. Hert SJA implemented their e tabhshed Emergcnc} Incident Plan and 150 members and 12 ambulance were mobilised to a tram crash in Watford

Thi wa ajoint emergency service exercise mvolvmg a tram accident inside a tunnel with dlr ficult access route The firt St John vehicle to arrIve became the co-ordlOatlOn unit and ome 150 simulated patients, IOcludlOg a number of simulated fatalitie , were transferred to Watford General Ho pltal.

All St John radio commUOIcatlon were e tablIshed through the County RadiO Command Unit and the new high band radiO frequency recently established was tried with ucces Much was gained from the exerci e and many thlOgS learned for the future

• Opened the St John shop with regular Saturday opening

Re-organised our Warehouse to give more space and faster picking.

Established purchasing on our computer system (we ' ll be developing this in 1990 to give greater improvement).

Introduced 92 new products.

Relaunched our Speedline delivery service for faster delivery

Introduced lowest price promise across a wider range of products.

TODA Y'S RESUSCI ANNE

Thi

We re maintaining our Price Promise in 1990. Our lowe t prices are guaranteed not to be beaten We ve upplied hundreds of model at our low , low prices. If you re

Our Mailing List

There

Free Display Stand For Courses

Badgers lIThe Story So Far"

This 4 minute video charts the Badgers development since 1987, a combination of animated and live footage featuring Bertie Badger in space and the activities of a Badger Sett.

VHS only, Pal compatible Order P19997 "The Story So Far " £6.50 Energy Programme

A 4 minute video outlining the elements of the Energy Programme - First Aid, Care, Transport and Communications.

VHS only , Pal compatible Order P19996 "Energy Video" £6.50

OXYGEN ON AMBULANCES

Hazard warning markings are required to mark the carrying of hazardo':!s substances by road. This includes the carrying of oxygen ill ambulance s. St John Supplies now introduces th e appropriate warning markings suitable for ambulances. S12592 is suitable for ambulances and S 12591 suitable for marking storage cupboards, etc. Accepted practice for ambulances is for the marking to appear only on the rear quarter panel to the right of the door (s ee diagram opposite )

1984.

Full details on how to save on VAT have mailed to Privileged Customer Card

There are many items and services which can purchased by St John Units without paying VA Our briefing gives full information on the relie! which can be claimed. Add J50 to your order you need an extra copy for your treasurer , etc Don't pay VAT needlessly.

Badges , First Aider Key Fobs and Certificate holders have a ready sale to all those attending St John First Aid Courses For a limited period we re supplying a free display stand when a selection of these items are Order S12591 purchased. The stand attractively A.M&U A.NeE fill (10 0x100 mm) displays and presents all of the I suitable for cupboards, etc products welcomed by those on CD : Order 512592 courses To prove how effective th is (2qO x 200 mm) £ can be , we 'r e offer i ng the complete sUitable for ambulances, la(9 d storage areas stan for only £99.95. The contents sell for £175 .5 0 so there s £75 for your funds , and the Latest Catalogue Launch .=-=..........-. stand 's free Easily transported and FIRST RESPONSE KIT

The authorised St John Ambulance First Aid kit for sports grounds (particularly football clubs) is now available. The easily recognisable haversack is easily carried to the scene of any incident and the comprehensive contents cover emergency situations. Order F40009 First Response Kit £47.95

and "1H'cia( offer on

UNIFORM BADGES FOR CADETS

Cadets are now authorised to wear two new badges on their uniform to signify the passing of the Essentials of First Aid and Preliminary Caring for the Sick The badges are to be worn on the left arm with the Essentials of First Aid Badge worn to the left of any service badge and the Preliminary Caring for the Sick Badge worn to the right of any service badge For full details of positioning see paragraph 4 Dress Regulations Cadets (P11365) pages 10/ 14 These two colourful badges (45 mm diameter) red for Essentials and blue for Preliminary Caring for the Sick , will enable cadets to proudly display their exam -

Badger Supplies

, . All Badger Setts will be receiv! ing copie of our Badger range ;, Catalogue. Extra copies are . . available by telephoning Saleline and quoting }52.

NEW THREE CROSS AWARD VIDEO LAUNCHED

FIRST AID MANUAL

We've been able to hold the price since the latest edition was published in 1987 but when stocks of the next printing arrive the price will go up to £4.99. There's still a significant saving on the bookshop price of £5.99 and there 's the extra St John discount on top for bulk purchases - up to 30% extra. We 'l l hold prices until the last possible moment, but as soon as present stocks run out the price will change.

LEATHER EQUIPMENT POUCH

n up to date version of the Three Cros ward Video ha just been launched. n invaluable teaching aid showing the late t techniques in Emergency id. Forty-two minutes long, the video i presented by Phillip chofield and contains realistic action scenes.

VHS only (Pal compatible)

AMBULANCE DISPLAY RACK

Leather Equipment Po u £9.95 To display your growing collection of model ambulances we've introduced an elegant wooden di play rack. It could be wall mounted, stood on a desk or sideboard or displayed in a glass cup-

Our new pouch i a hh board. With ufficient space for twelve quality hide leather eq u models (we'll be adding to the existing ment pouch. Thi tough po u range), this is an elegant way to display is made for the most demand u your models. Wat ch out for a new model applications and is reinforced ambulance early In 1990. extra trength. It ha plenty of m

Order P20004 Three Cross ward Video £15 (+ V A T for Schoo l s) for pen, cissor torch ,etc. , a: quickly clips onto any belt. Similar pouc h. are used by profe ional ambulance nationwide, but we've bought in bulk to pa s on tremendous saving on our normal pric of £1 1.9' Supplied empty to add your own equipment. 0 other popular equipment pouch in wipe clean vip F15000 continue in the ra m

_ A ct u al size • Brigade Member's Badge t ., thi uni e badg mark )our Ill( mh r hip t.l! h wa " ith ut damaging clothing. ' uppll lI1dl 1Clually bo o d the art' ideal for to n w memb r . Th black and whit nam 1 31 gold ff t of the badge omplt'm nt an occa"li and will b wid J appr ciat d b\ Briga r member e r wh reo

A badge that member everywhere have b n waiting for i the Brigad e member' badge. for non-uniform wear thi elegant but dI s?reet (13 mm diameter) ha a clip-on pin fittIng. EaSIly affixed to blazer, jacket, dre ,

NEW RESUSCITATION KITS

The new kits are based on Laerdal Medical's silicone resuscitatorsthe only complete range to be highly recommended in a 1988 DHSS evaluation. Complete with various sizes of airways and a 125 litre capacity oxygen cylinder to deliver oxygen for 25-40 minutes, the kit is easy to carry at a weight of 4.4 kg and is complete with a handle and shou ld er straps.

.Each resuscitation kit is supplied WIth a bracket for wall mounting and additional space for accessories

LOWEST PRICE GUARANTEED

LATEST ADULT UNIFORM BADGES

With the launch of th e Energy Programme are two further badge ' f r Brigade . M e mber completing th tatutor FIr t AId ur e , ommunit Fir t id and Ca ualty Handling ection hould ear the badge " Fir t Aid" (B04760 ) in p o iti o n :2 be tw e e n th e um y Fl a h a nd unt y ( [u /l el'( (/ p p lica bl c). It i wo rn ImmedIat e l y und e r th e o unt y n a me ( ee di ag ra m a b ove). Hi g hl y qu a lifI e d tirt a id e r will b e diffe rentiated from member s wh o h ave

If my order consists of a number of parcels, how can I tell which contains the despatch note?

The address label on the parcel containing the despatch note states "Despatch note enclosed in this parcel". It makes it easier to have your despatch note when opening other parcels.

Why are higher prices marked on the back of many books?

The price on the back represents the price which would be charged when the book is sold at a bookshop. Books such as the First Aid Manual are sold in bookshops at £5.99 but are available to St John Units at £4.99. There's a further discount on top of this saving (up to 30%) if you buy in quantity, When the price is marked on the back, trainees on courses can see the extra value they get from St John Courses.

It makes sense to always buy your books direct from St John.

Order F11900

Dressing Scissors £3.95

DRESSING SCISSORS

4 has been made in ide the lid by way of a transparent pIa tic pocket ecured with velcro traps. The kit have been de igned with simplicity and efficiency in mind , and are priced within reach of most budgets.

Order F790S0 Laerdal Re u citation

This range of feature make the kits uitable for use in many field including: leisure and port facilities, occupational health, educational establishment , ambulances, fire service , police force , dentists and midwives.

Ju s t completed the Indu c ti o n o ur c. Th o c who w i h o nl y t o ge t invol v ed in hould w ea r b a d ge "Welfar e " (B04770 ) l!1 th c sa m e po s iti n so a not to 1111 lc a d 0111e o f the publi c who ma y think c\' c ry- E n c m t J hn Ambulan c e i a hi g hl y qu alib e d lr t Full dctail of the rc g ul a tion g o ve rnm g the II c o f the e b a d cr c i g i ve n in B.O. 1814 (Bri ga de rder 9) Order B04760 Bad g e First Aid 6Sp

A new style scissors with a tough shearing action with serrated blades , makes easy work of most materials. Stainle steel for durability and easy grip handles make the e ci sors the ideal choice for demanding first aid application. Large size ( 20 cm/8" ) for tough work. The sci sor are ideal for the leather pouch.

COMING SOON

A hospital ded icated to 51. John was already active when the Crusaders captured Jerusalem In 1099 and an independent Order of the Hospltallers was established at the pelitlon of the Warden , the Blessed Gerard , by Pope Paschal II In 1113 Under his successor, Raymond du Puy , the Order assumed an addilional military task ,which became hs ' major concern , particularly in defence of the Crusader Kingdom of Jerusalem and later in Rhodes and Malta Following the re-establishment of the Grand Priory in England and the foundation of the British Order of 51. John , The 51. John Ambulance Association was founded in 1874, and an Ophthalmic hospital was established in Jerusalem In 1882 on the Bethlehem road outside the Old City This was r&-bullt on a new site after the last war, where the Order is once again , able to perform its ' original function of the care of 'our lords , the poor and the Sick '

From the Lord Prior of St. John,

The 5t. John Ophthalmic Hospital continues to do outstanding work in Jerusalem and elsewhere in the Holy Land.

This tour will give members of the Order an opportunity to see its' work for themselves. Visits have also been arranged to the holy places and sites connected with the early days of the Order. The programme is comprehensive and should prove both informative and stimulating.

Grey of Naunton

IYOUR HOTELS I

REGENCY PAlACE HOTEL - AMMAN

A majestic establishment situated in the suburbs of Amman

PETRA FORUM HOTEL - PETRA

Nestling In the Moabite Mountains thiS IS a friendly spacious hotel.

JORDAN RIVER HOTEL - TIBERlAS

A mcx:lem , popular hotel. in the heart of the c ity by the Galilee

SEVEN ARCHES HOTEL - JERUSALEM

(Fonnerly the Intercontinental Hotel)

On the summit of the Mount of Olives affording an unparalleled view of Jerusalem Old City .

All hotels are superior 4 star rating. ---

HIGHLIGHTS

ST. JOHN- The highlight of our VISit Will be to ST. JOHN OPHTHALMIC HOSPITAL in Jerusalem to VIew ItS extensive work

PETRA -

GAULEEJERUSALEM-

This "ROSE RED CITY - HALF AS OLD AS TIME" will be a main feature A City cut into solid rock dating back to 797 Be.

We will sail the blue waters of the SEA OF GAULEE and vi Sit th e Gospel regions on the northern shore

We shall spend four nights in this great BIBUCAL CITY , bu s tling With the character and culture unique to Jerusalem

THE ITINERARY & PROGRAMME

DA Y 1 - RJGHT FROM LONDON TO AMMAN

We meelat London's HEATHROW AIRPORT where Ifter normallormalitles , board the scheduled service 01 ROYAL JORDANIAN AIRLINES departing midmorning and Irrivlng late afternoon In A AN Jordan On our Irrivil oor private coach will trlnsler us to our hol.llor dinner and accommodation Overnight in Amman

DAY 2 - THE GIlEAD MOUNTAINS & JERASH

After break last we leave our hotel by coach lor a short orientation tour 01 AMMAN Including the ANCIENT CITY WALLS Ind ROMAN AMPHrTHEATRE, belore continUing north through the GILEAD MOUNTAINS to JERASHpossibly the best preserved ellmple ola Provincial Roman City In the Middle - East Ind which was one 01 the CltteS of the Decapolis In the Roman perIOd

We continue to AJLUN with /1S 121h Century AD Cutle bUilt by Salah II Din 15 pan of the Arab delenses against the Crullciers and IHordlng I breathllklng view of lhe Jordan Valley Then we malla oor way back to Amman for the lite afternoon and dinner at our hotel.

Overnight in Amman

DAY 3 - DOWN THE KJNGS HIGHWAY

Our coach will like us through the MOUNTAINS OF MOAB to the Crusader s1ronghold 01 KERAK , built by Baldwin I, then proceed to SHOBAK, the Crusaders Montnall before finally arriving It Petri for dinner and accommodation

Overnight In Petra

DAY 4 - PETRA - HALF AS OLD AS TIME

The best pan 01 the day will be spent here at one 01 the most Impressive unspollt wonders 01 the world Entry to the clry is through I narrow fissure either on loot or on horse-back to be then confronted with the majestic ruins of this Incient NABATAEN CITY In the late afternoon , we return by coach through the DESERT HIGHWAY to oor hotel in Amman lor dinner and Iccommodatlon

Overnight In Amman

DA Y 5 - INTO THE PROMISED LAND

Our first v sil 01 the day will be to MADEBA to view the flmous Madeba Map belore continuing 10 lhe summit 01 MOUNT NEBO where Moses stood Ind viewed the Promised Land Then we cross over the RIVIf Jordan and Imve at JERICHO for I short visit liter which , we lollow the Jordan Villey north to the HOSPrTALLER CASTLE of BELVOIR built In 1140 AD leaving thIS location we follow the shones of the SEA OF GALILEE to Tlberiu II)( dinner and accommodltlon

Overnight in Tlberla.s

DAY 6 - ntE CRUSADER CITY OF ACRE

Lenlng liter breakfast , we shaliltop It NAZARETH for I shon ViSit belore continuing to MEGIDOO , an Incllnt Solomonlc Crtywilh excavations revealing 22 layers of set1iement Then we arrive It ACRE · CRUSADER CAPrT AL from 1187· 1291. The underground headquarters of the HOSPrTALLERS and CRUSADER TOWERS are I great f•• ture Ind Impl. time will be given to fully appreciate this special cJty 1n the lite attemoon. we return to TlBERIAS and the hotel for dinner Overnight In TIberiu

DAY 7 - AROUND ntE SEA OF GAUlEE

We commence with. sail across the SEA OF GALILEE from TlBERIAS to CAPERNAUM Ind the MOUNT OF BEA TrTUDES and , alter vIsiting thiS Gospel ar.a , continue to the HORNS OF HmlM - where the Crusaders were defeated In 1187 Proceed then to MOUNT CARMEL lor I shon stop , follow the Mediterranean toast to CAESAREA - built by King Herod and exhibiting the Crusader Harbour , Cilldel , and Church of S1. Paul. Proceed through the JUDEAN HILLS to EMMAUS for I short stop before arriVing at ABU GOSH to view the Crusader Church Finally we drive Into Jerusalem and 10 our hotel on the OUNT OF OLIVES for dinner and accommodltlOO

Overnight in Jerua&lem

DA Y 8 - I/IITRODUCING JERUSALEM & BETHlEHEM

A Your morning Will be free for leISure wi1h opportunny to a\lend local Church Services 01 your choice P M - To INTRODUCE JERUSALEM we drive round the WAUS OF THE CITY VIeWing the eight gates then continue to VieW

CHURCH OF ST ANNE by the POOL OF BETHESDA before then entering the TEMPLE AREA where the SolornonlC Temple stood We pass by the WEmRN WALL and amve II the ANTONIA FORTRESS - residence of Pilate , from where we follow the VIA OOLOROSA throogh the narrow streets to CALVARY al the Church of The Holy Sepulchre Strolhng past the JAFFA GA TE and ArrnenlenOuarter In the Old City , we arrive at MOUNT ZION to VieW the ROOM OF THE LAST SUPPER Ind ST PETER S CHURCH. Our final visit will be to GORDON'S CALVARY Ind a ht Century rolhng stone tomb lus1 outside the Damascus glte Return then to oor hotel for dlnlltf

21," APRIl ""MA' "'f)

AROUND THE DIVISIONS

Skegness

South Shields

Suffolk

Questions on Caring for the Sick and the 5th edition First Aid Manual

Series 2, Number 19

STOP PR ESS

This year UK Volunteers Week will be held at the beginning of June (1 to 7 June 1990) The week is being sponsored by BP and a publicity pack is available free of charge to all organisations who register their intention of taking part

The publicity pack includes information and ideas on successful events you can run , how to maximise media coverage , getting sponsorship for your event and a free poster.

So, if you are planning an event to publicise the role of volunteers in the community, send details to Sheila Edwin. The Volunteer Centre UK, 29 Lower Kings Road , Berkhamsted, Herts, HP42AB, requesting a publicity pack which will be sent out in early March.

AMBULANCE SERVICE DISPUTE

2. You are called upon to treat a casualty suffering from hypothermia caused by sudden immersion in very cold water The ideal treatment is

5. A casualty with a nose bleed should be advised to pinch the soft part of the nose What should you be prepared to do?

Members of St John in the West Midlands celebrated Christmas on duty at the Birmingham control centre

As at 19 January, the following St John Ambulance counties have been answering 999 calls:

Bucks: Between 10th and 19th January, have responded to 165 calls

Durham: Working in Northumbria

Greater Manchester: Between 30th December and 14th January have responded to 114 calls.

vehicles on standby only

Hertfordshire: Involved since 24th

November No figures yet available

Hampshire: Between 7th November and 15th January, have responded to 858 calls

Kent: Involved since 12th January No figures yet available

London: Up to 13th January have responded to 2,422 calls.

Northumbria: Between 22nd December and 15th January have responded to 550 calls

Surrey: Between 9th November and 18th January have responded to 180 calls

Sussex: Up to 17th January have responded to 342 calls

West Midlands: Up to 14th January have responded to 2 ,204 calls

Warwickshire: No longer involved - army called in

AMERICAN SOCIETY SECRETARY DIES

The Reverend Canon Edward West , OBE , DO, founding secretary of the American Society of the Order died on 3rd January in New York.

" Members of th e Gr a nd Pri o ry 01

Venerable Order are greatly sadden ed a death of Canon Edward West , Secret, your Society He has for many ye ars bee only a devoted worker for St John cau particularly the Ophthalm c Hospital also a comrade merit ng ou r affe ction

JENNIE EAVES LEAVES ST JOH

After more than 9 years at national quarters , Jennie Eaves , Special Project Badger Leader, left St John Ambula n'

3. In the treatment for bleeding from the gums , after how long should you change the dressing?

take up a new position last month

" I know that you would wish to jo inr thanking her for her enormous contr ib.------------------. to St John during her time here and to her happiness and success for the fu l. said John Sunderland , Commiss lc in-Chief

Correspondence and telephone ca ll! of course , continue to be dealt with ir Special Projects and Badger depart llli

NATIONAL RAFFLE

St John in Derbyshire have rightly po out a miscalculation in the amount the January St John World as having raised in their county through the nair

Hereford and Worcestershire: Four sum of £2,684 501

The Lord Prior, Lord Grey, sent the following message to Mr John R Drexel III , the Chancellor of the American Society : raffle. They, in fact , raised the impre:

4. When approaching the scene of an emergency, three rules apply? What is'C'

Use common sense

Know your limitations

6. When treating severe bleeding from the scalp, this bandage does not provide adequate pressure to control the bleeding TRUE or FALSE?

7. To place an unconscious person with a spinal injury i nto the recovery posit ion , you require a team of A. 2

9. Having successfully opened the airway what may happen?

10. A sudden contraction of which muscles may cause this fracture?

4 C 6 D 8 8 Forwhich condition is this action part of the accepted treatment?

11 You are treating a casualty who has a broken arm. In what circumstances would you carry out th s treatment and what type of transportation would be recommended? Answers on page 19

BRUCE COLTMAN , Northumbria Police Centre

Cadet Help and Information Pages

Hello and Welcome to the February portion of C*H*I*P*S, the column within St John World written with Cadets in mind.

numbers together -' One,Two,Three' bring them back to the corner started In! You can , of course , bUild to ' One,Three,Two ,Three,Two Three.,Two '. eliminate the last person each time , If time permits , , , , , Alternatively, street , avenue and road can replace the numbers for a touch of

• Estimating

• Letter scavenge

producing

•

Choose

That's entertainment 1

T ake along to your meeting a

contain-

ing a variety of balls and run the evening either inside or outside your HO, with only these as your main items of equipment

• Astride ball

Cadets stand in a circle with their legs apart One Cadet stands in the middle of the circle with a large ball which he attempts to throw between the legs of one of the other Cadets

If he succeeds, he changes with that Cadet.

Except when actually trying to stop the ball, everyone must keep their hands on their knees. No score if the ball passes between two Cadets.

• Indoor Netball

Divide the Division into two teams. A Cadet from each team stands on a chair at either end of the hall. The ball is passed from team member to team member (no moving with the ball) until the ball reaches a given area and a goal is scored by the team member standing on the chair catching the ball.

If the ball is not caught , it goes back to the centre for a throw-in

• Fire ball

Two groups of six Cadets each stand in the middle of the hall with the rest of the Division in a wide circle around them A large ball is thrown at the Cadets in the centre , aiming below the knee As each is hit , they join the circle Two more groups of six Cadets enter the circle and the game is repeated Finally, the two winning groups of Cadets go into the centre to decide the winner

Run the following relay game and then ask each group of Cadets to discuss and make a list of games they can play using just large and/or small balls They must be prepared to organise some of these games and , with a bit of luck , the rest of your evening is planned and run for you

• Grab the ball

Cadets form small groups and each of these groups is numbered A football is placed in the centre When a number is called, all

Cadets of that number run around th e side , in through their place to grab football

Should some of the balls have lost bounce , why not use them as craft mate (a) the cups of an anemometer, which ISL to determine wind speed , (b) as pUi heads , (c) sprayed silver to form pa rt lunar landscape

That's entertainment

There are times (and we all have them )1I an activity doesn t last as long as t IS grammed to , or your key membe diVisional staff falls ill and cannot provide equipment needs for the final game

We now look at some games and act lv which require little or no preparat ion some everyday items of equipment.

• One, Two, Three

on the time and watch who stands up

This month we devote our two pages to a range of games to supplement your training programme. signal , from which they have to estimate minute. They should stand up when they ave done so - you will need to keep your

A game for the nimble-minded mathem cians in your Division The Division sta one corner of the headquarters On the of One ', the Cadets run the length of the to the adjacent corner On the comm Two ', the Cadets run the width of the ha the adjacent corner ; and on Three ', they Many schools in Hertfordshire helped raise funds for to the corner diagonally opposite 0 a new SJA county HQ during

• Pen-pictures

(Above) The C-in-C, John Sunderland , on a visit to the Merseyside weekend camp for 157 Badgers and Cadets with cadets who took their Action Pack certificates.

What is the challenge?

I t is a new St John award for 15-25 year olds

To achieve the award you need to complete one activity from each of the following eight sections :

Action Leadership Community Communication

Creativity Environment Independence The Path Ahead

The activities required to complete each section vary according to the section and your own needs and abilities In Environment , for example, you might set up a group project to clean and monitor a local pond for four months

The exciting difference between The Challenge and most other awards is that YOU set the goals , YOU set the standards and YOU decide when you have achieved The Challenge.

How did it come about?

A meeting with Her Royal Highness The Princess Royal in 1987 highlighted the need to :

Provide direction and excitement for 15-25 year olds who, after being Cadets, found Adult Divisions somewhat of an anti-climax And to encourage recruitment of new members

The Challenge was developed by a working party of Cadets and Adults to ensure that the needs and expectations of 15 - 25 year olds and St John Ambulance were met.

Who can join?

You can take part in The Challenge if you are between 15 and 25 years You do not need to be a member of St John Ambulance Brigade.

Whatever your ability/disability you can take up The Challenge!

How long does it take?

There are no time limits but it must be completed by your 28th birthday. As a rough yardstick, it could take the 'average' participant

18

about 2 years to complete

What do I get when I've finished The Challenge?

In addition to the satisfaction of planning , setting and reaching your own goals , you will receive a badge, a certificate signed by the Commissioner-in-Chief, and an explanation of The Challenge that may be used as an employment reference

Who checks each section?

You do , with help as necessary from your Group , Group Supporter, and/or an outside expert. The questions provided in the Guidance Notes and Record Book will also help you in your assessment.

Does this mean I could cheat?

You will be setting your own standards and to a large extent assessing your own achievements, so yes you could cheat BUT what would be the point? It would be rather like going on a diet to lose weight and telling all your friends, but then in secret eating biscu its and chocolate At the end of the day have you gained anything? Well , yes, probably several pounds! Seriously though , do you see the point? You would be the only one who loses out. Similarly, if you cheat on The Challenge, you end up the loser

How do I know what standards to set?

You won t be on your own You will be setting your standards with help from your Group and a Group Supporter, prompted by questions that you will find in The Guidance Notes and The Record Book.

If I'm already really good at an activity, do I still have to complete that section?

The whole ethos of The Challenge is selfdevelopment, or in other words , participants set their own personal challenge

For example, if Sebastian Coe wanted to take part in The Challenge then just because

he can run a mile would not _ he automatically passes the 'Action P

tlon. Instead , he would need to set al goal such as running a 3-minute mileorl natively he might want to learn a newt

and set himself a suitable target. At the

I r end of the scale, someone who has had l might fin cH 0 II- day

What publications are there to Guidance Notes. is just what il. lntroduction: Michelle Mills, 17, Cadet It IS and seeks to gUide xou Halesowen Division , West Midlands Challenge from start to f!nl sh Requirement : to complete her residential The Record Book ThiS IS your pe rs (on for The Duke of Edinburgh Gold organiser for The Challenge in which record , among other things , a summa wa the activities that you undertake. It also I was introduced to Mrs Duke, County tains helpful notes about The Challe l\( Commissioner of Hampshire, the organiser Can I do The Challenge with inof a St John Holiday for the Disabled to be Division? held at the South Coast World , Regis, in September 1989 We all arrived at Yes In the ory It be camp, where St John helpers were to do so , but In reality It IS unlikely that an)share a chalet with our disabled friends, so Division will have enough young Pc that someone was there if help was needed within the 15-25 year age range wan t! Our friends disabilities ranged from muscle take part at the same time The rE disability (accident victims) , paraplegics , Challenge groups are usually made Down's syndrome , cerebral palsy, some young people from a particular are amental disabilities and a blind girl with a meet on nights other than that of the ir caring labrador dog as her guide sional meetings It is not intended tha' This was my first experience of caring for Challenge replace St John meetingsthe disabled and I soon learned of the difduties , but is in addition to them ficulties involved. The camp had gone a long Willi be insured for all ofthese activnway n providing for the of a person dependent on a wheelchair, With many of the You will be covered by The Order of St,kerbs made into ramps , table accommodafor third party insurance , but probably ntion at meal times allowed wheelchairs to be personal accident insurance and hazarbrought up to the table , but , oh dear, the activities Some Counties carry more "swimming pool proved difficult. The enance than others , but in any evertrance was at an elevated level , with the insurance policies contain some excl u5 changing rooms below So after much fuss

we entered via a fire exit.

Water therapy is marvellous for those unable to co-ordinate muscle control and , by the way, for helpers who ve had a late night!

There were many worried looks when we joined our disabled friends for swimming , and lost them in the water-rapid track We all look able bodied in swimming costumes

Unfortunately, during the marvellous summerwe had this year the weather was unkind to us Visits outside camp would have been nice , but I soon realised that it can be very uncomfortable being pushed around in a wheelchair in the rain So we made just the odd shopping trip to Bognor and visited the Wild Fowl Park at Arundel , both of which were very enjoyable Evening entertainment usually went well past the normal bed times of many of us

A typical evening included a cabaret till midnight , then off to the disco until 2am or thereabouts Then it was back to the chalet for a cup of coffee and more natter before bed When you have to be up by 8am the next morning for breakfast , that doesn t leave much time for sleep

In a camp of this size some small groups tend to lose their identity - so it is nice to really get to know your group by working together on separate projects away from the

5,000 other happy campers The camp helped here by letting us use the Bingo room for a short period in the morning for our art work The comfy seats were also good for a quick snooze!

My admiration goes out to Mrs Duke and her many helpers/sponsors , not forgetting her family, who have devoted so many caring hours to the handicapped of Hampshire and Berkshire

Glenys Duke writes: We are happy to welcome youngsters in the 16 to 25 age range who would like to spend a holiday caring for someone less able on a one to one basis It is valuable St John training and lots of fun

St John events for 1990

Challenge and th 20th to 22nd - Medical Conference Nottingham to National HQ for the Issue of M ' Challenge certificate ay OK so I want to do The Challenge, wt 1st - ip AG M I 3rd - First Aid Competition, Buxton 11th - Bntlsh Ports Federation First Aid

Ambulance Service dispute

(Editor: This is one of a number of letters received on this subject.

Over the last few months we have seen the Ambulance Service dispute escalate to the position whereby ambulance personnel are now only dealing with Emergency 999 ceills and other situations that a doctor may class as a 'Doctor's Emergency'. The fact that the Secretary of State for Health, Mr Kenneth Clarke, has taken it upon himself to go back on an agreement made five years ago during the last Ambulance dispute, in which ambulance personnel were told that they would have a pay scale equivalent to that of the Police and Fire Brigade.

In return for this deal the ambulance personnel agreed to drop shift allowance pay, unsocial working hours pay, and agreed to a flat rate of pay for overtime.

This may seem irrelevant to St John Ambulance, but as both a member of the Brigade and the nursing profession I am disgusted to see on the news that members of the St John Ambulance and British Red Cross Society are agreeing to undertake Emergency 999 calls from the Ambulance Service controls. I feel I am right in saying that our members and members of the British Red Cross Society do not have the training or experience to consider themselves able to step into the shoes of professional Ambulance personnel. We are not and never will be professionals.

I think the Brigade should consider the implications that will arise by entering into this dispute, as relations between ambulance crews and our volunteers could and, I expect, will be marred for a long time after this dispute is over

Another factor that may arise from St John participation in answering Emergency 999 calls is the legal aspect of our members administering life saving techniques rather than first aid.

I felt the Brigade will be ruining years of PR work by dealing with Emergency 999 calls. I am aware, as everyone else is in St John, that we are not politically orientated. But I put it to you, in these circumstances we are doing the wrong thing!

D. A. SKINNER

AIM Student Nurse

The Chief Commander, St John Ambulance, Dr Herbert Ellis, writes

I understand the concern that St John Ambulance should not become involved in politics.

There is, however, a principle which overrides all politics and disputes - and here I speak as a member of the medical profession as well as a member of St John - and that is to save life and relieve human suffering. In order that we might reconcile these principles during the current dispute, we

20

have made it our policy to respond only to humanitarian requests for help directed through the appropriate authority That is to say the ambulance service and the police

Thus we are only providing an emergency service for humanitarian reasons We do not wish or have any desire to get into the politics of the dispute.

I do understand the concern about this matter, but let me reassure you that any suggestion that this is a political act is quite incorrect.

We have not actively sought publicity for any role our members have played in providing emergency cover, however, the following press statement was issued at the beginning of November to explain our position

Press statement made from National HO, London, on November 7

St John Ambulance regrets the escalation of the ambulance service dispute

As a result of a request from the Police , St John ambulances , manned by their trained volunteer members, are being directed by the Police to respond to emergency 999 calls in London at the moment.

Ambulances are based at police stations , each manned by two St John volunteers trained to similar standards to London Ambulance Service crews On deployment , a member of the Police accompanies each ambulance to assist with communications and navigation

During the current ambulance dispute , it is the policy of St John Ambulance to respond only to humanitarian requests for help , directed through the appropriate authority.

"We are only providing an emergency service for humanitarian reasons. I do not wish or have any desire to get involved in the politics of the dispute," said John Sunderland, St John Ambulance Brigade's Commissioner-in-Chief.

Spur to youth

As a Greater Manchester cadet I think it is wonderful that St John has made such a concerted effort to involve young people to a greater extent and to give them more responsibility. As Kate Adie said at the Annual Conference at Blackpool, it is important that young people, instead of being

alienated, should be encouraged anda d't Well spotted sir! This picture was in d t t k "d E lor. , e 0 a e part In a WI e range of actlvil the form of a transparency which was acciSt John I have be en abll dentally printed the wrong way round No partl?lpate In many wonderful things , Iro in dress regulations as yet ! survival weekend run by my county, Ie change instructor course run by National HQ d · paramount that these, together with ,Ba sig n. ·· other objectives outlined in the OctobeI h to draw your attention to November are given support by 'Do you know your Manuals?

In St John, If people Question six states : " When treating inencouraged to JOin and remain With us fected wounds', for which symptom would Ralph G Wilde , 16 you especially carry out this treatment? " A Cadet, Greater Manchester diagram illustrates the question The answer

Wht b t ? is given as: " If the injured arm is swollen ." a a ou ours. Iwouldliketopointoutthataswellingisa

We were interested to see Upminster sign a 'symptom Hornchurch Division s claim that their arr A V. lister, lance journey of 530 miles might be a rer Course Organlser and Lecturer St John World) The vehicle The Medical Dept, which vets this series, for Berkshire Eastern Area show thatorwrites: our vehicles , a Bedford CF, comp lr journeys dunng 1980 and 1981 Wit h Lister IS correct. Ho wever, IS an following mileages : 1200, 1500, symptom which could indicate and 2344 All of these journeys we re A £10 00 cheque will be sent to the behalf of Aeromedical Services to Fra.flrst correct answer drawn out of a hat on and Spain. Our longest UK only Journey March 1. Answers be addressed to : 645 miles Is 2344 miles a record? SlgnlSymptom, Medical Branch , St John Bnan Rockell Ambulance , 1 Grosvenor Crescent , London Deputy Area Commissioner SW1X 7EF

Our club ... Lulworth Court

After reading the May St John Worl d great interest I must say that I foun d severely phy slc ally dlsa bled men and article 'A St welcome in Londo n women Our al m IS to com?lne a real I t t btl I' ht atmosphere With the nursing care essential on y very In eres Ing u a so en Ig er to the W II b ' f h I' d k and informative e elng 0 our 0 I ay ma I was not aware that St John had a Voluntary helpers are a Vital part of life at Lulworth Court and are urgently needed house and I was Impressed by what during 1990 for one or two weeks at a time. available not only to members of the Or If you are over the age of 18 and interested but to all St John personnel , and not to rr In thl s chall rt t I englng oppo unl y, pease contlon also to those from organisations y, tact · Pat McC II' H I'd 0 Ing In a similar field (Ie Red Cross Po' a Ion , 0 I ay rganlser, Fire Service and members of the Court , Chalkwell Esplanade, I have since been fortunate enough to Westcllff on Sea, Essex SSO 8JQ. Tel : 0702 431725 at St John House Club , 50 Eaton Place arrival I was met with a very warm and found the atmosphere of the place friendly indeed found the accommodation to be than adequate , with elegance abou but as Major was quoted as saying I article : There s nothing lah-di-dah I must say he is right. From the word very much at home, in extremely relaxed pleasant surroundings.

The only criticism I could make is t club did not appear to be used

Anyone visiting London over night s look into staying at our club Bernard Robinson SJA Leek

Dress sense

Could you advise me if dress reg have been amended as the picture 3, December issue, shows white ha worn over the left shoulder? R Spiegel Wembley

Come to 10M regional finals

May 1990 sees the SJA No. 10 Region assemble on the Isle of Man for the Regional Competition Finals. This will be the first time the' Regionals' have been held on the island.

The Isle of Man has its own currency and its own stamps It is world famous for Manx kippers and the International IT motorcycle races.

There is a very active St John contingent on the island and we hope, duty requirements permitting, they will all be in attendance on May 12 at the Villa Marina to compete and meet as many St John friends from 'across the water' as possible.

An exciting day of competitions is planned along with a full social calendar. For younger members there is a disco evening for Friday, May 11, with Saturday bringing everyone together with a live dance band and a disco. On the Sunday, May 13, a tour of the island has been planned before everyone goes home.

SJA Isle of Man hopes to see as many people as possible coming over for the weekend, and can assure everyone that

Quebec Cub Pack raised £74 for the village s St John DIVision from a rummage sale Patrick Freeman and Sarah Allen here receive the cheque from 11-year-old cub , M chael English

(Photo ' Loughborough Echo)

a warm welcome awaits them. Of course, the weekend is not just for those competing - indeed it is hoped that wives, girlfriends, Mums and Dads will come. In conjunction with Everymann Inclusive Holidays, aspecial Stjohn minibreak has been arranged from Friday, May 11 to Sunday, May 13, or Monday, May 14. It includes: Return sea crossing from Heysham, Lancashire.

Two or three nights accommodation (evening meal, bed and breakfast). Transfer to and from sea terminal to accommodation

An optional full day coach

first aid in schools

Children save lives in Wales

Leanne Williams, 14

had stopped breathing after having climbed into a washing machine full of water With your friend, you were first on the scene and your prompt action in giving emergency first aid undoubtedly saved the baby's life.'

Christian Hyde, 12, of

STJOHN FELLOWSHIP

• Disposable

• Unique, patented personal face mask also redUCing potential for crOSS-Infection

• Breathing is done in lifelike fashion , through nose and mouth, not through another part of the body

• Chest rises and falls, stiffness adjustment simulates chest compliance ranging from a young child to an adult.

• Lifelike stomach expands if insufflation technique is wrong

• instrumentation monitors insufflation techniques , pressure and hand well as air volume Display can be read from both sides, providing convenient Instructor/student interaction.

RToday's ·®An eSUSCl ne

- designed with the ins tructor in m ind!

With an innovative face and airway y tern for Re usciAnne, students can be given their own "per onal" face and in tructors will have little or no clean-up after cIa

Resusc i Man ik in Faces

Replaceable faces are ea y to change, between tudent or after cia

Simply snap onto the airway connector and Re usci Anne is ready for u e!

Resusci Manik in A irways

Disposable airway connect directly to the manikin face coupling This eliminates cleaning the manikin head after cla " making clean-up a breeze! One airway per class, then di card. Clean up i that ea y! A reu able airway is optional.

Flex ib le and affordable sys te m

This unique Re usci manikin system offers you the mo t convenient and cost-effective way to reduce or eliminate manikin maintenance during and after class.

Update kits for modem Re u ci Anne manikin are available . Old inflatable or foamfilled Resu ci Anne manikins cannot be updated.

CONTRIBUTIONS

Contnbutlons

ST JOHN AMBULANCE ON SAFARI

Why

Ri

SUBSCRIPTIONS

imparting knowledge

..' .painlessly

Get organised with your: Training - and its presentation

Aspeaker stumbles through an excruciatinglyturgid presentation during which slides come on in the wrong order or upside down, the video fails and we cannot read the scrawl on the flip chart. It is a training nightmare we have all had to endure and - if we are honest - many of us will admit to having unintentionally perpetrated on others!

Nowadays, in the television age , everyone is becoming more and more demanding in the standard of performance they are prepared to sit through At home you can switch channels at the touch of a button. Who can blame those who switch off their interest in - and even their membership ofavoluntary organisation that fails to provide aconslstently high standard of training?

As far as St John IS concerned , there is absolutely no doubt that the information to be put over is of proven quality and of literally vital importance. It is the way in which it is put over that often leaves much to be desired

" I've sat through some of those nightmare performances ," said Seamus Kelly, Assistant Commissioner for London District and atop Instructor involved with St Joh n for 26 years " It s true that people are becoming SwatUtcdhents dlearnlngt {Itrst more sophisticated in what they ll accept. a emons ra Ion. bandaging Training doesn t have to be the muddled getting by that we have lived with for so many years ."

" Standards have risen tremendously over the years," he added , "but we mustn ' t get smug about it. We must continue to Improve." Even those who suffer from the worst stage fright' can get it right by doing their homework and following a set of simple rules

Help is at hand from Carole Dwyer, the Brigade's National Training and Development Officer, who has prepared easy-tofollow guidelines that can turn the most disorganised public speaker into a polished performer

By DAVID McDINE

Carole develops and runs all national training courses and is responsible for the resources centre at national headquartersand the new manual for training officers.

The manual shows how to identify training needs , discusses the way people learn and how to appraise your sessions It has a section on leadership and team building , including exercises , covers resources and will soon Include a section detailing how to set up and run a training workshop

Carole sees it as a significant move to improve training at local level. The Training and Development Department was set up only three years ago , yet this year it will be running 29 national courses of 18 different types

The weekend courses cover management , youth leader and cadet instructor training - and making presentations New this year are youth leader training for personal training advisers , a Duke of Edinburgh Award leaders programme , cadet NCO training and cadet proficiency subjects

Subjects for one day workshops include the Challenge , managing conflict , Links , assertion training , counselling skills , time management , fundraising and stress management.

Full details are available in the Brigade leaflet National Courses 1990 produced by the Cadet and Training Department at National Headquarters

But , Carole points out, it is vital that this more professional approach to training is backed up at all levels by better standards of presentation. "The prospect of giving a presentation or running a training course will always be daunting unless you follow the

MATLOCK YOUTH HOSTEL

& TRAINING CENTRE

rules , but the message is that anyone can do it and everyone can improve , however nervous they are ."

Carole has studied the subject in depth, picked up the best advice from training speCialists in commerce and industry, and learned from her own experience

"Rule one is prepare well! " she says If you do , you are more than 50 per cent of the way there , but be aware that preparation is time-consuming and that venues , speakers and equipment often need to be booked well in advance.

Remember the five Ws : WHO is your audience?

WHEN is the session and how much time will you have?

WHERE is it, what are the facilities and what else do you need?

WHAT is the subject matter?

WHY are you doing it and what do you hope to achieve?

The next step is to collect your thoughts , consult the appropriate sources, such as books or people , to gather the necessary information , and then to get your ideas down on paper Build a framework establishing the main points you need to make to achieve your aim; ensure that you can support your arguments; and try to prepare for all the questions that might be thrown at you " The beginning and ending will need to have impact, so try to think of something different , such as a joke , an appeal or a demonstration ," advises Carole To make sure it goes well , you should rehearse and see what others think of it. " Ensure you remember your lines by using notes , note cards or whatever suits you best. Pay attention to your body language You will

January

Speaking at the presentation , which was Ittended by Baron von Richthofen, Amassador of the Federal Republic of rmany, and Sir Sigmund and Lady

rraining (from page 3)

nake more of an impact if you stand rather han sit and keep to small, natural move1IIIIIIIIInents - avoiding distracting mannerisms lr paCing up and down

"Also pay attention to your speech , varyng the pitc h , pace and volume to avoid a

irone , and use the lighthouse effect'icanning the audience so that you include weryone without staring ," RUle two , says Carole, is to make it ineresting. People only take in information if F OR DISCOU N TED to, so you need to motivate your by telling them why they are there , RAT ES ON A LL

DESTI NATIONS P L EAS E Provi de a variety of stimuli and use exer, practice, questions , tests and PHONE SABITA SUKH U ut resis t the temp tatio n to cram in too much Pan World Travel Ltd and allow time for one point to 8-10 Royal Opera Arcade, Pall Mall, In befo re introdUCing another London SW 1Y 4UY Visual ai ds are mp ortant. "They assist the Tel : 01-9300471 Fax: 01-930 2380 he lp th e au d ience to understand Iplec f · f L- - e o In orm at io n a nd th ey a d d interest

Sternberg, Chancellor of the Order Lord Vestey said: "I am sure these annual awards, generously donated by the Sternberg Foundation , will enable counties to boost their recruiting and provide an incentive to St John Ambulance in the rest of the country "

Representatives from Merseyside , where 54 new members were recruited in the first five months after the launch of the Energy Programme, received a cheque for £1,000 from the Sternberg Foundation Lady Sternberg presented the cheque to Derek Cooke, Area Nursing Officer, and Terry Baldwin , Area Com missioner.

Fifty one new members joined St John Ambulance in Cumbria under the Energy Programme and Lord Vestey presented the second prize to Muriel Wakefield , Corps Super-

and variety," says Carole

These aids include the blackboard , whiteboard , flipchart , overhead projectors , slide projector, video , models - and the real thing The secret is to choose the aids which help clarify your information most eHectively

Each has its good and bad points The flipchart can be used to collect ideas on the day or can be prepared beforehand and it is moveable But it is not as good for revealing information bit by bit as is an overhead projector Models like Resuci Annie and Skeleton add realism and clarify points and can be used for demonstration and practice , but they can be expensive.

Visual aids should be used only if they make something easier to understand

" Don't shovel them in!" says Carole And use large lettering with key words or phrases , not sentences and make your diagrams large, clear and simple

A bove all , says Carole , you do not face your task a lone. There is a wide variety of resource material available to help you make your training or presentation a success

Ideas for exercises are obtainable from

, and Susan Cooper, an Energy recruit on behalf of

, where 44 new members have joined.

commercial training companies and video packages on a wide range of topics are also available commercially and from The Open College

The variety of books designed to help with all aspects of training and presentations is enormous and of course S t John is an excellent source for books , videos , exercise material and other resources that the Cadet and Training Department is happy to lend

The contact number is 01 2355231 , ext. 216

The last word goes to Seamus Kelly, who had three rules of his own. "First put yourself in the shoes of those who are going to listen to you and relate what you say to their level of knowledge. Then ensure that you know the subject thoroughly - no kidology! And finally remember that people find it difficult to pay full attention for more than 35 to 45 minutes , so break your subject down into manageable portions."

Since this article was written , Carole Dwyer has left St John Ambulance. Her replacement is Nick Suggitt , who, with the rest of the Cadet and Training Department , will be happy to advise or assist. 5

(L to R) Award winners Derek Cooke (Merseyside) , Andrew Kirke and Susan Cooper from Humberside - Sir Sigmund Sternberg - Fiona Hamilton and Muriel Wakefield of Cumbna , Terry Baldwin (Merseyside) at the presentatIOn of the Sternberg Awards And (below) Terry Baldwin (left) and Derek Cooke receive a £1 ,000 cheque on behalf of Merseyside from Lady Sternberg of the Sternberg FoundatIOn

intendent, and Fiona Fletcher, an Energy recruit from Barrow in Furness. Mrs Phillips, Chief President , presented the third award to Andrew Kirke, sergeant from Withernsea Division

Humberside

Hillsborough . girls of the

;ervice Hospitals "'elfare Dept

Hillsborough - FINAL REPORT

Lord Justice Taylor's final report into the disaster at Hillsborough stadium last April was published on January 29 As expected , the report recommends many ways in which safety at football grounds can be improved, ranging from the introduction of all-seater stadia to the abandoning of the proposed national membership scheme

The recommendations regarding first aid cover and first aid facilities at football matches have been slightly modified from those originally put forward in the interim report.

However, Lord Taylor still maintains : " It would be unreasonable to expect , at any sports stadium , medical facilities capable of dealing with a major disaster such as occurred " What is required is a basic level of provision of first aid , for professional medical attention and for ambulance attendance , together with a system of coordination with the emergency services which will bring them to the scene swiftly in whatever numbers are required What will amount to an appropriate basic provision for the future , eg the equipment in a first aid room , requires expert evaluation and advice."

A significant change , from St John

Ambulance 's point of View, IS the re -wordlng of the sentence describing the type of ambulance cover required : " at least one fully equipped ambulance from , or approved by, the appropriate ambulance authority should be i n attendance at all matches w i th an expected crowd of 5,000 or more " Th is , of course no longer nfers ambulances attending these matches should be ambulance authority vehicles

An additional recommendation under th is section is that all matches w ith crowds n excess of 25 ,000 should have , n add it ion to other ambulance attendance , a major incident vehicle equipped to deal with up to 50 casualties on site and similar to vehicles currently used in such situations by the Scottish Ambulance Serv ice

The recommendat on regard i ng the attendance of a doctor at all matches has been amended so that at football matches where there are unlikely to be more than 2 ,000 supporters there is no longer a requirement to have a doctor present throughout the match

St John World will be looking at the implications of the Taylor Report in the April issue

o n as oepresen e e esco a Cup and £1 ,000 to Robert Hunt and Gficer, who often has to cope people In Forster, of Bracknell D iv s on , wh o ghtened , depressed and anxIous £947 at the i r local store aged between 25 and 40 , es sent i al Asec d f£500 tt Ph qUi rements are a sense of humour, a d G on Oprblze 0 b hwelfn f tOh 1 atur ity and the ab i lity to listen and befr end , n race x ury on e a 0 e co d ' h t th K ' L 1i h £9(' Ys Barbara Townsen , Director of t e a e Ing s ynn esco , were " It b d ff It ' b b t th ra ised DoncasterStJohn can e a I ICU JO , u ere d t db ' M F ' e enormous rewards ; It IS a great p ri v ilege raise , were represen e y ary arr, I f ' d ' Barbara Joyce , who rece ived the thlr Jeop e con I e In you of £250 John Eastoe announced t ha presentation would be made ann ua Since 1980, SJA Coventry has been visiting collectors have every encourage theJohanniter Unfall Hilfe in Kiel every other make the most of opportun ities thsyear, while the Kiel members have been Tesco are allowing SJA collect ons aholidaying with Coventry members on the stores throughout the country on Fnd,other years Saturday, May 11 and 12 Last year only five Kiel members managed to visit Coventry for a week in October Their stay included seeing Warwickshire ' s new county HQ at the Agricultural Centre , Stoneleigh ; the Coventry Motor Museum ; a canal trip ; an open market ; a Roman fort ; the , II Police Museum; Blackpool you name it , e they did it. O .Coventry s guests certainly had a great ' time

(Right) The K el members at a Civ ic , II reception in Coventry (Below) on a slow e 0, boattflp along Ihe Coventry canal 'ello. Three police officers of Batley, West Yorks , knew exactly what to do when a man and swallowed his tongue PC Anthony (centre) hit him on the chest, causing him to

Newly recru ited welfare off icers undergo a month of tra n ng at Aldershot , where they are fam i iar sed w ith serv ice ife so they know how to f i nd the r way around the m i litary network Although most recru i ts have counsell ng sk i lls they are also g iven extra tra i n i ng to help them cope w ith stress and

bereavement.

Towards the end of the Falklands war, two welfare off cers went out on the med ical sh p the Uganda , and later a team of off cers accompan ed bereaved relat ives on a tr i p to the Falk lands for the memor a serv ce Although the r pr mary role s to help serv i ce personnel , the welfare off cers occas onally get i nvolved n the aftermath of c v d sasters , such as the s nk i ng of the ferry n Zeebrugge , when the i r sk lls can be invaluable Two off icers stayed in Zeebrugge for two months i mmed i ately after the d isaster

A four wheel drive ambulance , ideal for the rough terrain of Cumbria , was presented to SJA county by the major food manufacturer Heinz on January 12 at a ceremony at Carlisle Castle

Heinz presen 4-wheel dri " ambulance t

SJA Commander Cumboa , Dr Geoffrey Stitt (right), thanks Paul Williams, HeinZ director of personnel , for the vehicle

behalf of the Heinz Charitable Trust it gives me great pleasure to hand over the keys of this specially-equipped veh cle ."

" We re delighted to assist the Cumbrian community in this way," said Paul Williams , Heinz dir ector of personnel , making the pre sentation. " Our association with St John A mbulance goes back many years and on Dr Geoffrey St itt , SJA Commander, who received the ambulance on behalf of St John Ambulance , said : " We are extremely grateful to He nz for this new vehicle , which is ideally suited to the duties we undertake i n Cumbria ." The ambulance w ill be used at a variety of dut i es throughout Cumbr ia ,

SI John Fellowship

Lady Westbury is new President

I am pleased to announce the Lady Westbury, CBE , JP, has agreed t o succeed the late Lady Brecknock as president of the St John Fellowship

La d y Westbury retired as Superintendent-in -Chief on December 31 19 89 During her six years in the appointment she visited all parts of this country and also met many St John members overseas She has always taken a great interest in the Fellowship and was presented w ith the Fellowship Badge at our AGM in 1989 She has been connected with St John all her life. Her grandfather, the Earl of Scarborough , was Lord P rior and her mother, Lady Serena James , was for many years Co u nty P res dent , North Riding of Yorkshire , and is a Dame Grand C ros s of t h e O rder

Lady Westbury was County President of Humberside before bec o ming Superintendent-in-Chief.

Mem bers will be able to meet her at the Annual General Meeting in London on May 1

S h e ila Puckle , National Secretary, St John Fellowship St John ' s Gate , Clerkenwell , London EC1M 4DA.

8 St Helens & Knowsley Fellowsh p present ng an oxygen set to James Darw n , Area Comm i ssioner.

I.

i nclud i ng motor cyc le scrambles Lowther Horse Trials and at Ca Racecourse

Dr J C Graham , who is Chief ME Adv iser to He inz, a knight of the Orde John, and former Surgeon -in-Chief John Ambulance Brigade , attende ceremony. Little Jasmine Loveys of Lowestoft, wa s appointed when to ld she was too young for Badgers She's only three and has to another three years But she s obvio, feeling better now that she's county mascot - complete with new jumper. (Ph Eastern Daily Press)

The Specialist Vehicle Builders

People keep coming to us for something special. ThiS IS not a single success story - we can tell you many

For the success of Pilcher - Greene as a company can be clearly seen and accurately measured by the success In service of the many different speclalpurpose vehicles we build and supply

People keep coming to us for 'something speCial'

And that's exactly what they get. We have been successful pioneers In the development of speCially built vehicles , that are deSigned and equipped for vanous speCIfic tasks, for well over sixty years now. By taking and adapting the rugged and well -tned baSIC chaSSIS of the World's finest vehicle builders, PllcherGreene have bUilt their own success all

[)t\F -1-00

the careful attention to detail required In creating purpose-made products to meet demanding speCifications or fulfil speCial roles So successful have these Pilcher -Greene 'specials' become, that we regularly • _ turn some out as 'standard' vehicles In a highly successful range that offers Wide chOice to our customers - In many different areas of human activity But we re ready to build to your specification - If you have something special In mind Skilful englneenng and craftsmanship, unique bodywork deSign, great care and attention to meeting performance needs - these are the hallmarks of our success In the creatIOn of vehicles that Will match the speCifiC demands of their operators - dunng a long, reliable, and highly cost - effective service life,

on the road

Ambulance

Journeys

Since

But it did not break the d iv sion s record for the longest (757 miles) in one operat ion. That was in 1981 , when we were asked to

Since

1 Someth ing different happens and g ives the patient something to talk about (ie, relieves boredom)

2 The crews of both vehicles are more Malcolm Rutherford on

ndhogs &Hedgehogs

The British have always talked a lot about the weather They have good reason to , for the weather is always changing If you knew that it wou Id nearly always be hot at midday, with no rain, from May to September, there would not be much to say Nowadays they talk about the weatherforecasters as well. Perhaps they always did a bit. "Forecast wrong again ," people say with satisfaction. But I date a change from the great storm of 1987, which the forecasters failed to predict.

Ever since, the weather forecasts have become much more complicated and harder to understand I often sit through the long forecasts after the nine or ten o'clock news on television and am not at all sure at the end whether the man has said that it is going to rain in my part of the country the next day What he seems to have said is : "It might , but then again it might not ."

And one can sympathise with the forecasters who, after their experience in 1987, no longer want to take the risk of being wrong. Instead they blind you with science and charts and diagrams and the balance of prob abi ities. One also has to recognise that the weather-forecaster on television has a hi g h profile, quite unlike the anonymous voices on radio. He might be recognised in the street or on a train, and taken to task if he

had said that it was going to rain in Hampshire when it did not.

Thus the modern forecaster is probably wise to hedge his bets But there is change that has been less noticed This is the return to old-fashioned weather forecasting : the kind that relies heavily on the behaviour of the birds , the beasts and the plants At its best , such forecasting needs to be supplemented by records kept over a long period of time - at least a century, preferably more

We have an outstanding example of the old-fashioned forecaster at the Financial Times He is called Bill Foggitt Some of our readers think that Foggitt does not exist and that we have made him up, rather as Peter Simple in the Daily Telegraph invents characters like the "go-ahead Bishop of Bevindon ." Although I have never seen him, nor even talked to him myself, Foggitt is a real figure. He is 71, lives in Thirsk and never seems to venture much beyond He was brought to our attention by a young reporter whom we recruited from the Yorkshire Post. The reporter has since gone on to more exalted stories like "How did Ferranti get in such a mess?" Yet one of his tasks remains to keep in touch with Foggitt. Foggitt knows everything about the

alert on the journey, the patient is on board

3 The journey is shorter for each ell

4 Members have a chance to lTV members from other parts 01 country

5 In the event of a vehicle breakdowr accident, we have points of can' around the country where helpfol patient ' s needs is available and journey can continue w ith minimum of delay

Peter Tate DIS Northampton HQ Division

weather, but uses unconventional methods For instance, he forecast the 1987 storm by watching the behaviour of his neighbou r's black cat and checking it against the movement of the barometer The cat was jumping about all over the place , and the same happened before the most recenl storms

The reason why Foggitt knows so much is that his father, grandfather and grea grandfather before him all kept the most detailed records : not on Iy of the daily high and low temperatures and rainfall, but also of the wild life, like when the frogs spawn Not long ago, he came to the notice of the Me Office The Office has paid him the compliment of producing some of his fam ily weather records in bound volumes So you can see that Foggitt does exist

Moreover, Foggitt is not alone Recently, came across Groundhog Day in Punkx· sutawney, a small town in Pennsylvan ia Groundhog Day is February 2 and more widely known as Candlemas The locals, watched by people from all over America take a groundhog and see whether he casts a shadow If he does, there will be six more weeks or so of cold weather to come If he does not, winter is pretty well ovel, (Incidentally, there was no shadow this year )

The custom is said to d ate back to the first German immigrants to the State. We told Foggitt the Punkxsutawney story, which he had not heard before He said : "We do the same sort of thing in Thirsk - only with hedgehogs ." The groundhog and the hedgehog seem to be similar kinds beasts. For the record, there was no shado'" in Thirsk this Candlemas either © 1990 M alcolm

From Malvern -DISDoreen Speare, June Falconer and Sarah Gregg enJoYing the 1989 summer at Newquay

Wish you were here.. .

Forthe fifth season running, the St John first aid post on Newquay's Town Beach was open for the 1989 holiday penod thanks to divisions throughout the country, whose members came to provide cover and enjoy a holiday.

The Beach Hut was open from June 17 to September 15 and 362 people received excellent treatment from SJA members.

Return visits to enjoy the superb weather were made by DNO Josephine Brace, of Balham and Tooting; OS Doreen Speare. of Malvern; DS David Rees, of Aldershot; NM Ken Perry of Pershore; OS Keith Miller, and eso Gladys Wilson, both of London Transport. All were supported by enthusiastic members of their divisions.

Enjoying their first VISit were Les Hoare, of Northampton HQ, OS Margaret Anslow, of Fleet and Cookham, and DO Brian Cooke, of Cwmbran, again supported by members of their diviSIons.

Newquay Division provided accommodation free of charge for up to six members In a flat above their Ambulance Hall, which is a 10-minutewalk of the beach hut.

There are only a few vacant weeks available In the 1990 season. Divisions wishing to send a team to provide first aid cover in Newquay. should apply soon to Mrs Betty Munro, 3 Trenance Avenue, Newquay, Cornwall TR7 2HH. Phone 0637 877386.

0 / 0 Reg Ashman, of Bath City Ambulance and ur Ing Division, after completing the team te t ectlon of the

Meet the Wilson famlfy. Mum (Stephanie) jOined Whitby Nursing Division in 1977 and also helps WIth the Badgers Heidi jomed the cadets m 1986, Bernidette in 1987, and now Andrew and NIcola are Badgers Stephanie, who holds several long distance swimming records. has an ambition to sWim the Channel

Sarah James, Clevedon cadet, receives her 1.000 hour certificate from Mr Stuart Hadler, county commiSSIOner. (Photo: Myra Meredith).

AROUND THE DIVISIONS A ROUND THE DIVISIONS

Hants Leicester

Smart-and pretty- are Coedpoeth Badgers Rebecca Vernon and Cara Edwards who were winners of the Badger Buzzz's Ela stoplast competitIOn (Photo: Wrexham Evening Leader).

Ashley Coulthard, a spina blfida sufferer. is the county's first Super Badger and was presented with her certificate miniature badger by Lady Barnard, county president Ashley, here with her grandmother (left) and her mother Mrs Lynn Coulthard is now with Durham City cadets

Dorset

J un ior members examine exhibit in the new publicity unit of SJA C lwyd. The 16ft long umt was on display for the fir t time after the county caro l service at Gre ford. North East Wales. Also prese nt is the Commissioner for Clwyd. Roy Eaton, and the Reverend David Griffith the county publicity and development officer.

It\-yke Regis nursing cadets bid farewell to Mrs Anne White, who has been nursing officer SJA Wyke Regis for 16 years Her successor IS Mrs Stephame Mansfield SRN (Photo: EBJ)

Chaplain to the Order. Canon Brown dedlcateo' county's new van which transports FAW COl! equIpment.

15-year-old Jagrutl Amln, of Leicester. won the

Regmald Bates QUIZ for Cadets, with (left)

Kingston

Catherine Hardy, 14, of Coleorton In second place. (Photo Leicester Mercury)

Wit h Badge r Lea der Sa ll y Linsley is the second gro up of Supe r Badgers in a year for Cobham Divisio n , Su rrey. They a re (L to R): Isla Salisbury, 10, James Trewby, 10, and Wendy Linsley, 9.

During November, at Gnm by and Centre, Dr Gordon Cameron, County Director, presented a silver salver to Joan Francis on her retirement after 15 years as Centre secretary; a tankard to John Morton, Centre treasurer for seven years; and an inscribed plaque to Sydney Thompson, chairman and first aid instructor for 27 years.

From January 1 1990, counties are to have only one Association Centre, which in Humberside will be at the County HQ, Hull.

Cadets and Badgers held splints aloft at marnage of DIS Sonya Button and Peter John- Retinn g Area CommIssIoner Dr Peter Tasker. pres ents Mathew Barlow with the Commlssioner's Commendation Between them IS Gar) Packwood. a school fnend knocked do\\.n and injured by a van Mathew called an ambulance. kept Gary slIll. covered hml WIth a coat. escorted Fleetwood Badger smce the set' him in the ambulance to hospital where he gave years ago, Rachel Gnnrod put her It details of the aCCident

At Windsor Safan Park last summer

IS raised by inflatable bags to free an aCCident 'victim : (Photo Windsor Express)

Three Aldridge Badgers - Richard Williams. Richard Fell and Rhia Fell- helped the Mayor of Walsall and staff plant flower bulbs in the Safeway car park.

Kent TN27 8AT.

New Editor for St John World

All editorial material for St John World should now be sent to Carole Richmond, St John World,1 Grosvenor Crescent, London SW1X 7EF. Carole works at headquarters from Wednesday to Friday and can be contacted on 01-235 5231 ext 250 Subscriptions will still be dealt with from Wood Cottage, High Corner, Butley, Woodbridge, Suffolk IP123QF.

Training

in service hospitals

Anyone over 18, who is interested ind( two-week course at one of the St hospitals offering training to St members, should contact Myrtle the Superintendent in Chief's office, na headquarters for details.

Cadet Help and Information Pages

Hello and Welcome to the March portion of C*H*I*P*S . This month we look at the production of divisional newsletters, and cover some youth related articles in C*H*I*P*S News.

Prince Edward watches a first aid display staged by the Nailsea Divis ion competition team which was placed f fth i n the national finals The event was a Duke of Edinburgh Award day last summer at Ashton Court Bristol (Photo : Myra Meredith)

How to produce a news-shee

Producing a news-sheet

Let us concentrate on a part icular area of divisional promotion that every Division should at sometime or another be able to have a go at. I have purposely steered away from the more technical aspect of magazine production and instead have concentrated more on content and compiling.

As far as production, most of my comments and observations are confined to publications that are poss ble with duplicators and photo-copiers This is because I feel that in most cases Divisions

should be able to gain access to such machines, whereas other methods tend to be more expensive and outside the reach of most Divisions.

Why bother?

Why should a Division consider producing a magazine or news-sheet? They cost money, take time to compile and distribute and , in some cases, expose the deficiencies of the Division But the arguments for a publication far outweigh all these disadvantages I have heard superintendents say that a magazine

promotes diVISional pride , keeps members informed of what the divisio doing and acts as good publicity circulated to cadets and members 01 public All these are valuable views W some often forget is that produc lI'j magazine or news -sheet IS also an project for senior cadets , In which they a use the r School Resources Centresto publish and distribute

Where to start?

If your Division has never ventured into

world of publications, this is how to go about it.

First of all you need an editor, one person responsible for getting all the material together and then editing it, correcting spelling mistakes, grammar, etc Perhaps no one in your Division has that ability In that case, still appoint your editor and then put him/her in touch with someone (such as a parent or teacher) who will proof read the finished product before publication I should add a word of caution here to all potential editors You will probably find that although you continually ask members for contributions to the news-sheet or magazine, few will be forthcoming Few, that is, unless you are prepared to constantly bully and make firm deadlines for copy But do not despair When the deadline passes and you still have nothing to edit in most cases you will have to virtually compile the publication yourself

Why th is is shall never know, but ask any editor and he or she will tell you the same

The important thing though is not to give up simply because no one wants to contribute They do really, but never seem to get round todoing it. However, these same people will

always appreciate receiving a copy of the publication Threatening to cease

publication is useless It hurts no one but yourself

(Editor: They also tell you they ve sent their piece when they haven 't.)

The news-sheet

I believe that every Division should be capable of producing a news-sheet. The problem is just finding that dedicated editor. A month of divisional activities will probably easily fill a news-sheet. It is just a question of sitting down and preparing it. Somebody in the Division must know somebody who can type stencils or proofs Give them the material clearly handwritten for them to type it.

A news-sheet should ideally contain a lot of information To achieve this , each item must be short and concise. No need to go into graphic details of how Errol accidentally fell down the sewage pit. Just state that the Division went to such and such a place , did whatever they did , etc

Ensure that the news-sheet has a clear and well prepared heading This should include the Division s full title and the date

And somewhere on the sheet include the full name, address and telephone number of the editor, as someone outside the Division may

want

Content

The content of the news-sheet doesn t have to rely solely on divisional matters , although most of it should. However, a few short articles of general interest such as equipment review or a political topic , could be included A good example of what I mean appears every month in St John World entitled " On Call ."

Finally

I am fortunate in being in a county where a numberof good news-sheets are produced. I can honestly say that on the whole the quality of publications is very high and all our hard working editors deserve much praise

Please send copies of your publications to C*H*I*P*S so that we can all see them

To Divisions which have still to take the publishing plunge - take it now It is hard work , but the rewards are great. Remember to keep items short , the format interesting , and then keep your fingers crossed that someone will supply some copy

(Left) Nine new nursing cadets for Avon's Crocker Pill Division were enrolled by Myra Meredith, Woodspring Area Commissioner

New banner

Grange over Sands, Cumbria , nurs ng Ce and badgers had their banners dedicatedJ parish church by the Revd Alan Gibson d, January. The nursing cadet banner presented by Mrs Jill Asplin and her bIi John Davey in memory of their mother. Mollie Davey, late president of SJA Grange the new badger s banner by Tom Andre'l/'i present president It is the county s first Be' Banner

Chips news

Your're better off talking to ... Bank will be backing community prOjects Involving your people to the tune of £250,000 during 1990, under its Barclays Youth Action Scheme This scheme , aimed at promoting a spirit of enterprise , offers of up to £15,000 to projects which stimulate community service and encourage leadership and organisational skills in young people b PreVious projects which have been aided scheme include city farms , a travelling y Ibrary and the conversion of a double-

decker bus for use in an isolated rural area

If you think you may qualify for a grant , further information and application form can be obtained from Barclays Youth Action , Barclays Community Enterprise , PO Box 256, 25 Farringdon Street , London EC4A 4LP.

Telethon 1990

Provisional dates for

Next month

Wolverhampton's Northcote Quad DivisIOn received a £586 cheque from Pendeford Safeway storey raised during St John Week last year The linkup continued over Christmas and Will continue throughout 1990 Thanks , says Northcote members

Please send your efforts so far in the C*H*I*P*S Challenge And also any comments or articles that you want published Look forward to seeing you in April

CHIPS, St John World , St John Ambulance HO , 1 Grosvenor Crescent , London SW1X 7EF 17

StJohn

(Above) The old Orde r chapel restored And (right) It I! ves aga n as cadets are enrolled under ts roof

ancient and modern

Four centuries and a Commandery chapel

W

hen Queen Mary Tudor died in 1558, the mediaeval St John Commandery at Swingfield was finally expropriated from the Order. Situated in Kent , about six miles north of Folkestone , it had held sway over a wide area and , in their early days , had housed Sisters of the Order before their transfer to Somerset. Thereafter, the land and buildings changed hands many times and gradually fell into ruin , until only the Chapel remained , and even that was sadly dilapidated

About twenty years ago , rescue was undertaken jointly by the " Ancient Monuments " and the Kent County Council News of this fired my imagination ; I saw a potential focus for St John activities There was talk of a grand opening ceremony, at which we could have played a part. The work was duly and meticulously completed , but there was no opening ceremony and no publicity.

I could then see three possibilities It would make an inspiring objective for a pilgrimage; we might get a St John Badge and a plaque put up for the information of visitors; and it might serve as a venue for St John ceremonies , particularly Cadet Enrolments. I concentrated my efforts on the first two of these might have had more success if I had gone all out for enrolments But I was trying for a massive pilgrimage from Canterbury ; this proved impossibly complex and was 18

ROBERT PERCIVAL Commander, Order of St John

frowned on by the police A small one , from Hythe to the Swingfield Parish Church , was arranged by Leslie Ashman , the Deputy Commissioner That was all that could be done then

Plans for a Cross at the east end of the Chapel were turned down on policy d iscussions as to a plaque foundered on both wording and material. Eventually I reached retiring age , had to leave the Brigade , and tried to reconcile myself to the idea that it had all been just a fancy

But then I joined the Ramblers' Association , and one day found myself walking with a lady member of the Canterbury group In conversation I told her of my sadly abandoned hopes She thought about this for a while , then at the next stile she said : " I don t know that your pilgrimage would be impossible " There the matter rested, and I did not see her again for some weeks , but when I did she told me she had been talking with her Canterbury colleagues and they were sure that they could devise and supervise a safe route from Canterbury to the Chapel. Accordingly, I got permission for Swingfield from the English Heritage, and from the

on had taken part in the pilgrimage A week Sir two later I received an invitation to conduct o Cadet Enrolment , which they had arto take place in the Chapel on Tuesday July 25 Naturally, I accepted eagerly I arr ived pretty early, but the car park was already full The stands bleakly in a field , but inSide It was glOriOUS

There had been colour enough for the pilgrimage but now it was fit for a wedding A blaze of flowers had been arranged by Margaret White , in charge of the Cadets There were flags of the Order and Brigade , and colourful display boards proclaiming every facet of St John - the Order of Malta , our own Order, the Brigade, the Hosp ital , the Badgers A table at the east end was covered by a ' fair white linen cloth '; on it stood the recently-blessed little cross , a candle , and a vase of flowers All went to soften the austere beauty of the ancient building - which was full

Three Cadets , Mon ica Drayner, Emma Geldart , and Aaron Pavey, were enrolled by myself , aided by Agnes Lawrence , a Dame of the Order and ret i red county super i ntendent. The Cadets Flag was blessed by Lawrence Smith , Rector of Eythorne In h is address , he reminded the three cadets that each was now a part of h istory I think that all present were deeply moved by a sense of commun ty w th the past - not least the off iciat i ng chapla n Thus , 1989 has seen th is old chapel used once more after more than four hundred years for the sort of purpose for wh ich t was bu i lt. And I have seen the fulfilment of an old dream and , more than that , have seen that dream str i ke f i re i n others

The role of the Instructor

by GERRY VERNON , Development Officer, S&W Yorks

It is often said that a person s dog becomes very like h s master Certa i nly this is true of our children , n that they become very ike their parents Their voices are so s i milar to Mum 's or Dad ' s that they could answer the phone and discover from our fr iends all those things we prefer to keep from our children before the friend at the other end of the phone realised that i was jun ior they were speaking to and not jun or ' s Father believe the same truth is to be found in students who attend our first a id courses Often you can tell the type of instructor who ran the course and the quality of train ng firsta ders had rece ived , as soon as you see the Dean of Canterbury for the use students in operat on They are , at least n Gregory s Chapel Th s last has a spt first aid terms , what we have made them s ign f i cance for us , s nce on its a lte rsla What kind of instructor produces the most cross and candlest i cks bear i ng ba dgi competent students? If we take for granted the Order They were donated by five 81. that a course is well prepared and carefully members from Kent to commemor alE structured the mportant question is to V s it of the Grand Master of the Ord: establish the kind of role an nstructor should Malta to our serv ice n 1975 I also obla play the bless ng of the Comm iss ione r, 0 Here are three classic possibilities : Audrey Emerton who put not ices If county c i rcular 1. The autocratic instructor

At 9am on June 171989 a band of This is an instructor who makes it known assembled in the cathedral. Som e to everyone that he or she is in charge , the Ramblers , some were St John of all knowledge and that suggestwo or three were both Ri chard Ttlonsondoinganythinginadifferentwayare Bishop of Dover and a member of ou r not welcomed The students from this i nsaid prayers with us , gave a sh ort structor stop learning as soon as he/she apposite commissioning address , and stops teaching ; there is no self motivation in us off on our 14-mile walk Refresh mthe students to examine beyond the strict both on the way and at Swingfield , werE limits of the syllabus or to develop any kind vided by members of the very active 81. of personal initiative The didactic method Fellowship The pilgrimage ended , as rules Supreme begun , with prayers and an addres s2 time in the Commandery Chapel and lt The laissez-faire instructor

John Gleadall , Assistant Chaplain 1 \ term describes the instructor who Order. He also blessed a small crosS ,rr that students should more or less for the occasion , which stood on th e. Ictate should happen in a class There which did for an altar Julia Findlater, fn)l' ls often little direction and even if the course Order Museum at St John's Gate in structured at the outset it soon well , and Jack Hewitt , 0 St J into a disorganised ramble ber and now president of Dover 01 an unconnected collection of anecgave talks on the history Of the build ," a es The students on such courses may Some members of the Tllmansto ne ppearto enJoy themselves and believe that

the i nstructor IS " very nice " but they never learn anyth i ng effect ively

3_ The democratic instructor

Th s person centres teach i ng upon how students learn Th is focus of activ i es determ nes all the i nstructor s plann ng and relat onsh p w ith students The i nstructor rema ns the person i n charge , but always i n an unobtrus ve style Where ever poss i ble the act ion does not take place up i n front of the class ', but among the students who are self mot ivated to apply the knowledge they are acquiring and to explore the implicat ons

of it beyond that wh ch has been expla ned The instructor and the students become o nt searchers for new knowledge It is n th is type of s tuat on that students beg i n to develop that i ndependence of thought and act ion wh ich

The cho ce s yours There s however a maj or problem for some i nstructors n develop ng the democrat c ' role ; they are reluctant to spend the hours of preparat on wh ch such successful teach ng demands

The autocrat ic i nstructor does not requ i re such detailed preparat on Th is may explain why some i nstructors degenerate into th is easy opt ion so typ ical of the up front' type of nstructor whose lessons are also often self ndulgent ego tr ps Your students are go i ng to become ke you ; make sure you w i ll l i ke what you see when you next meet them

The result of good instruction

Minehead Badger Christine Stevens shows what an 8-year-old does in demonstrating mouth-to-mouth resuscitat on under the supervision of an ambulance cadet and watched by her brother John , also a Badger. 3 cadets and 2 adults demonstrated CPR and the recovery position

c ,-,TO " '\', ,- W, "LL' "''-'' "L - t.?

EMERGENCY SIRENS AND BEACONS Enter al n • While on a recent house-to-house collection 272-274 Leeds Road, Bradford , West Yorkshire B03 9QX emet a leader of a small group of volunteer Telephone (0274) 733933 Fax (0274) 308212 :ntertainers under the of LEDA, Live Entertainment for the Association. They have been vIsiting a For quality and excellent service at all times, along with

pr icevariety of disabled centres and h ave to o f mainly B ritish products , including Sirens , Barlights , Matrix project their to a number Of a nd

S iren

'

, please contact

Sales Offlo

: phYSical , hard of hearing , sight f

r f

rther

problems , etc They cover Surrey and south London , and - operate from the village of Capel in Surrey The husband and wife team who spearhead the group are concerned that they are not getting any younger, do not belong to any national organisation , and would not like to see this work fa d e away They wondered if they woul d do better under the banner of a nat ional organisation that is involved with welfare

V.F.. SPECIALIST VEHICLES liTO

So we are making arrangements for them to aff iliate with Surrey St John , perhaps as

aux iliaries , and at the same time pursue a L policy of having a few uniformed adult and cadet members to go with them to the for various venues Perhaps some of the cadets

REFURBISHED AMBULANCE & WELFARE VEHICLES All may be able to get involved and join group We thought that when we are talking REBUILT TO THE HIGHEST STANDARDS. to people doing the Energy Programme we GUARANTEED WITH RECONDITIONED ENGINES couldaddthis dimensiontotheotheropt ions of membership of St John

Benefit from 12 years experience by telephoning 0484 LEDA woul d like to see their extend or fax 0484 845061 to other counties , my reason for writing to the Stjohn World , to see if Stjohn in other areas EMERGENCY HOUSE MANCHESTER ROA D already take part in entertainment for MAR'SDEN ' d sabled people A nyone who has anyth ng , to say on the subject , please write to our HUDDERSFIELD W. YORKS . County Welfare Off i ?er, Mrs E i leen , Wheaton , 16 Meadow H Ili Purley, Surrey - - John E Sm i t h

challenge

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.

helped supervise trips and organise activities such as sports day, the Talent Show, camping trips , soccer matches (and shaving foam fights!) We lived , worked and played with the children 24 hours a day and the work was physically and emotionally draining , but I not only gained an ins ight into American life and culture and helped towards nternational understanding , but developed new skills of my own I learnt to water-sk i, w indsurf and to ride a horse I also learnt to cope with the continuous demands of nine very hyperactive little g i rls All th is led to a better understand i ng of my capab lities and i ncreased my conf dence i n myself

We also had the opportun ity to travel Amer ica after camp , which was an exper ence i n itself , and of course you make many fr ends not only Amer can and English , but all nat ionalit i es as Camp Amer i ca recruits from all over the world If you are th i nking about taking up the new Youth Challenge , take advantage of what Camp Amer i ca has to offer E ther way I would highly recommend it for all young people with a sense of fun and adventure

For a colour brochure , more nformat ion and an appl ication form , wr ite to : Camp America , 37a Queens Gate , London SW7 5HR Or contact me , Dawn Simmons , at

of

Actively involved in St John lnsurance Arrangements in more than 30 Count ies

by Camp America I a camp cou nsellor I spent the 8 weeks Ooklng after children from various backgrOUnds, aged between 6 and 15 years It ex tremely hard work but very fulfilling Was expected to assume a position of and trust , being foster-parent , eacher an d confidant to the children I also

162cm (womenl. we would like to hear from you

St J ohn W orld can now accept your who selected embark on what is now a better career than • e £3 rrent bas Ic salary ex tends from £9,900 for the youngest entrants to advertiSing. those who 've made it to Chief Superintendent. plus free , . , , ul odat lon or rent al l?wance But if you 're the type of person we want , St John members happily give their spare time fo ri be mOre Interested In lob satisfaction benefit of the community - they could sense , vitality, courage, decisiveness , leadership I k · f ' b h h th ' b'liI'w 'll '.p YSlcal fitness-thisisw hatwe look for in you If you are chosen , 00 Ing or a JO W IC gives em responsl I 'e I tra inyou for a rewarding career that is always demanding , and is worth while , nard uous, sometimes very exciting but never dull • t ' I £9 'I ol ur Are yo u good enoug h? Find out more, write to ; , ,,-,

News from Scotland

STJOHN FELLOWSHIP

The Prior of Scotland (right) , Sir Stephen Miller (cen tre), and the Hospitaller of the Priory of Scotland.

Early in 1989 the Pr ior and Hosp ita ll e r of Scotl and lau nched an appeal to ra se £85 ,000 to endow a bed in perpe t u t y n t h e O phthalmic Hosp ital in Je r usalem Thanks to the generous suppo rt of several trusts and a great many ind iv iduals w ith n the P ri ory the tota l s um was ngathered in less than a year A pleasan t cere mo ny atten d ed by the execut ive off cers and cha i rme n of several of t he b ranc he s w ithin the Pr iory was he ld in Ed inb u rgh on De c emb er 13 w hen t h e Prior handed over

of

and

3 Tablets specifically pre - adhesive tape pared for the relief of men- 8 Bleeding swell ng , indCf strual cramp tation 4. Six 9 10 to 20 m i nutes

5 Hypothermia and diabet c 10. To aid the return of b oodl emergencies vital organs

6 Only when you are sure that 11 Thirty m nutes the patient is fully alert

Across :

1 My small company and little sister has a fungus infection. (7)

5 Sort of meat turning child s stomach with large mass (6)

9. Harmful to the body (7)

10 Three times an addendum for extensor muscle (7)

11 Support by cheering part of a tooth (4)

13 Bridge at the base of the brain (4)

14 Don't take a holiday (5)

16 How to deal with potentially aggressive patient. (7)

17 Ability to sustain prolonged physical exertion (7)

19 Bring back to health by rest and mineral. (7)

21. Animal species with no living representative (7)

22 May be used to determine reaction of pupils (5)

24 Shed the outer skin following scarlatina or sunburn (4)

25 Slight disparagement. (4)

27 Damage a structure by excessive activity. (7)

28 Print as for a frictative consonant. (7)

3 0 Inner coat of arteries and veins (6)

31 Used for injections in the Solent. (7)

Down :

1 Surgical procedure on a person? (5-9)

2 light-weight of the crew (3!

3 Injection for one wounded b); fire (14)

4 Contraction of the heart (7

5 Normal process of cell

6 Hearing test. (5)

7 Surgery in working order? '

8 Condition ariSing from wea tear of joint surfaces (14)

12 He frequently looks dow n" mouth (11)

15 Does this make one light-h ea. (4)

18 Voice in fatal toxaemia (4)

20 Pus in the pleural cav

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SUBSCRIPTIONS

Radio appeal launched after earthquake

AT 10.27am on Thursday 28 December 1989 , an earthquake recording 5.5 hit Newcastle , Austral ia s sixth largest city , w ith a popu la t on of 500 ,000 A total of 13 peop le died and 163 were injured Some 10 000 bu il d in gs were damaged and 1 ,600 people made homeless. Power and communications were cut for many hours but somehow

30 St John members from the N ewcastle area attended the disaster area w ith some on the scene with in 10 m nutes

Some members assisted the po lice to transport the inj ured , others travelled w ith ambulances from Sydney when crews did not know the area and some assisted at local hospitals. In the ear ly stages of the emergency more than 100 ambulances from every ava il able source we re used to ferry the injured and transfer patients from hospital to hosp ital The two largest hospitals in the area suffered ma or earthquake damage and pat ients were carried outs ide and makesh ift wards set up on lawns and surrounding areas The local radio station appealed for al l off -duty ambulance , police and firemen to report for duty but soon these emergency serv ic es were more than put to the test when their own commun ic ation network broke down and the F ire Br gade headquarters collapsed

Some 45 St John veh icles from Sydney , Gosford , Wyong , North Coast and New England Regions were despatched and trips that normally take over two hours were one hour whistle runs with pol ice escorts It was days before a ll the bodies were released from the worst - hit building , the Newcastle Workers Club , where most of the 13 victims died The St John personnel who turned out on the day of the earthquake have been praised on all sides. Alongs de the statutory emergency services and under the command of Corps Ambulance Officer Danny Lewis and Corps Officer J i m Brown , St John members worked through the n ght in terrible conditions to rescue and save lives

More radios and mobile units are now needed by the Sydney division to ensure that if disaster should strike again St John is even better prepared to help Any division or individual wishing to help should send contributions to Corps Supt John Comyns PO Box 306 Cardiff New South Wales 2285 A ustralia 2

Playing the for

be seen in a new exhibit on at The Order'S cleanliness and dign ty of the infirmary St

J 0 h

n museum , St John Gate , Clerkenwell. Gor - show the duty owed by members 01 geous silverware of all types is on display Order to "Our Lords the Sick ". Most of but it is the artefacts commissioned in the plate was 10stIA hen Napolean invadedtf.lNCOLN members Peter and Fiona Howie seventeenth and eighteenth century that and melted down stolen silver to pa \:ouldn t believe their luck when they were really catch the eye troops. However , there IS on d isplay :hosen to represent at the ComThe Order of St John at that time chose to silver shaving bowl from this period nonwealth games. It s not that Fiona and invest its wealth in crafted s lverware be - The Museum of the Order of St Joh n)e ter are superb athletes whose talent has cause it was easily converted to usable probably the largest collection of been discovered , it was their first currency Maltese silversmiths were very silver outside Malta The collection condld skills that New Zealand was after aware of the prevailing European fash ions of over one hundred pieces and this ex' .The to the Auckland games and the collection on display at the Gate tion is the first time that such a large CO Nlth Clifford Pettlfer from Royal Be rkshlre covers a range of artistic styles , from ba - tlon of Maltese silver w ill be on pub llc 3S members of the first aid roque classicism to the more extravagant play in thiS country earn and they had a glOriOUS time In ten:and light-hearted designs of the roccoco The exhibition w ill run from 9 Apr il tc :Jeratur,;s that topped 32 degrees centl

period Regulations of the Order ' S hospital end of May Telephone the museum The 8t John In in Malta published in 1726 state that pat - 253 6644 for open in g times and left, green With envy , ients had to be served from silver plates and details The bUilding was superbly eqUipped but It must be said that 8t John runs the health author ity ambulance service in N ew Zea

Mopping up after the floods of tears

OVER 45 Clwyd St John members offered much more than tea and sympathy to the victims of the Towyn Bay floods in North Wales last month. While the rest of the country watched the dramat ic teleVision p ictu res of the devastated sea wall and flooded homes , 8t John personne put in nearly 1 000 hours of work in an effort to ease the suffering of the Welsh refugees.

St John 's involvement w ith the d is aster centred around the Territoria l Army camp at K inmel. There , under the command of CommiSSioner for C wyd , Roy Eaton , St John (al ong W th the Red Cross ) proVided 24-hou r care for the cold , weary and shocked residents of the drowned village.

"Our members have been work in g on a three - shift system round the clock ," says Roy Eaton " Mo st of our work has been of a caring nature rather than first a d There are many old peop le who have lost everything and it is heartbreaking to see an elderly woman on two sticks cuddling a Yorksh ire terr ier and realise that the dog IS probab ly a ll she has left In the world

" We have had to change a few dreSS in gs and we did treat a dog s leg because its owner was so distressed by the inj ury , but

Challenging

really the most valuable service we have been able to offer is to talk and list en to the villagers and to try and put their minds at rest about any pract ic al prob ems they might have. "

The emphas is throughout the operation has been on welfare work and Roy i s conv in ced of the value of this exper ience to his members "We have never been nvolved in anyth i ng li ke th is before but the exper ence has been in valuable I can t thank people enough for the ded icat on they have shown i n turn in g out for shifts at the TA camp when they have a ready put in a ful l day 's work ." It is unlikely that villagers from Towyn Bay Will be able to return to the ir homes for some time as gas and sewage p pes have been fractured and electr ic it y supp li es cut off

BUDGET BREAK

ST JOHN welcomes the tax inc ent ives for charity giving in John Major s March budget. They should give a boost to our fundrais ng efforts St John World will look at the proposals in greater depth in May

including some very famous personalities who have agreed to speak .fered unl says lona, w

The Conference fee will be £38 per head fortheweekend This will include Civic Reception on Fndi bl k pain of being sunburnt her evening hosted by the Mayor and will include dinner and entertainment, Saturday lunch and thedtn l'l ac tights Although the HOWie s had to and dance on the Saturday evening There is a wide range of accommodation available Work at the games they did have time to visit Conference booking and accommodation shoud be made through County Secretaries of the spectacular tourist sites arou nd forms will be available at the County Office the firs week of May . ,AUckland and w

This annual event has been enjoyed by all the members attending in the past and am confid eZealand b ould like to thank New that everybody will gain enormously from attending this year derf I mem ers they met for their wonS M LATHAM sh ' u cstay and to Audrey M iles, LincolnBrigade I ommander for sending them in the pace

News '.

Winacar and help StJohn

h

ave priority Please try to ensure that your initial orders are as accurate as possible as The target for th

first orders will take precedence over second £180 ,000! So please start th nking about

be

very helpful if the books could be bundled in family hatchback with space for f

groups of ten with a

certificates Will be presented by John Sunderland C-in-C and

Sunderland , Commanderhie!. 'We realise that people have been through a lot in the last few months , so we wanted to give some form ecognltion for their efforts " says Laurie Hawes " The Chief Surgeon IS also looking into counsell ng ICOM radio telephones allow private commun ica-lcedures for any members who have had bad experiences ." between 2 or more radios in base-station vehide -m.Not all the memories Will be bad ones however It is now becoming obVIOUS that St John personnel and handheld livered and successfully treated a number of babies dUring the dispute formats

Pictured above is Ryan Kalick whose mother gave birth to him In a Sussex police station. Tony Kemp For more Isonthe SJA ambulance which answered the call. When Ryan stopped breathing Tony successfully details cam lete

Or: uscltated him " It 's momen ts like that which make It all worthwhile " says Tony the FREEP6sT Rya n of the babies saved by St John John Bergen is another He was delivered in the back aBirmin gha m am bulance by SJA member Dean Brookes Ico m(UK ) ltd Te 0,. I!you kno w of any other St John special deliveries please let S t John World know You can write to the Telex 9651791COM ltorial Office, St John Ambulance Headquarters 1 Grosvenor Crescent, SW1X 7EP orTel 01-235

After Hillsborough StJohn maki 9 this ground a safer place

The only good to come from the Hillsborough tragedy is that sports grounds could soon become safer places to visit.

Carole Richmond looks at the way some StJohn divisions are tackling the questions raised by the Taylor report WHEN

the W imbledon ground negotiate d w ith ste w ards to let the supporter w atch the ga me from the family enclosure

H e w as g e nt ly c o axed back into the g round a nd wa s abl e to w atch in relative c o mfort It

wa s a p e rson al t r iumph for him and a professio nal o ne f o r the St J ohn mem bers w ho hel p e d him c o nq uer his fear

That kind of inci d ent is just one of the p rob lems S t J ohn now faces after Hills b oro ug h Luckil y , that shocked and shaking fan

w as rel at iv e ly e a sy to deal w ith but w hat of t he g rea ter im p lications o f the tra g e dy and the Tay lo r re port

"Wha t is requ re d ," states the re po rt, "is a bas ic leve of prov isi o n offirst ai d , f or p rofessi o nal me d ica l att ention an d for am b ulance atte nda nce, tog ether w it h a sy stem o f c oord inati o n w ith t he emer g enc y services

w hich w il l br ing them to the scene s w iftl y in wha t ev e r numbe rs are re qu ire d Wh at w ill amount to an approp ria t e basic prov isi o n for the future e g th e e qu pment in a f irs t ai d room , require s expert e valu ati on a nd adv ice ."

Where w i ll foo t ball cl ub s go fo r that e x pert help? Hopefully St John w il be the f irst po rt of call and already both th e Le ague an d A s soc iat ion a re cur rent ly in d isc u ssi on w ith

St John Ambulance and Red Cross Ideal model for first aid provision at stadia has been sent to the Football ciation , the League and all counties John national headquarters It was the Bradford fire which London District to look at the football grounds Surveys were and advice was given - whether or not - about the dangers lurking In of London 's biggest venues

The hard work put in then is benefits now as the larger clubs have a statutory responsibility to g first aid act together and so turn organisation they know as expert " It used to be ," says Derek Fenton , mander of London District , "that visited football grounds I spoke to groun d smen and the ste w ards Now greete d by the M anaging Director ana· Chairman an d I can ne g otiate a first ad , at A rsenal's H igh b ur y groun d that c 80 0 sq ft and incor porates a rest room J o h n p ersonnel ." T he Tayl o r report also looked into question of am b ulance cover and herE word ing has p articular significance Ir Jo h n

n All they have to do is persuade a local authority of their worth a It has to be said that grounds ould noW be prey to mysterious private amcompanies who offer instant answers to the football club s problems

Some clubs may approach St John for help but more will sit back and wait for eople to come to them. Now is the chance for St John officers to negotiate the best possible. aid posts for their members , bearing In mind the need to meet legal and licensing requirements

It s vital that those that provide the fi rst aid at public events have be en properly trained to deal with whatever might happen It was Hillsborough which prompted Berkshire County Secretary Elaine Cook to initiate a disaster seminar at reading FC

Over 90 people took part in Exercise Heliball and It was the first time that such a coordinat ng exercise had combined the emergency services With the voluntary aid so cieties

Audio visual techniques were used to tell th e story of a press helicopter crashing into Re ading FC s packed ma in stand during a larg e category A match. The County Emer -

gency Plann ng team presented the scenario and then invited actions and resp onses from the voluntary services These were in turn reviewed by the emergency services and broad agreement on the best way to act was reached

"We were there with people from the police, county ambulance, fire and emergency and county council"

"We were there w it h people from the police , county ambulance , fire and emergency and county council. I th ink that the full role and potential of the voluntary serv ces beyond the first aid function was realised in Berkshire for the first time ," says Elaine "We could report on the experience gained at Hillsborough , Bradford and Hungerford and how we dealt With shocked spectators ,

lost children and the setting up of emergency phone lines and we were listened to with respect. "

It became apparent during Exercise Heliball that the t me was right to plan a pract cal disaster exercise that could put the lessons learned about co - operation to the test. A regular forum was also planned to make sure that experience was main tained Elaine will be part of that forum along with the professiona l emergency services.

It was nine months hard graft for Elaine to get Exercise Hel iball off the ground but she succeeded and in do ng so gained respect for St John

There are now opportunities for St John that have never existed before but these opportunit ies ex st for other organisations as well. To make the most of them local off icers will have to assess the r own situat ons and do someth ing about t. Emergency planning has gained mportance because of events like H ill sborough and Bradford - it s a chance for St John to become involved in a big way and it won 't be repeated It really is now or never

MARS is a state of the art resuscitator, designed to the requ irements of 8S6850 (1987)

MARS is very simple to operate , leaving the operator to concentrate on patient care , not try ing to remember how to use the equipment.

MARS provides resuscitation for patients who are not breathing .

MARS detects spontaneous breath ing and automatically switches to breathing on demand mode

MARS will detect spontaneous breath ing fa ilure and automatically return to cycled resuscitation mode.

MARS warns of an airway blockage.

MARS also provides Oxygen Therapy - can be used at the same time as resuscitation mode

MARS is supplied in a compact , robust lightweight case with all masks , airways and therapy outlets required

Sabre-AAV also manufacture a comprehensive range of Domiciliary and Portable Oxygen Therapy equipment.

Sabre-MV Limited, Unit 1, Blackwater Way, Aldershot, Hampshire GU12 4DL, England

Telephone: Aldershot (0252) 334581 Teletax: (0252) 21993 Telex: 858251 SABRE G

Jockey Club

Working to improve the I iockey's life

y"Carole Richmond

r from the Jockey Club mean that 1igher standards of treatment than ever will einforce at racecou rses for the people that ave the dangerous job of riding the horses I has been felt for some time that jockeys ere in a vulnerable position when injured ndthat medical standards had to be raised working party was set up and it is this )arty 's recommendations which have been mp lemented by the Jockey Club

Chief Commander Dr Herbert ElliS was a nember of the working party and the new 'Ules have direct relevance to the St John :rews at race courses

The working party's recommendations :ome into force in January 1991 and the ninimum levels of equipment and personnel hen acceptable at racecourses are as ollows : two ambulances with cross country :apab ility, staHed by two qualified ambuance personnel and carrying the following

One York stretcher

Vacuum mattress

Poles and canvasses

Defibrillator and Monitor

Airways (Guedel)

Infusion equipment

Inflatable splints

Trauma box

Entonox

Portable Oxygen

Sheets

Blankets

Fire extinguishers

Urinals

Masks

Full range of wound dressings

Disposable gloves and gowns

One orthopaedic Scoop stretcher

One carry chair

Laerdal Suction Unit

Resuscitation equipment

Intubation equipment

Intravenous fluids

Intravenous poles

First aid box

Piped Oxygen

Space blanket

Pillows

Water flasks

Bed pans

Sphygmomanometers

Incontinence pads

maxon

Illobile radio

Recognizable by : • Disposable head bag, making cleaning unnecessary and eliminating the risk of cross -i nfection between students.

• Unique, patented personal face mask also reducing potential for cross-Infection

• Breathing is done in lifelike fashion , through nose and mouth , not through another part of the body

• Chest rises and falls, stiffness adjustment simulates chest compliance ranging from a young child to an adult.

• Lifelike stomach expands if insufflation technique IS wrong

• Sophisticated instrumentation monitors insufflation techniques , pressure and hand positions as well as air volume Display can be read from both sides, providing convenient instructor/student interaction

An offer this good, turning in your tired , outmoded non Ambu ® training doll for £105 reward towards the purchase price of a new Ambu ® Man , can t last forever

So make you r move now!

Ambu International (UK) Limited , Charlton Road, Midsomer Norton , Bath BA3 4DR Telephone 0761 416868. Fax 0761 419429

"If:) _ ,

Since November 1989 National Headquarters has been preparing specific , extended training programmes to meet the needs of racecourses Obviously these improved standards will be useful in a much wider public sphere It is anticipated that this training programme will be circulated to the Count ies sometime in May and the pilot courses are likely to be organised in London under the control of National Headquarters

The jockeys themselves have welcomed the new guidelines although many were quick to point out that they had no complaints about the service from St John " Medical services have been improving at a lot of courses in recent years, but now they will all have to come up to scratch ," says Peter Scudamore , champion jockey and Vice President of the Jockey ' s Association Jockey Club spokesman David Pip e explained why the working party had been set up " It was becoming obvious that eXisting medical facilities were feeling the strain " The working party agreed that local contracts would be the most eHective way of doing this and the voluntary services will be able to tender for this work along with everybody else , although in some cases it might mean upping the standards." As with football grounds it is up to St John to prove that we can meet any standards laid down Further details will be circulated to counties shortly.

51 JOHN'

News from Jerusalem .

Matron moved by the plight

of children

When Cheltenham nurse Joan Turner visited Jerusalem on a pilgrimage she was so shocked by the plight of the Palestinian children that she vowed to dedicate her working life to easing their suffering

Joan Turner is now the new matron of the St John Ophthalmic Hospital after the retirement of Pauline O Donnell due to ill-health

Before taking up her post in Jerusalem Joan worked for six months for Medical Aid to Palestinians with children in a village called Abu Dis

She then returned to London for a refresher course at the Moorfields Eye Hospital

" I'm very excited about starting work at the hospital" said Joan just before flying out.

"It is a real privilege to wo rk at the eye hospital" she continued . " During my visits there I ve been impressed by the wonderful atmosphere, it really is like an extended family. "

Joan is already aware that working at the hospital may present some unexpected challenges " Many of the patients we treat

Joan Turner are Bedouin who have never slept in a bed before and so they occas ionally fallout. Life has been difficult since the Intifada began , but as far as I can see the hosp ital has continued to operate very effectively in the face of all adversity I hope to ma nta in the standards set by Pauline O Donnell."

Tribute to the retiring matrc

The staff of the St John Ophthalm ic in Jerusalem , were extremely sadden e.; the sudden departure last Octob el Matron , Miss Pauline O Donnell , due health

As soon as she arrived f ve years ago, O ' Donnell realised the need for the to keep up w th modern trends in nur and

AROUND THE DIVISIONS AROUND THE DIVISIONS

-Haslemere

Manchester

A glorious cake wa cut by Mayor of Haslerr Bnan Gould to mark the retirement supenntendant Mrs Bullock and officer Mrs Laker The occasion was alsou\e!: celebrate the 75th anniversary of the Haslem Ambulance DiVISion

Isle of Wigh t

Mrs Edna Doreen Healingdle<.l recently atth;. of65. She had a long and distinguished recoi. service With the Brtgade, beginning in wart.. London 47 yeilrs ago, and undertaking !Ii. different roles. On the [slan<.l she was form: County Staff Officer (Cadets) an<.l had for years more recently been County Trt:asurer. exceptional service was recognise<.llast her elevation to Officer (Sister) in the 0

Before moving from Lon<.lon to the Island in Mrs Healing had worked With Lloyd underwnters: she then worke<.lfl)r a legal firm many years.

Greater Manchester, South West Area Irlam and Cadishead Combtned Cadet 01\ Ision Winners of the Area Untform Cadet compo and Joint IndiVidual Cadet WInner

Team left to right· Gary Eilts, Russell Lamas, MichelJe Plevin (Joint [ndlvidual Cadet Winner), Craig Lamas, Chris Davies.

High Wycombe

As part of High Wycombe's development as a key St John centre in the south of Buckingham hire a newly refurbished ambulance was handed over to Tony Hudson, Wycombe Group County Staff Officer by the Rotary club and duly bles ed by the Vicar of High Wycombe - Rev Michael Roberts.

Other gifts donated on the same day included a 35mm slide projector and carou el and a stretcher and catering kettle

All this was combined with the presentatIOn to Vickie Greenfield of her Grand Priory Badge She is pictured with Sarah Shelley, Michelle Cae ar, Paul Butterfield and Gill Brown.

Some of the cost of a new ambulance for the Hull combined division (pictured above) was met by 19,000 vouchers collected from the BP Lifestyle promotion.

Members of the division constructed and

distributed to BP stations throughout the, large boxes emblazoned with the St John I

These boxes asked all buyers of BP petll deposit any of their unwanted Lifestyle in these boxes. The result was £1,270 toWiJl'I refurbished ambulance.

Pictured are County CommissIOner L. Brut BP Retail Sales Manager Graham Johnson Hull Divisional Officer R Holmes.

Greater Manche<;ter. South West Area. [rlam and CadI. head Combined DiviSion Winners ot the Area Competition, the team is left to right. 01\ Officer Brian Hill (Best individual), ambulance members David Killon, John Wood (Best re<;erve \\. inner). The team also won best team test and overall competition winner

Northumb ri a

'Skipper' Peter Cole. age 88 years Former Divi lonal Superintendent of Sleekburn Cadet Division, Northumbria, <.lied 11th January, 1990

Started the Cadet 01\ ISlon in 1947 and was well known in Bedlington for hi., youth work. Presented The Peter Cole' Trophy to the county for the best Cadet of the Year.

Norton Radstock

Norton Radstock (Avon) Ambulance makes a rOund trip of 40 miles to remote areas to pick up elderly disabled people and take them to a day centre at Paulton Hospital Superintendent Philip Easley tarts the Ip at 0900 hr each Wedne <.lay, the dnver IS Usually Divisional Officer Jean Paxton from Common division, they return at 1600 I' and take the people home Some ofthe tealone and look forward to the weekly outing. or others it is a break for the families who are for them 24 hours a day. The photograph them being tucked in for the journey Eo me , With Divi IOnal Superintendent Philip behind him, Divisional Officer Jean xton, and Area Staff Officer Barbara Kelly

.. ........ -",'t: "lCJ .... + " -,_ -

Swindon

In 1989 John Leslie Yates (Ex. Dlv Staff Sgt) and hiS wife Ruble May Yates (Ex. County Training Officer) Wiltshi re retired after 50 yrs in the Bngade

John Yates was with the Swindon Combined DiviSion and acted a Dlv Secretary for 14 years Rubie Yates IS to become President of the Pressed Steel (Swindon) Division, and is still actively concerned as an m tructor for EA.W. In recognition they were both presented with the Brigade 50 year certificate

Pictured above is Lisa Sutherland ofTv.lckenham and Whitton Divi Sion receiving her Grand Prior Award on Fnday 9th February at Chase Bndge School Twickenham from Area Staff Officer Alan Croft.

Woodspring

Mrs Evelyn Miller Barstow, area preSident for Wood pring receive a basket of flower fromSt John friends to mark her lOOth birthday. She IS a Dame of Grace of the Order and an active member of the St John Council in Avon.

Carol and [Udrt La(harn L1m\ rap the tea er\'ice pre en ted to them to mark Stuart's 31 years of ervlce m Surrey They were watched by County CommiSSIOner Martin Kmg after he made the presentatIOn Stuart Latham is no\\ Brigade Secretary at NatIOnal Headquarters.

readers' letters

Questioning competitions

I should be grateful , if someone amongst your readers, could please tell me why the St John Ambulance holds competitions amongst its Members, in First Aid and in Caring for the Sick.

What benefits derive , either locally or nationally, from these competitions and who are the beneficiaries?

I estimate that less than one percent of the Brigade's total membership is regularly engaged in the specialised training of a competition team, which means that members are not deriving any benefits, either locally or nationally, other than the few which comprise competition teams

Is there any financial benefit to the St John Ambulance in these competitions? I can only comment on the financial aspect of local competitions, up to the level of the Regional Competition, since I have no available information on any pecuniary benefits which derive from the National Competitions in London.

I know that no financial benefits accrue from local competitions. Indeed, it is the escalating costs of staging and running these competitions which prompted my original thought of why such competitions are held.

Is there a public relations spin-off from the competitions?

Experience in local competitions, shows very little public interest, even at Regional Competition level, and from what I have seen at the National Finals, a similar situation applies.

So! What is the justification for spending each year, quite substantial amounts of 'public money' on something from which no benefit appears to be derived?

If anyone knows the answer, please let me know. It would be nice to have some justification for spending the money on this year's Area Competitions, before we start making the arrangements.

R. Bradbury Area Commissioner Northern Area, Nottinghamshire.

Ingnoring the disabled

I am trainee on the Youth Leader Training Scheme, ir. Unit 4 Phase 1 it is clearly stated that consideration should be given to disabled youngsters being involved in our work.

What is the point of this if, when these physically handicapped youngsters have passed, on an equal footing, the Preliminary First Aid examination we deny them the opportunity to do any duties with us? Thus denying them the chance of obtaining a

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.

Special Service Badge.

Surely this is defeating the object. How can we encourage them and then not acknowledge their worthiness as cadets?

While it is often true that such cadets are unable to run as well as their able bodied peers, they are usually quite capable of treating minor injuries As no cadet is allowed on duty without adult supervision should we not re-think the ' no duty rule and let those who organise the duties use their discretion of the ability of such youngsters to do the tasks required of them?

I admit that when it comes to transfer these young people to adult diVISions , duties could prove impossible for them However we are always in need of radio operators and clerical workers , so could we not channel the handicapped people , with the correct training, into these jobs, thus making the disabled feel useful , while at the same time filling vacancies normally left open

This area is causing me much concern , not just as the mother of one such cadet , but also because we are saying one thing and then doing the opposite In doing so we are discriminating against one section of our community.

P. R. Smith (Mrs) Bedworth Division

The Chief Staff Officer replies: The Commissioner in Chief acknowledges the contribution that persons with disabilities can offer to our organisation A number of difficulties arise with this and he has therefore arranged to set up a small Working Group to investigate and report as soon as possible

We had to be there

In reply to Mr Skinner's letter in the February issue, our Division has now attended 1300 999 calls since the beginning of this dispute

Whilst most of our members would agree with Mr Skinner's comments regarding the political situation of the ambulance dispute and support the ambulance personnel's

claim , it is not for St John officers to me judgements based on supporting the other, although individual members have the choice.

Order Investiture by the Lord

A request was made by the Police ano responded for all the right reasons We e not trjing to step into anybody s shoes1 couldn t hope to provide as good a serviCl the full time ambulance service does w' working normally AS COMMANDER

Prior, February 8

Our members , who are no t Sir John Alexander Carter experienced as full time crews , h Vera May Crosby answered emergency calls In the past Surgeon Rear Admiral David Laskey behalf of the London Ambulance Se Lammlman LVO OHS FFARCS and It IS true to say that their officers do' Frances Erskine Gracey confidence in our ability to do the job wei Wilfred Thomas Arnfield SJA crews in London have been train ed Ursula Harrison SRN SCM HV h gh level and have undertaken exa m Ro bert Ian Moss tions with LAS officers as the assessor

All of the drivers In our DIvIsio n' AS OFFICER passed a strict d riving test taken by a Pel Thomas David Briggs LLB advanced driver We are not profession Kathleen Lillian Quail but we must get away from the think ing" Geoffrey Brown TD MB chB nobody is capable of dOing ajob we ll un FFOM MRC? LRCP DIH SJA they are be ng paid I think that to Superintending NurSing Officer otherwise IS to deliver a severe blow to Elizabeth Mary Chandler OARNNS morale of our members whose 01' Kenneth Barrcroft Francis commitments are certainly suffer ng 2' Mervyn Doreen Redding result of the Increased workload Lady Bidwell I cannot understand , from a legal pOl' Frederick John Wells View , how uSing life saving f irst Ins Mae Lee Fowler procedures In an ambulance answe ring. Peter Thorpe calls can be different to an y 01' Dorothy Eileen Mortimore circumstances Ernest Moubray Glossop

If you dialled 999 In the cap i tal du ring Pauline Maud Robus dispute and asked for an ambulance, el Richard Arthur Welch MSc an Army ambulance , a Police van , a MB ChB DOBstRcog MRCGP car or a St John/Red Cross amb ula' MFOM DIH would arrive Only the latter oHe rs Ian Laurence Mills

Essex Warwickshire

Royal Navy

Devon Warwickshire

Surrey Manchester

Cheshire Warwickshire HQ

Royal Navy Humberside

POAC

Humberside

appropriate level of comfort for the pal AS SERVING BROTHER OR SERVING SISTER IS capable of transporting a bab y Ir Incubator and has enough room In sldt the patient , doctor, nurse and equ lprr required when transferring cntic alh patients

We have travelled to the other sidi London before now because ours was only suitably eqUipped vehicle for the There is no doubt in my mind that t· patients would have suffered 01 considerably, perhaps even died hao followed Mr Skinner ' s policy Ce rte relationships With some LAS personn el all) have suffered but should we sacrif ice: ideals for good relationships?

We have the right equipment correctly trained people filling a vital nee( humanitarian reasons If that results Int PR then I think that is the price we must; Paul Newman 0/0, Leyton and Leytonstone Divisio'

Write to the St John Worl letters page, Editorial Office, I Grosvenor Crescent, Londo SW1X·7EF.

Fundraising Your check list for having a ball

F U n d ra I - 5 I- ng-;ie xcell ent advice on the ?asic p rinciples,of fundraising. The leaflet IS deSigned With local branches in mind. It outlines 12 differ-

he

I

p fro m ent sources of income whi ch can be exploited, from collections to covenants, raffles

headqua t

to Rotary Clubs , gifts in kind to Give as You r et Earn

Fiona Rankin Special Events Officer

Could your version of the St John Ball be a moneyspinner?

EVERY year, St John headquarters at Grosvenor Crescent organises the St John Annual Ball in December to raise money for St John Ambulance Br igade and St John Ophthalmic Hospital. Weeks of organisation, selling tickets, decid ing on menus and entertainment and arranging for items to be donated for the auction and raffle prize draw culminate in a super night out where guests may wine , dine and dance into the early hours. The St John Ball regularly raises over £50,000.

Principles

You will not have the facilities to organise an event on this sort of scale but the principles are the same whether you are trying to raise £100 or £10,000.

Good organisation is essential. The best way to ensure that one person doesn 't do all the work is to form a committee (however this will slow the decision making process)

Each member then takes on a specific task such as a souvenir programme and advertising or getting prizes for the raffle.

Cost

F d , covenant forms un raising IS an occupational hazarl anyone involved in a charitable orga' At the current baSIC rate of tax co venants tion - have you ever wished it were ea!' can Increase the value of a donation by a The Marketing and Appeals depart. third, ,c ourtesy of the Inland Revenue. A produces a variety of materials to donation of £1 00 at no this field, and outline below are the extra cost the donor. ThiS IS too gO,od to ments and leaflets currently miss out Separate forms are are designed specifically for use by SI for use by IndiViduals and by members throughout the country. and both can also be used for depOSited All these materials are available fre: covenants. charge! Legacy leaflet "A will to help others"

Fundraising - A guide for St John A number of the largest national charities lance v?lunteers receive over £20 million annually through

An A4 size ?ooklet prepar ed by LIZ Ga legacies, and only three percent of wills Sponsorship and Promotions Manage' proved in this country include a charitable pan arranged If required Perhaps small tab le gifts of perfume or cologne could be donated and this too should be indicateo Planning thiS : Ticket price : £60 (admISSIon £15 Whether you are organising a ball , dlnVA T, voluntary donation £45)* ner uncheon , sporting day or Simply a re•Any person paymg only the baSICm the above should serve as a gUldemum charge will be admitted to the flJ li ne With careful planning and lots of enthution without making any furtherpaymf slasm you cannot fali to organise a memoIt IS important to remember tha rable and hopefully , profitable event. often if people are unable to alte r'/: Have you organised a local event which event : they may be to proved an absolute moneyspinner? St donation towards Menllo; John World wants to hear from you as we on your ticket application forms a series of practical fundraisIn9 Ideas. Contact the Editorial Office, 1 Sponsors Grosvenor Crescent , London SW1X 7EP.

If you have good contacts With

bequest, This leaflet is a brief guide to making a will. There is a blank box for County office or Divisional addresses.

Give As You Earn leaflet

The Give As You Earn payroll deduction scheme is gradually becoming an integral part of charity fundraising, providing regular income which is essential for efficient planning. Between April 1987, when the scheme was launched, and the end of October 1989

98,000 people signed up for Give As You Earn 4,700 registered beneficiary charities and branches had received a total of £7,1 million and the average donation is £5 30 per month.

A new leaflet, incorporatin g suggestions from County representatives, is now available. It includes a reply slip which can be stamped with a local address

For further details on any of these leaflets ring Christine Muskett at National HQ on 01 2355231

You must work out how much your event is going to cost you and then how much income you are likely to generate With this 16 simple exercise it may become obvious that the event will not make money Your main costs are likely to be the hire of a venue, catering, entertainment , printing of stationery (including ticket application forms , tickets, souvenir programme , raffle tickets , posters), decorations and photography (guests will pay for photographic reminders of the evening).

The pr ice for a ticket should be established by working out what your costs will be , deciding how many tickets you could sell and then working out accordingly what each ticket should cost. It is important that your tickets are available at a realistic price. If the cost is too high then tickets will go unsold and no money w ill be raised However if you can manage to keep your costs low you might be able to build a voluntary donation into the ticket price The total ticket price should be broken down on the ticket application form to show that the price includes a voluntary donation and that guests will be admitted without paying this if they wish VAT need then only be charged to that part of the ticket price which covers your

return you can offer complimentary tiC' the,re IS a course at National Headquarters advertising in the programme or a which might interest you. On 14 September display on the night. The local pressalY there IS a one day fundralsing course which might well be interested in the com pa' diSCUSSion and identification of involvement with your event. Iffere nt methods and offers guidance on There are different levels of spar chOOSing the one best for your specific ship. A large company might be preparf The price is £6 and is a legitimate pay for the hire of the venue and the e< argeonCounty , Areaand Divisional funds ing, a small florist might just agreeto pro t or further details ring the Course Adminisfloral decorations for nothing If spor on 01 235 S231 ex : 253 ship is not possible for some compa. from Hargreaves Photographic they might prefer to put an advertiseme Polaroid Fundraiser pack , which your souvenir programme These a Polaroid camera and 10 Polaroid cover the cost of all your printing. ball film packs , plus fun photo mounts , publicity posters , streamers and a Smoothly and e book. By taking photographs seiling them in folders for £1 50 (or Y?ur event run as more), you can make a rofit of at £50 pOSSible. People Will support St John for every 100 shots RP t d h t ' f t 'f th t egis ere c an les ure I e name sirs memones 0 recoverthe 15% VAT on the ack which night out where everyone was looked acosts £99 75plusVATf N 'I Cloakroom facilities should be prov id: corsage or b uttonhole presented t Ount, Hawthorne Road Litherland Liverguests on arnval and a table and seapool L20 6PX (051 9229922), ' FETE & FAYRE ENTERPRISES LTD. CARS HALTON SURREY SM53PG TEL: 01-647-2964 01-773-0842

Publicity Getting the message across

by David Mc D ine

A St John Ambulance hero proved a fundraising bonus when he appeared on That's Life. So much so that there was good news the next day for John Mills , the Order'S Director of Public Relations , when he spoke to a group of St John fundraisers and discovered that the public was giving much more because of the TV coverage.

"The story of the St John member 's bravery in saving a boy ' s life touched viewer'S hearts ", says John , "i t was an object lesson in how positive public relations efforts can create a favourable climate for fund-raising."

Effective PR is equally important in the battle to win recruits , in publicising events , encouraging the public to take first aid courses and generally raising awareness

The St John PR effort is co -ordinated and directed from national headquarters and there is a continuous campaign to present the Order in a good light.

However it should not be left to headquarters or the county office to put St John across in a good light. The St John story is essentially a local one, involving local people at local events The County PRO cannot be everywhere at once and there may be times when you have to act immediately to grab the opportunity to raise the public prof ile of St John.

"To use PR effectively you need to get to know the people involved and provide the type of material they want ," says John Mills

The best way to do this is to draw up a list of local newspapers , radio stations and regional television contacts and then to let each of them know about any local events you plan such as a recruiting campa ign or public first aid course

When you send a press release the key word are simplicity and brevity-try and get the main point of your event over in the first paragraph It should be on headed notepaper, marked news release, typed on one side only , with double spacing and wide side margins An absolute must for any news release is that it should include a contact name and telephone number.

Local radio stations offer many opportunities for publicising St John. Colin Mason , a memberofthe Stjohn PR 'think tank forthe centenary, is managing director of the Chiltern Network , a group of four stations He believes that St John volunteers should not wait for the broadcasters to make contact but should knock on the doors of the radio station themselves.

RI:'

Fast-Fold

John Mills, St John Director of PR , holds a certificate presented for excellence In PR You can

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WELCOME to a special page devoted to the Three Cross Award scheme. I ' m thrilled to be able to say that the scheme has already given someone the necessary skill to save a life - see Robert's story below

I'd also like to · congratulate the students at Badger House for the perseverance and dedication they showed in studying Three Cross with Mary Thomas. You can read Mary s story on the right.

Let me know if the Three Cross Award scheme has helped you and I'll tell your story to the World!

WH EN seventeen year old Robert Back took his Three Cross Award as part of his public service college course he wasn't to know how soon his new skills would prove to be useful. A student at East Devon college during the week Robert has weekend job at Norman s Cash and Carry in Newton Abbot. While he was working there a colleague was badly injured by a fork lift truck Composure

The store's manager, Mr Stacey tells the story " As one of the first on the scene, Robert displayed immense composure and administered First Aid in a very professional and re-assuring manner His presence had a claiming effect on the whole situation. I have no doubt that Robert helped to save that man's life ."

Robert's is one of forty students on the Public Services course to have completed the Three Cross Award

Teaching Three in a special way C

Mary Thomas County Staff Officer Training

Berkshire

BADGER HOUSE is the Extended Education Unit of Brookfield School , Tilehurst ,

Reading The Unit caters for students aged between 16 and 19 years who have either severe or moderate learning difficulties One of the aims of the Unit is to make them as independent as possible and therefore they need to be able to deal with any minor injury which might occur during normal everyday life

A small group of students with severe learning difficulties had completed a course on Home Safety which had increased their awareness of the dangers in the home Their teacher, Elizabeth Chapman , felt that the natural progression would be simple First Aid instruction to enable them to cope w ith minor cuts , bruises , burns and scalds She approached St John to see what suggestions we could make regarding the syllabus and between us we produced a possible programme

I agreed to go along to Badger House after the students had had some preliminary instruction to reinforce the teaching and to give a different viewpoint. It soon became obvious that specific teaching techn ques would have to be used Everything had to be broken down to its very simplest level and nothing could be taken for granted Casualty make-up was used to s i mulate wounds which the students then had to treat. Their concentration was remarkable and even the most limited student achieved success. Frequent repetition reinforced what they had learnt.

From cuts we progressed to bu rm : To mtet people , :: , POLICE :: scalds where the problems of differe nt '

work 'n a team, >. between hot and cold water, concepts c:

and different textures of cloth had :

taught. When practising the treat me' :

patients literally had to keep the For furthrr cold running water for 10 minutes as t: Inform:.tion

by the clock on the wall ! There was no : InCfuirt at your way of making them realise how Ion : localpolktstatlon

treatment had to continue or ring II!

We also covered fainting and th is for An application rorm CONST AB ULARY :: the teaching of the recovery posit ion. lw.·

incredibly, to the recognition of uncon sc _-------------------------. ness The students amazed us by their, to remember the sequence of ope ra and to put them into pract ice. The ydl so successfully that we then tackled tiJ; of the telephone to make an emergenc Again there was much to remembe ' many problems to overcome , part lc

SUMMER SCHOOL MATRONS

remembering and d ia lling the nu Qualified Nurses or fully First Aid tra ined individuals With sUitable making themselves understood and c expenence are requested to act as Matrons In Residential Centres for - ove rseas students dUring the summer (July and Augu st) a sensible message A compute r DUlles entail First Aid and nursing duties plus welfa re requirements and gramme and two way telephone in thf accommodatIOn were used to teach these skills Pay £:130 00 per week plus full-board accommodation A v isit to the local hosp ita l helped th For an application form contact : EF Residential Department, 1 Farman Street, Hove , Sussex BN3 1 AL. SJW) complete the p ic ture and taught thE -I recognise important words su c'

and Ambulance '. At every stage in the program m' practical work was complemente colouring work sheets and the

CLASSIFIED Apology

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CONTRIBUTIONS

contributions to the Sf John World are always welcome They should be typed, treble line spaced, on one Side of paper only (if in longhand please pnnt names of people, places, etc) and sent to the editOrial address below If pOSSible supply a phone number for the wnter Matenal can vary from a paragraph to a 5,000 word article - but It should all have some connection With St John and ItS work Photographs should be glossy black and white prints

SUBSCRIPTIONS

Team work and terror in Trafalgar Square

S t John Am bul a n ce

c r ews wo r ke d h a nd in hand w it h th e London

A mbulanc e se r v i ce durin g th e viol e nt poll

ta x di s turban ces in

Trafal g ar S quar e,

w ith not a tr ace of bitterne ss from th e ambulance di s put e Carole Richmond

report s on th e Stjohn

e x perience that da y.

Publi c Duty Officer Derek

Rud ge who ran th e St John operation says "T here was complete co-opera tion - LAS

crews eve n bought us refre hm e nts when we were too bu y to move."

A poll ta x prote t which had been bill ed by th e organiser as a family day out ex plod ed into violence on Saturday 3 1 2

"We were briefed a nornlal" says Derek" and we had three mobile first aid pot and eight ambulances to cover the protest march.

"Luckily when the trouble nared we were able to call on 20 other vehicles that had been anending football matches and the boat race in the London area. Ten of those ambulances were sen t immediately into Trafalgar Square."

St J ohn crews treated 10 2 people and 43 of tho e were taken to hospital.

A St John crew was stationed at Dow nin g Street and wi th the ag reeme nt of a LA officer a s huLLl e se rvi ce was se t up with t John ambulance ferrying th e casualties to a pick up point where th ey were take n by LAS tr a ns port to ho s pit a l.

On e of th e designated ho s pital s - Univer ity College Ho s pital - had to c lo e during th e afternoon because s taff co uld not

cope with any more ca..,ualtle,>.

The majorIty of casualtie" were brought out of thc trouble areas by civiltans and police but on one or tw o occasiom St John member. went in to get the Injured out.

"We were not there to play heroics but it is imp0..,slble to ignore a wounded person " Most of the crowd was helpful, but a lth ough no t John per onne l were a LL acked an ambu la nce was s toned and damaged wi th a piece of wood in th e axle. There was animosity towards anyone wearing unifornl

"One of th e most distre sing thin gs" ays Derek, "was the way th e crowd reac ted to injured policemen.

"We had to s tr e tcher tw o un consc io us co ns tab les ou t of th e c rowd a nd a we did so th e ri o ters c lapped a nd jeered"

Mo s tofth e injuries dealt with were fractures and head wounds o bod y was lef t unauended

al though ..,ol11e had to wan ICO' ambulance to arme.

'> the lolence fillied '>tnggered and ..,10\\ stand dl was co-ordinatcd by 5t J, mbulance and the L

Most crews had gone h by I Cl.OO but three tJohnv eh werc not '>tood dov n u 11.00pm "By then the stram beginnIng to show" says Dt "it had been a long day ." Derek has a wiele cxpene of riot duty in London bu t admits that th e Poll disturbances were the n: frightcning.

" ) was at th e GrosvenorS q anti - Vietnam riots in the 1 th e ou th a ll an ti-raci t riot sW even ti cs and numerou ' 0\1 Hill Ca rni va ls butmyexpen er in Trafalgar Square were the n horrify in g yet.

" We will learn from expe ri ences th a t day but I ho oe hope that we never have It thro ug h a ny thin g I ik e th at agd

NEWS

Taught

by St John to save their mother's life

WHEN Ashley (seve n ) and Matthew (J 1) learnt fir s t aid during a chool holiday the y didn't r ea li se that the le s ons the y were taught wo uld one da y ave their mother 's

They

C ou rage

Ashley and Matthew learned their fir t aid on a chool Venture Holiday at Butfin in Ooniford Bay , orner et. Butlin run many of th e e holida y throughout the country and t John

To

Photo RIchard Gar

New Barnet HQ opened by Margaret Thatchel The video

that saved lives before it was launched

by Kate Macher

e' and in h e r subsequent speech surprised man y pre ent with h e r knowl e dg e of the Order and the work of St John Ambulance includin g Ca d e and Badgers.

During a tour of the £240,000 building (w hich i already bein g used for First Aid at Work cour se for indu s tr y and commerce), th e visitor were shown the damage cau ed to Barnet Dh i ion ambulance during the poll-tax di turbance in Trafalgar quar e

PRIVATE MOBILE RADIO FOR THE BUSINUS USER

Every year 800 - 900 children die from accidents, halfofthem under five years o ld It was growing concern abou t this figure which promp ted t J ohn Ambulance to launch a video designed to ave babies'lives pon.,ored by Heinz and called 'Breath of Life', the

Ian Video is a 15 minute step-by -.,tep gUide on infant re'>uscital1on

The \ideo IS narrated by Esther Rantzen, V\ ho say., : ·'It IS immensely valuable for anyone who has ever worned about what the) would do If a baby stopped breathing " PublIc awarenes of the high Incidence or chIld dcath was heightened rcccntly when Dr Da\ id Zldcman, 'isistant Surgeon-in-Chicr to John Ambulance, appeared on B B Television's That's Life with Ether Rantlen and gave a demonstration on Infant re u.citation. In the 1'0110\\ ino week., as a direct result of broadcast, three babies 'live were aved.

Esther commented "It's one

Soap stars launch Cross video in Wales

f of th e best thin gs that has e er happened to That's Life:'

Eight month o ld hloe rrom Dagenham was one of those babies. Her grandmother,

Two stars from the children's soap Grange Il ill travelled toa\\ Kathleen Dolan, k.ncV\ exac tl y school to launch the new Three Cross Award Video in Wale s.' What to clo when Chloc started Maguire and Paul Adams, better k.nown as Tegs and Matthc\v \ chOking because or what she had Riscn ComprehenSive school in Gwent and while they were seen demonstrated on television , presented pupils from all over the county with first aid certlfical Kathleen's quick. think.in g Scan and Paul were chosen to launch the vldco 111 Wales Ix proves th e value of th e visual thcy had acted a first aid Incident dUrin g an episode of for teaching First Aid. , t The y wer e .Jolncd a t the laun c h by Wclsh und

prOV ided

John

IN BRIEF

\I1 hospitals, ante-natal clase and health visllor clInic. t the launch of the \ ideo \I1 pril Dr Zideman pok.c about the importance of learning infant re'>u'icitation.

"There is nothing more sobering than the death of a child. Ithough pre\ ention is beller than cure thi , is not alway po'>sible The cure here must be infant resuscitation.

"

s you will see in the ideo there ar man auses of death in young children It has alway seemcd strange to me that a mothcr-to-be is fully prcparcd 1'01' the V\ onderful birth of her baby in ever thing c\cepr \\ hat to do in th e ultimate cmergenc)

ml It is not only l1lothcrs wc shou ld bc considering. Ho\\ man professional bab) mindcrs ha e formal First id tr aining'? Il oV\ man) bab sittcr", grandparen ts. brothers and sisters \Yould k.no\\ ho\\ to copc in

terril') ing -ituation?

"A a paediatric anae theti t and Chairman of the Paediatric ub-committee of the Re uscirarion Council in the United Kingdom I have been made more than aV\are of the need for a teaching programme on infant re ucltarion

"We in t John mbulan e incerel) hop that thi "Breath of Life" \ ideo \\ill fornl the foundation for training in infant re uscitation throughout th e country and that. as a result. \\ hen a bab) need - help. someone \\ ill be there \\ ith thc k.no\\ ledge and the abilit) to perfornl the e simpl liCe-sa\ ing techniques.

"I consider this film an important landmark. in teaching infant resuscitation."

The 'Breath of Lire' \ ideo i a ai !able for £6 99 plu £ 1..+5 P P from t John upplies. Prior) I louse. t John's Lane. London E IM.+D

FROM HEADQUARTERS I

BRIAN ROCKELL , DIRECTOR OF SUPPLIES

There' good news for St John in thi year' Budget. Through the Charities Tax Refonn Group we have been pre ing Cu toms and Exci e for orne year to extend the existing relief on VAT to traini ng equipment and thi year re l ief ha been granted.

The relief cover medical

eq u ipmen t u ed for training and t hi particular l y benefit re u citation training models.

Supp lie h as now reduced the price of a ll Re u ci Anne model and accessorie and Stjohn Unit

cou ld sav over £30,000 becau e of these c hanges.

We have al 0 been pre , ing tha t a wa terbome ambu lance used by St John for fir t aid and rescue purpo e should be tr ated e actly th same as a land based ambulance.

Reliefhasnowbeene tended to cover t hese and also airborne ambu lance - though it is not known who i going to buy the fir tone!

The reliefi not retro pec t ive and came into operation on the 1st May.

Purchases of eligible goods from t John Supplies do not require a AT de laration but to claim the reliefrrom othersources a declaration ha to be completed.

Privileged Cu , tomerCard holders have full details on the extensive li t of products on which we have been able to secure relief, along wi thdetail of how to complete a declara t ion.

Privileged Customer Card holders are being mailed W Ilh an up to date Customer Card showi ng the telephone number changes and details of our phone hnes

Remember t hat all London number. will be changed from 6 th May and both Grosvenor Crescent and St John's Gate numbers will now be prefixed 071 instead of 0 I.

aid the process here IS a Ii ,t of the hospital representatives on those council tha t have appoin ted them

Avon - Dr Angela LOckwell

Bedfordshire - Mrs M Biswell, MBE

Berk hire - Sir Peter Hudson. KCB. CBE. FBIM. DL Buckinghamshire - 0 representallve Cambridgeshire - P Marshall and Squadron Leader R Mills Cheshire - Mrs E.M. Young Cleveland - Mrs W Worland Cornwall - Major Charles EdwardCollins Cumbria - Mrs John Gillman

Derbyshire - Col. L. Wright, TD DL

Devon - Mrs C. Lee - Fowler

SIR STEPHEN MILLER, HOSPITALLER

Th e a pp o intm e nt of H os pit a l re prese nt a tiv es on co un c il s has pro ve d a s uccess with a ware ne s o f th e Ophth a lmi c H os pit a l in J e ru sa le m improv in g g rea tl y. T o 6

Dorset - Gi les Romanes, FRCS

County Durham - W inifred Gray

Essex - Dr. M.A. We ll er, OBE, MB, BS Glouces ters h ire- Mrs A tkinson, RG

Guernsey - No rep re enta ive

Hampshi re - urg. Capl. A. Rin toul, F RCS

He reford & Wo rces er - Lady Roberts

Hertfors h ire - 0 rep resen tative

Hu mberside - L. Barker

Is le of Man - No represen tative

Is e of W ig ht - No re prese nt ative

"It i<; of paramount Importance that OLlnty Pre<;ident" allend the BrIgade Conference III Augu"t " ,>ays Georgina Phillip the hler President.

" s the conference ha the title ' I nto a Decade of Opportunity" it is obvlou l) vcr) important that Pre'>ldents meet executive officer and member" to di"cu,>s their role in the future

"There IS no way that Presidents can contrIbute to the growth of St John unless we become part of the team effort

Jerse) - Mrs T H Boothman

Kcnt - 1'\0 representative Lanca hire - 0 representative

Lelcestershlre - D I lead ley MG

Ltncolnshlre - J Jollands

London - P Cracroft-Brennan

Manchester - Dr. M O' onnor

'v1erseyside - 0 repn::sentall\ 'c orfolk - J Thornt n orthamptonshlre - F. Roberts orthumbna - R Bellwood

orth Yorkshire - Mrs crope

olltnghamshlre - The Ven G. Handford

Oxfordshire - 0 representative

Shrophire - Jane DaVidson, RG , o C

Somersct - Mrs J Lloyd

South & West Yorks - D Cooper JP

taffordshlre - 0 representatIve

Suffolk - Major A Dubes , MC

Surrey - R Henry, CBE, LVO , PM,

CB IM

Sussex - Dr Grey Giddings and Rev

Dr Lawson agel

Warwickshire - Dr Michael Coigley, MBB ,F RCGP

Wes t Mid a nds - Mrs Jaync Caclbury

W lts hire - o untess athcan

ommanderyof Ards - Col.J. Hughcs

Priory of Sco t land - Col. A J Wa ll

Priory of Wales - Mrs McDouga ll

and to do that we m communicate at all leveb WI\ the organisatIon.

"There arc incredibl e th l happening in the counties tho'ie that have had Succe\ e periences have the their knowledge with tho se need it.

"The BrIgade conferenc rare opportunity to exch. information and we thai 0PP0rl1l11Ity:'

The Bngade conference " from ugu t 31 to SC[lter at the Winter Garden\. GI Mah ern, Conference and accolllmodal hooking should be made thnx

Looking at the range of careers for the nurse

by Helen Etheridge (Department of Health Information Section)

NURSING

and technicians You need the abilily not only to listen to other people's opinions, but aho to express your own, succinctly and clearly.

Although the physically and emotionallydemanding work can involve long hours, the sati'ifaction of seeing someone well and able to fend for themselve s again i considerable. There are bonuses which cannot be found in many career. - like seeing the expression on a patient 's face a you progres together.

ur ing IS about the total concem for the parients and their health : helping them overcome immediate problem , and look after in the future.

R eg i t e r e d M e nt a N ur e ( RM )

individuals They have the same rights and respon s ibilities as everyone el. e. The job of the R MH is to develop the full potential of each person according to individual needs ci rcumstances thei r and R MH<; need a mixture of practical teaching and nur ing In addition to the usual nur<;ing skIlls and discipline Clients range from the severely handicapped, who need to be taught the very basic (lIke clothing and feeding them elve ), LO the Ie everely handicapped who need to learn in other kill

You will need a highly agile mind to find a ucce sful approach plu the patience to keepon trying

ROS BIDMEA D DIRECTOR MARKETING AND APPEALS

The marketing and apr department are plea'ie d announce that Barclays Ban recently made a donal1 on £ I 0,000 to t John Ambuluf)

The donation was made un the auspices of Bar " ommunity Enterpnse 'ich( and wil l be used to help prol training courses for Bn1 members, particularly leade r Eight weekend course three - part manag ment cour Making Presentations, C, o Training, adet lnstru Training and Cade t Aid Training - are to be helpei the do nation as we ll as fil'e o day workshop

T hi s £ 10,000 will Barc lay' o nl y do na io n toStlt th is year a nd it is good that II' be spe nt on projec t · that th e w ho le organisa t ion.

\l ur e edu cati o n i curr entl y und er goin g a ma jor reform. A n e w y tern of nur e duc a ti o n ca ll ed Project 2000 ha beg un which lea d to qualification a a fir t le ve l nur e More cia room ba e d and acad e mi c th a n th e pr ev iou method of trainin g nur e Proj ec t 2000 will run in tand e m with the current y ' t e m until it ha been introduc ed throu g hout England.

When you appl y to ent e r nurse education , you can choo se to be in e ither y t e rn.

In th e current y t e rn of nur se education a r e man y area s that offe r Chall enging and ati fy in g ca reers - Regi s tered

Nurs e, R eg i t e red ental Nur se, R egi ter e d Nur se for the M e ntall y Handicapped.

R eg i t e r e d Ge n e r a l N ur e (R GN)

RG s help the sick and disabled back to health and independence In hospital and in the communit).

As a general nur<;e you would be e'l\pected 10 de elop a plan or nur"i ng care b) continual I) as e ing each patlcnt. s the nursing plan i put into aCllon. ) ou monitor and adju'>t it according to the patient " rcspon C c. ThiS encourage nurses to Ihink through alternall\ es bcfore making deci"ions \\ hich, in turn. means better care ror the patient.

s a nure, you \\ ould have re ponsibility forlhe tOlal nursing arc orpatients and would need to be selfreliant, using initiative and imagination You need to be indcpend nt too, as not all the training tak.es place in the hospital - you wi ll spend time working in the community.

R ha 10 be able to wor k wi th o thers in a I am, \ ith professionals uch as doctors. radiographer physiotherapists,

Mental illnes ma) be difficult to define but Its effects are clear. It ts concemed v. ith the abnonnal working.., flhemind.lts ufferers react to ituation in way that other people ma) rind odd. lion of people canuffer from mental illne n increa ing numberoftheelderl) are mentall) ill and require treatment - in thetr homes v. here er pos"ible One of the mo t encouraging fact. about being an RM the ucces factor: of their client. (a mentall) ill patient are knov. n) arc uccessfully treated. The greater percentage are trealed out ide the ho pitaL and of tho e adm itted 0\ er hal f return home within a month

Tact. pallen e and kIll are needed to qualify as aRM Y u need to be able to re pond to the changes in people \\ ho. in the early tages of treatment. may nOI be reached b) ordinar) r mlS of logic or ommunication.

R eg i t e r'e d ur e for th e M e nt a ll) H a ndicapp e d ( R N MH )

menial handicap i usuall) a condition a person is born wilh. though severe accidenL can cause it. Like an inherited phy ' ical handicap. mental hanJicap i a lirelong ondition

Today, mO l people be Iieve that tho e \\ ith mental handicaps be trealed like an) other

Once you believe in those you are caring for as individual helptng them de\ elop as far a ' the) can. no matter ho\\< limited that may be. I the challenge and 'iati faction of the job.

Other option for anyone choo inganur ingcareerinclude becoming a Regi tered ick Children' ur e or a Regi tered Midv.ife Pr oj ec 2000 7'ur e E duc a ti o n. The three year P2000 coures are held ar nursing and mid\\ ifef) ollege,> linked to college,> of higher educatIOn.

Eighteen month,> are pent on the Common Foundation Programme \\ hich pro\ ide,> a general introduction to nur ing, followed b) a further eighteen month in one of four areageneral nursing of adull children' nur -ing. nur<;ing of menta II) ill people. or nursing people \\ ilh a mental handicap You"illu uallychoo eyour area of nur ing b fore beginning your education.

For a more detai led look at all these nur:ing careerchoice ' \\ lite to: Health ervice areer•. PO BO"\ 20-t London E: 7E 11 one interested in a career in nur ing should check the n \\ recruilment se tion 10 be found at the ba k ofthi maga7111e on page _3 anJ 2"+

Then.: ) ou \\ ill find health authoriti offering courses

7

NURSING

The phenomena we call chronic pain

Robina Ma sse y is a nur se tutor w ho is no w se nior lecturer in profes s ional nur s in g s tudi es and di s tri c t nur s ing at Buckin g ham s hir e C oll ege of Hi g h e r Education. She is a N ur s in g Offic e r for th e Bri g ad e i n

Buck s . In 1987 s he w a s a warded the Fe d e r a tion of 18 + groups Nur s ing Bur s ar y for Profess ion a l N ur ses se r v in g in the Brigade and u s ed thi s to s tud y th e nur se's r o le in chronic and s e vere pain control.

nursing staff, relatives and friends. Ac, pain responds to treatment and the palie ge t s berter. It is more easily th an c hronic pain and ser e" a usel purpose by limitin g ac ti vity to aliG damaged ti sue" o heal.

hronic pain Impo e" se\e socio l ogical. phy"ical and emotlo tre" es on patient and their farn i lies. I: a comple ing, subJecti\ e e p rien cea, only th e person suffering th e P' understands how debi I i tating chronlcpa

\\hic h patients Differe nt personalities reac to pain in different way and pain ofte n defies both definition and measuremen t.

Nu rses must accep th at th e pain i" exactly w h a th e patient who i.., exper iencing it it i s. Thi i.., th e most accura te ll1ea<.;urement we can ge t and IInportance hould be attached to the patient's own perception of hi" pain , a there may be many other con tributing factor.., which heighten the pa tient perception uch a.., anx iety about family, finance or job 10"'''

There ore it is e<.;scntia th at a per<.;on who IS uffering pain i treated a.., the Individua he i.., and not compared wi th anyone el e who i.., ..,ulTering or ha'> pain in the pa<.;t. To him the pain Isun l4ue and nobod ha<; e er ..,ullerec.l a'> he has.

Often th e whole fami l y will need to be included in c.li"cu'>sion about the patient ',> treatment.

There are many ways nurses can minimise a patient'" pain, but first and foremos t th e patient mu"t be believed and involved in his own care. This approach

There is a need for the nur s e to continuall y de velop

s en s iti v it y and imagination b y tr y in g to put her s elf in the patient 's place.

NURSING

pain is fir'>t and foremost to empalhise with the patient and endeavour to understand the isolation, loneliness and despair most of these patient'> suffer.

The nurse needs to recognise the need for a team approach to care which must include the patient and if nece sary hi.., fami y.

There is a need for the nurse to continually develop sensitivity and imagination by try ing to put herself in the patient's place.

It i.., also neces'>ar y to understand our own reactions to a patient' pain.

When we ourselves feel fru trated because tr eatment does not eem to be working, it is easy to blame the patielll for putting it on. We are often. as nUL es. made to feel helpless v. hen all our effort seem to fail.

The purpo e of th e, tudy und ert ak en wa to under tand th e nur e role in c hroni c and seve re pain control and how patient. with benign intractable pain co uld be helped by the nur e's intervention.

Acute pain i accepted as the pain th at follow injury or infection and i exper e nced b everyone at some time [t can be relati ely minor, suc h a" a mild headac h e, brui"e or prain or major such as ap p endi citis or a fractured limb

It i ea ily under tood by medical,

hronic pain erves n u eful pUrp<l' and people ulTering prolonged pain. often mi underc.,tood, and lab el h pochondnacs or neurotic do friends ha e litt k undcr tanding nature of th e pain. and th e patient can' regarded a" a nui ancc and sO becorr isolated and depre sed.

In underta"ing a tue! into the natUIT cause and treatment of chronic pam ariou pain CIIllICS and t reatment th roughout lhe coun lr , it became Ie th a t there i" a wea lth of matenal 31 exp rtise avai ab e to nur ses. hea lth pr fe"sionals ali " e. wh avai them e ves of th e "n ow ledge

It became in creasingly eviden t dunn my tour that different pain u

d i ffe r e n t me th ods and d rfere approache and th er e are a variet) tr ea tm nts ava ilabl e which have pro \l\ succe" ful in tr ea tin g c hroni c pain.

The e in c lud e analge ie' tranquilli ser, anti - d e pressa nt , phyic. th e rap y (i.e. ice, h ea t, m assage ac upun c tur e, n e rv e blocb, autogenic trainin g, re a aLion technique' co un se llin g, gro up th erap y, th erapeull tou c h

Mo clinics hav e adopted multidi sc ip l inary approach to tr eatlll en u sin g a variety of pain re li f both on an in - patient or out-patient ba I)

How ev e r , both re earch and ex peri ene, are still inadequate in tatin g which 0' the se approache will be mo t help ful t

Pain i... a ubj cti e, per onal expe rience to th e per on who is ulTering from t and become th e major com ponen t of the live.., of the patients and their rami lie \Iho pre ent them elve for treatment.

ha proved ..,ucces"ful and rewa r ding in caring for patient'> with chronic pain.

The nurses role in the treatment and care of patielll" \}y ilh benign intractable

H owever. when v. e are succc"sful and have the privilege ofeeing omeone achie\e pain relief. or able to contro his pain in order to improve hi quality of life, the en<:.e of

i inde cribable.

The patient s ufferin f!.fro m chronic pain ne e ds someone who willlistt!n.

Why we should all care for the sick

Who h o uld take the Caring for the ick co ur e?

If al l member. were to take a caring for the sick certificate I think t John would have a tranger brighter future.

I'm very concerned that empha<,is is often placed on fir. t aid when the skills invol ed in caring for the sick are just as important if not more so when dealing with a first aid situation. Historicall the Knight of t John cared for the sick, not ju t the wounded,and we mu t 'v\ork to continue that theme.

aring for the ick, sup rvise on public duties and in hospital orhOIT for the elderly as well as clinical '>kills in the very varied actIn of t John.

I the Brigade a preparation for Ih, intere ted in nur ing a a career? s a rand Prior adet I can hone, sa that the preparation I received a cadet'> LOod me in good '>tcad for Ill) flU training and e4uipped me with leaders ,>kil"'. Mor cadet'>, male and fern ,>hould enter the nur<,ing

Ho w u ef ul are the kill learnt in '>0 continue the partner'>hip with Cari n g for the ick?

Chief Nursing Officer

Dame Audrey Emerton joined St John in 1946 as a cadet. Apart from her work with St John she is Regional Director of Nursing for the South East Thames Regional Health authorit y and Chairman of the UK Central Council.

A qualified midwife and nurse tutor Dame Audrey has strong views about the importance of nurses in St John. Here she explains to Carole Richmond why she thinks everyone in the organisation should take a Caring for the Sick course.

They are incredibly useful. tudents learn how to lift and move casualties and patient; how to talk to them in a reassuring way; how to dres and undress and how to care for someone in pain or trauma, as well a learning how to place them in a comfortable position.

I Ca r e in the Comm unit y the ame a welfare work?

o it is a much more intensive cours

I ee welfare a<; more of a neighbourly activity than a nursing one, though that is not to belittle welfare's importance. To do welfare work for St J ohn you need caring for the ick level one which give a ba ic knowledge but to perform nursing ta k you need leve ls one and two

What can so m eo ne qualified to thi le ve l do within t John ?

They can take on a upervi ory role at public first aid dutie and do voluntary work in wards for th e elde rly in ho spitals und er the s up ervision of a registered Nurse.

I s there a role for qualified nur se in the Brigade?

A very definite role in that Regi tered Nurses are required to teach a nd examine

Do you think the nur ing and C3r' ide of t John wi ll b come m l important in the future?

Yes I do. Th go rn men t ha rew released a white paper' aring for Pear which outline,> the go ernment' pi for communit care

This '>tat ,>" ommunit care me, providing the servi e and support \\n people who are affected by problems ageing, mental illnes'>, mental handle or phy ical or sen ory di,>ability need be able to live as indep ndently as pas)1 in theirown hom s, or in homely ,ellif in the community"

There is obviou,,> scope for St John provide som of this care and we mUll aware of the demands that an increai e ld erly population will pia e on SOC II as a who le.

The caring side of our work 01 now be emphasised so that we are een able to offer advice and help need it.

The Ca rin g for the S ick learoi module tak es up half of th e En er; pro g ramm e' induction cour e . il vital that p eo pl e within the Bri gade well as those out id e it recognis e import a nc e and treat it with the re it d ese r ve

Kent

Lesbia Sha v., a lire less \\ orker for t John in Kcnt, has retired after 17 )-cars of service ali county secrctary.

She was pre'icnted with a Illusic ystem by her colleagues at a farewell pany helclll1 her honour. he IS pictured above with County Comn1l',,,ioner Doug Ellis Who paid tnhute to her work o\cr the years as County ecn:tary and Brigade Officerasslstll1g at difficult public duties uchas the Leeds Castle open airconccrts and race mcetings at Brand" Hatch. Lesbia was made a ServlI1tl istcr f o the Order for her IIlvolvcmcnt In 1975 Order Servicc at Cantcrbul"} Cathedral.

Mair Farrimond and Lindsay William of the Buckley Badger et in Clwyd County proudly display their prizes after competing against twenty other badger teams at competition held in Mold. The girls were presented with their prizes of a shield and a watch by Mr Eaton, the Conlnlissioner for Clwyd.

Berkshire

Victona Yokota

on a separate occa Ion.

The Super Badger award is for those 'v\ ho ha\e pas ed a ">erie of challenge in first aid and general '>kills. Over 240 children in the country can now call

Clwyd County

Tammy Lennox fram Slough and Michael from the Woklngham Badger Set are pictured below with their Super Badger awards and Eric Hearne, deputy area commiSSIOner.

from Cippenham and Burnham receJved her av.ard

AROUND THE DIVISIONS AROUND THE DIVISIONS

Essex

John Hyam receives the keys to the brand new Metro City car, first prize of the Stjohn National Raffle, recently presented by Charles Houlding ofD. Houlding & Son, Triangle Garage, Heybridge, Essex.

Mr Hyam who comes from Burnham -in-Crouch, Essex purchased the winning ticket from Superintendent Brian Anderson of Burnham on Crouch Division.

Pictured left to right are: Divisional Superintendent Brian Anderson, Charles Houlding, John Hyam and his wife Joyce.

Chester-Ie-Street

Billy Usher was lying in a pool of blood when he was discovcred by Alfred Wilson. Luckily for Billy, Alfred is a Divisional Officer in the Chester-Ie -S treet division and he knew exactly what to do.

Billy was suffering from a fractured skull and had no vital signs of life. Alfred did mouth to mouth and cardiac compression and then dressed the wound. By the time an ambulance had arrived Billy was in a stable condition.

Alfred is pictured on the left above receiving a letter of commendation from Commissioner County Durham J. Nichol along with Billy himself. 12

Northern Ireland

TheEnni ... k.illen Divi ... ion was only fonned in 1988 but the dl\ "'Ion's youth didn't prevent Pascal 1cGO\ em (pictured abovc with hiS v.:ife Geraldine) from \vinninlT the individual/irst aid competttion at Fermanaghn'yrone area competition"

Lytham St Annes

Mcmber of Lytham t Anne"" Ji\illl had a day from dut} v. hen VISited the Granada's TV sllldlOS Manche tcr.

They were <.It-com pallied ! Lancashire's Coullty Co III III IssiOn Lioncl HalTls and his wile.

Thc County Commi sioncr's am out..,lde No 10 (pictured above) II, greeted by howls 01 amusemcnt ff( cadcts and badgers and set thc tone 'aN what Vias by all accounts a vcry enJO)' day out.

tvt Pictured above are dekgatcI., to the Northern Ireland District's recent "Leadership odule" I 'h D' W lie Introduced ould-bc oilicer to the ngourl., 01 Ide III [John.The Irector of tl , , C II 11,S well received v. LiS haron Bav.ler and 1£ \\ LIS held at Loughn o ege C, OOhlo'Wn, Co Tyrone.

Shropshire

Fourteen team from all o\er hre\\ bur) took part in hrop hire' annual fir t aid competition \lember \\ ere faced" ith cenario ranging from a dog bite to a caffolding accident.

The, ictim "ere member of the Ca uaJt) Union and pictured abo\ e are Paul tone (1"') and L) nn Campbell (19).

Sheila deputy county training officer, aid uch e\.erci e "ere a valuable part ofSt John training and timulated a lot of intere t.

The" inner of the Count) final. "ent on to the regional "hich" ere al 0 held in Shrop hire at Shirehall in Shre\\ , bur) on \la) 12. "" inner then go on to the national final.

Getting to know you .......

Dear Reader, As the new editor of 8t John World I'm very keen to know as much as possible about you your views on the magazine With this In mind I'd be grateful If you could a mintues and the price of a first class stamp to fill In questionnaire and return it to me at 8t John World, Editorial Office 1 Grosvenor Crescent, London, 8W1 X. All the inform'ation you give will be treated in the strictest confidence and your contribution is important to the future of 8t John World.

Carole Richmond Editor

11 Doe the World compare favorably with the Review'?

12 Please tick. the features you particularly enjoy and V\ould miss if they ceased to appear.

Practical feature,,> offering guidance on a whole range l ">ubject from fund ral ing t amhulance maintenance

nal "is of peed ie fir

2. On examining thi ca ualty you find that the right ann i injured, with which arm would you commence the removal of the jacket? 6. Which foml or "indirect force" would ou expect to cau e thi t

of fracture? 7. In a prained ankle when the li gam nts are damaged hat happen to the bone in the joint?

SOVEREIGN'S AWARD

THREE CROSS AWARD

Welcome again to the page that is devoted to the Three Cross A ward scheme.

A very special presentation took place in Wales when Timothy Davies received hi s Three Cross A ward certficate in Wales and a special letter from the Prior for Wale s, Captain Norman Lloyd Edwards for becoming the 18 ,000 pupil in Wales to take part in the project.

You can read about the Prior y for Wales' Project for Schools on this page.

I'd also like to congratulate pupils at the Catholic High School in Chester and tho se at St Gregory's Catholic Comprehensive School in Bath for passing their Three Cross Awards.

Remember, keep the new s coming in!

\leryl(Kate)Deanio.,rrom uo.,c.,e andio., Theaimoft h eThe overeign' Award currently in her third year ao., a o.,tudent i to encourage young member of the nurse at London Il oo.,pital, Whitechapel. Brigade to greater effort of per onal

She won her award ror a research achievement and comm unit y en e in project on facilitiec., for the elderly in the work of , t John and at the arne Bognor Regis and running a c.,ummer time to de e Jop their initiative and playscheme for mentally handicapped broaden their experience. children. The fir t two "in n ers of thi

She hao., worh.ed with the elderl o.,ince pre tigiou a", ard received certificate the age or the t\>\.el c 'When ao., part or her igned b the Queen at a ceremony in

Pupib or t Gregory\ atholic olllprchen..,i, e chool. Bath alkr their pre..,enlilt i 5t John dutieo., ..,he visited an old people"" London, pre ented by HRH T h e Grand of the Three Cross \.Yard certi l'icate.., by the Deputy Eac.,tt;rll rca Olllllli.., lone' home on aturda) morning" Prior at Ken ington Palace.

Derek Ho\>\. ard.

Rebecca Griffith from Avon i now tudying to be an occupational therapist and hope to u e her skill to teach purpo efuJ activitie to the temporaril) and permanently di abled.

Rebecca won her award for are earch tudy on the membership of Sr John and foretting up and running one of the fiL t Badger et in A von.

Rebecca ay that a large part of her ucce wa due to the heJphe received from her Superintendent Mar) Black.

Joining them in the picture are Barbara Kell), rea talTOITicer and fOnlllU tu Anne Miles. ' Actively involved in 8t John Insurance Arrangements in more than 30 Counties

The pupils decided not to take the certificate" out. ide a.., it \>\.u" er) wind) an : SYDNEY PIACKETT & SONS LTD and they had worked too hard to have them blo\>\. n away. ""

Christian Hyde, a pupil of Ysgol Gyrun Gwynlliw puts a sc hool pal in th e recovery position at a press demonstration to s how the s uccess of the We lsh Three ross Award projects. On th e same day Timothy Davi es became the 18,000 pupil in Wales held proudl) aloft puplh at th e atholic Il igh chool in pictured below with chooh Officer Ian John..,on 1'>0 in the picture i" the ch oo' ur,>e, Ann Baldaccino \>\. ho tau gn the children ror their Three ward,> The atholic Il igh chaol one or a growing number or in the hester area to ha e it'> p trained in emergency aid wi th the of the rea Health Authority 'S chools ursing sen ' Est. 1920 For further details of Spec i al ist Schemes for Property, Ambulances and Brigade Members please contact: Mrs Joan Pearson Lloyds Bank Chambers, Hustlergate Bradford, West Yorkshire BD1 1PA Tel: (0274) 308755 Fax: (0274) 732832 o

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CHIPS

Getting the best from

your NCOs

Welcome to a special elongated edition of CHIPS. It's to make up for April when you didn't get any at all (poor things). The official story is that my priceless prose was caught up in a postal strike in London but I think that 's just an excuse for the new editor's inefficiency! This month CHIPS is going to concentrate on the training of those important people within our divisions - the NCOs.

On the following pages you will also find some exciting places to visit during the summer holidays and cadet news from around the divisions

Introducing the NCO

The NCO will prob ab y be o ne of the older Cadet in the Divi ion and co uld be prep ar ed for th ei r job by helping ot her NCOs for a few month They wi II be el ec ted b eca u se of their l eaders hip abiliti es and the exam pl e th ey et to the other cadets in th e divi ion

A well-trained NCO i an a et to an y divi sion. Preparin g them for th eir role and encouraging th em o nce they h ave b eco me an NCO an important ta k and here are orne idea which mi g ht he lp

The NCO Meeting

Thi s should co ns st of the Offi cers of th e Divi ion, and if appropriate any potenti al NCO s within the Divi sion

It i s an opportunity fo r the Sup erintend ent to discuss with th e NCOs how thin gs are go in g in th e Di v i ion and they ca n b e consulted about future pl ans for activitie , camps, dutie s and so on.

Set a ide a few minutes at th e end of the Divi ional M ee tin g for thi s from tim e to time

Occa s ionally gather th e NCO s together at the beg innin g of a m ee tin g to di sc uss with them what th e Divi sion s going to do that eve ning.

18

Respect their View

Talk to your CO. about current tr nds in th e li fe of the Di vi ion and outside too.

Wh at new games wou l d th ey li\...e to play?

Is there anyequipmentthe Divi sion needs for game or activi ti e ?

Wh at are th e atest craLe at school? I s there some thin g here that th e Cadet. wou ld lik e t o include in th eir Di visional

M ee tin gs.

Whi c h ion programmes are th ey watching? Are th ere any TV games they wou ld lik e to tr y during the evening?

Wh at books ar e th ey reading and what soap o peras are they wa t c h ing on TV ? I s th er e a th eme for a Special Di v sional

M ee tin g based o n o ne of th e. e?

Using the uperintendent

An CO ' outing with the Superintendent i omething r ath er spec i a l and th e NCOs will apprec i at e thi s (a nd have many a ta e to tell to th e r es t of the Cadets when th ey r eturn ).

If th e Divi sion nee d s some new equipm ent or a game t ake th e NCOs out to buy it , and et th em , hop aro und with you for th e bes t bu y.

H ave omethingtoeatanddrink w hil e you are out.

If you have a large numb er of COs divide them up into sma ll gro up s and l et some of the younger l eade r try arranging Os will been the ga mes. You mi g ht even g ive a N 0 part or th e up eri nte ndent' s team -ana or twO the chance to l ead a game. seen as u h, which is importanl for Do involve others to he l p you with th e ret of the Di vision. se sions and th e games. Member<; of the

In thi s way th might have the expertise you are looking for.

CO' Conference

W ould it be a valuable e pcrience for If time pelll1it s, try to arrange for the Os of your Di ision to meel ot to visit a local place of interest Os ? Wouldan rea 0'<; onfere ') during their confer nce. help [I depends where you I ive and what is Youcoulddl,>cu,>,>lhl'>Vvlth aurA: 1 bl II b Id b ,.. avala e oca )', utavl !toutcou e adet Oi ll ee rs and th e h h hi ht fth d R h h II e Ig Ig a e ay. at er t an a up eri ntendents in th e rea - and \ug going to one plaee in a massive gro up , the} di'lcu '> it wllh their O 100. Ilh) nOllry to fi a number of visits and

Th rea might bring togeth er le t the CO go in small partie. their Os fur a trainin g afiemooo you cou ld aim it at those cade t'> \\h ohj been se l ected as futur e N OS SO that rr receive preparation for when the) bec( Os.

It could be held in your headquane th e rea Il eadquarters (if your area' one) or in a school. The 10 ation ch(l\ doesn'tha ct beinyourar aatalli r venue i<; within reasonable acces ana place you choose is betler than an)t" your own rea can provide, go on adventurous and travel a bit!

Ma\... e that any Os trai mn. fun, adventurous and enjoyable. T will not want to sit listening to pe al. for too long (do s anyone) and will ie. so much more if th ey are active. Five sesions und er th e foilowin gul co uld be arr anged. The fifteen minutes at each. h oose man eac h sess i o n but insist that th mu st not be arranged in , uch a wa) 0 th e C O s si t and li sten while thO doe all the talking The NCOs wilb be bored ti IT! The l eade r s runnin g sess ion s co uld devise quizzes, u e c har t s (e nco urag in g th e NCO s to \\1 key word as th ey ari se in th e se sion m ag net bo ard s and so on. Try so m e rol e pl ay or play aell! and with th e a t essio n why not in\ --'

Phil's Flyer and Sand Aid - otherwise known as members of Lytham t Annes Cadet - raised £103 in one hour when they took part in a charity Swimarathon organized by the local Lions club.

Nur ing Cadet Superintendent Sandra Ronson is pictured above preparing the teams at the start of the race.

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BE ADVENTUROUS I

Be adventurous this summer

u tria, orway and Italy and a wide range of activities is available.

If you have charge of a group who e behaviour resembles wild animal you ould always take them into deepest frica via Berkshire

The African Adventure tarts at Windsor Safari Park with a journey throu gh the Park' animal reserve. Giraffe, rhino" lebra, camels, baboon, tiger and a pride of lions can be viewed from only a few feet away.

Wind oreven ha it own 'Tree Top' with magnificent views over the park and the Elephant Garden which house even A frican el ephan ts Vi itor can crui e down th e Congo River on the frican Queen RiverboatRid eto eeanimatedreplicasofelephant ,hippo ,cro and a python.

There are lot of rides at the park including the Kilimanjaro Toboggan run which wind it way aero the Park from top to bottom Regular how at Wind or include Winnie. Britain" only killer whale; the Birds of Prey Show, the Parrot Show and Uthingo, a group of authentic Zulu dancer and mu ician

For tho e with violent ta te there' the Medieval Jousting Tournament taged at Fordingbridge in WilLhire.

Organi ed by Geoff and Val Win hip thejou t ha e been popular outdoor en tertainment for the pa t 30 year. Based on the tournaments fir taged in France in the 12th Century the joust.! olTer ami ture of co lour, excitement, danger and comedy.

The original jou ting tournament were introduced to uphold the noble t ideal of chivalry and a a relatively peaceful way of keeping the impetuou and bloodthir ty knight ever ready for battle. However, natural rivalry often led to the tournament becoming dangerou and even fatal conte ts On one occa ion over 40 knight were killed

The hor em en who take part in the modern competition killed a

The hydraulic power packs are electrically driven , using thr alternativl.; supplies, routed via each of the river bank and from three on-site power generators

The Thames Barrier Visitors entre is open seven a from 10 .30 - 17 .00. With the aid of a video and a working model, exhibition describes the construction of the barrier. new audio - visual display explains the effec ts of ri )ing 1\ levels and another attraction is Iiallett 's Panorama the rir t Pan or( in Britain for 75 years. This depicts , a paintin g and SCUIPh models, the City of Bath a<, seen from a hot air balloon

The nearest British Rail it, harlton , but a more interell approach is by boat from Westminster Pier throu gh th eCil London, the Greenv.lch Meridian and past the Observatory and CUlty Sark

hes<,ington World Of Adventures t arge ts groups fro John Ambulance with discount days which offer [2 off th e price and free entrance to any leader with ten cadels

Designed to fill the theme park at les<, bu<,y times the discount .!. offer a chance to discover the delights of Cheo.;sington at a \ cry ; price

One of the most recent attractions at he'>sington is "Transyl\'an et in a Bavanan -,> tyle Village, Trans)'1 anla house"

ST JOHN AMBULANCE

Riverside College of Nursing

CONTRIBUTIONS

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SUBSCRIPTIONS

"Worse than K y lie , but better than Bros"

"A difficult job, well executed and well planned," Ih al Ihe erdict after a heclic week nd at the London rena.

With more th an 40 per onnel from all 0 er London, Geoff Jack on, Div. Superintendent.

Mile End Di vi ion coped wi th over 400 ca ualties during the New Kid on the Block concen over one weekend in May.

The concert were meant to be pread out over Friday. Saturday and Sunday but power failure on th e Friday meant that twoconcerlS were held on Sunday.

Mo tofthcca ualtie were young girl who had got over excited at the c o ene of their idols.

" I don't lik e th e word hy teria" ays Geoff, "mo I of th em were ju t a little emo ti onal."

One eri ou ca e was a fan who became ill with excitement.

Sh e wa referred to ho pital and on the way the she topped breathing. R ecen tl y qualified ambu lanc e member John Smith s tart ed mouth-to-mouth and brought h er round.

Divi sonal ursing Officer, Ian orris had a treat w hi c h many young girl would kill for - he bandaged ew Kid Jo ey MacIntyre's foot. H e had injured it while playing ba ketball.

Th ank to Ian treatment Joey was ab e to go on.

" On e important a pect of this exe r c i se" says Geoff, "was the co-operation between us and th e London Ambulance Service. It prov e yet again that we can all work togeth er."

A co ntrol vehicle from the LAS was at the Do ckla nd s Arena over the weekend, providing invaluable hack-up.

" The weekend was exhausting but hon es tly th e be weekend rv e eve r h ad " ays ambulance member Dav e Lewi s. " I've learnt an awful lot about how to organize a duty ."

Most of the callalties at the

"Defibrillation the wa y ahead " · medical conference told

Delegates at the St John Medical Conference in April were told b) Dr. Tom Evan that semiau tomatic advisory defibrillation was the message for the 90'<, and that a pilot operational study hould be implemented by the autumn of thi year.

Dr Evans, Consultanat Cardiologi t Royal Free H ospi tal and Di trict Surgeon , London Di tri ct SJA pre ented the case for advi ory defibrillator to an audience of St John medical per onnel a NOLLingham University.

H e h as already carried ou studi es and tests to find ou whether good first aider can earn how t o u se emi-automatic defibrillators and, perhap more importantl y, retain th e knowledge. Dr Evan has no doubt that it i s po ss ible to train fir t aiders to the req uired eve and he illu trated thi s with examp es

rrom his own district.

(The protocol dew,ed by. Dr Evans. hiS '>tudle'> and conclu ions will be e\amined In more depth In a later ,>ue of t John World.)

Dr Evans' wa one of the highli ght'> of an extremely Il1terestlngand thought provoking conference.

The themc of the confcrence was 'Cri ' and dclegates heard from Dr John hortland. Consultant Pathologist. University or heffield and ommis ioner SJA, S & W York hire , about the most notable crisis to involve t John in the past year - Hill borough.

Dr Shortland covered many points in his talk but it was the emo ti onal aft ermath of the disaster which provoked mo t di cussion.

The co un e ll ing procedures implemented by S&W York hire

were de,>crihed and problem, othercountlcs who one day race a \llllilar highlightcd

One or the'>c was the e: the medIa had on some of lhe John mcmb rs. with DrSh ortl stating that some had needede\' counscliing arter the media with them.

( tJohn World an article in the near rutureaN the need for counselling all disaster.)

Other topic dcalt conference included lhe hopll of the first 31al and the first alili physical disability and caring pcople

Points raised in an with th e hief Medical Olli' urgeon - in - hier. hier Uf) Advi er and Chief ur\1 Officer will bc discu ed in oe month magazine

Successful resuscitation at Old Trafford

Report by David Jeffrie

ASO Transport

Greater Manche ter ;'-S alUrday 10 March, I wa'> the driver of one or two lhal were on dut) at Manchc'>ter

Unl led Football Ground, My allendant wa'> Maurice Dunn. Shonly bcrorc hall lImc we wenl in to the Fir'>t id Room \\here almo'>t immcdlatel) \\.e heard 011 tile radiO that a member of the crowd had collap'>ed \.\.Ith a \uspecled cardiac arre,>l. DaVid Lee. who \.\.a" In charge or the duty, asked me to take my ambu lance to the ,>corehoard end oflhe stadium.

011 anwal at the ,>cene we our cot strl:tcher to the ga te \\here I could ,>ce that errort.., "',ere being madc to rc'>u,>cllate an elderl, man l ie wa,> II ftcd onto

th e strctcher. An airway had becn IIl'>crted and a resu,>citator wa,> in u,>e. hm Lee from Stretford ombincd and MaUrIce Dunn irom Sale Quadlilateral accompanied mc in th e ambulance. R e'>u'>ci t ation continued In the ambulance a.., we raccd to thc hO'opllal with blue light'> bla/ing On arrIval we raced the pallent throu gh the corridor to a room \.\. here all 0\) gen ,>uppl) could he tapped II the time \\.e maintained comprc'>'olons. A heart mOllltor \.\.a<; ,>ct up and defibrIllation u,>cd. I continued compre'>slo1l'> 111 between rter ri\'c ,>hock.., the heart \\ a'o re,>larted and thc ca'>ualt) admllted to Intcn,>iH! care

We returned to the rootball match ) phoned the ho'>pitallatcr and \.\. as told the man had made a good reco\ er) ."

Record numbers treated at the 1990 London Marathon

StJohnpersonnelgaveo er7,000 treatment- during the 1990 marathon, a steep ri e in the number of incidents. The mara t hon wa al 0 malTed by the death of a 39 year o ld runner who co l lap ed between first aid post.

A S t J ohn ambulance crew

wi th a police e cort ru hed to the cene and CPR wa immediately begun. Thi con tinued in the ambulance a it drove to Guy's Ho pital. Sadly, the man wa,> declared dead on arrival.

It wa the record number of ru n ner a well a cold and wet weat her at the start that cau ed the increa e in people needing trea tment.

A alway S t John wa well prepared wi th over 1000volunteer first aider equipped v.ith 15 Ib of va eline, 1000 pia ters, 5000 cotton wool balls, 6000 paracetamol tablet and 1000 vomit bags. I n addition 400 tre tc her beds, 800 woollen blanke ts and 5000 ADT foil bl anket were avai lable for use. Every year for the past ten St John has had a presence at the London Mara t hon, an experience ec hoed th roughout the country at smaller ma rathon and fun runs.

St John member staffed 3 1 mob il e firs t aid sta tions posi tioned

a lo ng th e 26 m il e ro ute a wel l as s ix inte nsive care and recovery unit s in t he finis h ing area sou th of Wes tm ins ter B ridge.

Ru nners had to be t reated for c ra m p, b l is ters, sprains and st r ai n s, chafing, headaches, fat igue, de hyd ration, hypo th ermia a nd hyperth ermia.

H ypo thermia was one of the majo r prob lems th is year because many of th e run ne rs had got co ld a nd wet wai ting for the

to ge t going. S t J ohn broadcas t a wa m ing on na tiona l te

Branching out all over the world

hlsg ood to report the ronnatlon of rive new Branches thi" month Tho'i e iO England are both the first In theIr re spectIve ounties The thr ee In \el' Zealand bring that country' s LOtal to four , all in the orthern Region of outh Island MarsJ,.e-by - the -Sea & DIstrIct Branch leveland

Contact Mr'i R Beadncll BEM Mul g rave Villa, Ox Close , Saltburnby-Sea. Cleveland TS 12 I P Oxfordshlrc Branch

Contact Mr'i W. W W Hardacre. St John Hou'ie High treet, KidlII1gton Oxford 0 52D

The tJohn Fellov.shm A,>hburton Mld- anterbuQ ewZealand

The SI. John FeIIQ,v, ship Timaru outh Canterbury. ev. Zealand Al'on Branch Christchurch

Contact for all thrce branchc.., Mr Ke In mllh. 203 MemOrIal Al'enue, ChrIstchurch. ev. Zealand. BR N H A 'T I ITI E

The object or thc Icllowshlp i.., to J,.eep in touch; in touch with old frIends, in touch \"Ith t John. and not leas\, to continue our servIce LO mankind. PrevIous nnual reports ha\c menlioned the JOInt meetIng of two or more Branche,> In ounlie.., \\ hlch help to J,.eep members In touch. In somc ountles an annual ount} ReunIon is popular. This year It has been heLin - warmIng to hear 01 VISit.., by members betwecn Branches throughout the ommonwealth HarWich branch In Esse\ heard a tall-.. on t John in ustralia b} a member v.ho hopc.., to start the fellowship In Dan: in on hiS return home Wlt\"ater..,ranu & Quth Trans\ aal Branch in Johannesburg gave agreat welcome to the <;cLretary or LI c'l)ool Branch and her husband In eptcmber. the Pre'>ldent or carborough Branch and her sIster "pent an unforgellable holiday" with the ecretar) or Weiland Chapter. Ontario. dunng whIch that Chapter JOIned \\ Ilh LIncoln orps hapter to give them a part)

The Central ommlllee has uiscus"ed \\ hat more can be uone to calT) out another aspcct orl-..eeplng in touch - helpIllg members In need Most branches contact member.., who arc III. and tal-..e the ulsabled on outlIlgs and to hnstma Panics

Central Area, I lants. Include in theIr programme talks by R son self-care, dIet and benefIts available to the elderl}.

All members are encouraged to ,>eel-.. ad\ Ice and iI' necessary to apply for a grant from their ount) or the Brigade Bene\ olent Fund. The response to our final object. to support the activIlIt: or the Foundations of the Order. IS unendIng Almost every branch reports fund -ralslI1g for t John in somc form - whether to hclp the local DiVIsion , adets or Badgers with equipment or uniform or to send a donation to the Il ospital in Jerusalem.

In adclItlon to theIr support ror t John man} member scn e theIr local CommunltlCS. ur congratulations to Mr W. Iberry. Chall1l1an of Doncaster rca Branch. v.ho rccei cd the BE this year.

Members 01 We..,tgatc Branch Kent care ror Arthritis sufferers at a HolJday Centre. member drIves disabled and elderl) people tOthe local shopping centre, and tv.o more help at Barl-..ing Hospital and In Victoria, British oluIllbia, members aSlst the blind and handicapped With Correspondence

A number of Fellowship members are still ssociation instructors and it is good to know that more and more Brigade members arc now InVolved with their local Fellowship Branch. The Fcllowship is open to all who serve John.

rd Ro a d , Cr oy d o n , urr ey C R9 9E R. h o uld yo u wa nt a n immediat e qu o t e, it ' a asya Fr ee ph o ning 0800 289 578. Written confirm

Strengthening the

li nk with Safeway

Over 400 afeway and Presto ,tares throughout the country wi II be taklllg part in the St John Ambulance/Safewa) FundralslIlg week from 15 - 22 September. This weeJ.. WIll be devoted to fundraising and promotional activIties linJ..ing dlvllons and badger'> .,et'> to their local

Lastyeara fund raIsing week 'WorJ..lI1g Together' ral'>ed £70,000, It I., hoped year'.., spCClal week WIll raie far more "There's everything to play for"ays Ros Bidmcad, Director of Marketing and ppeab "not ani) 111 tern,., of the money that thIS kInd of Inlllatl\ e brings Into the local dIVISIons but a\<'o III delt:loplng the partnership between sLOres amI dIvision "

Each county office ha'>

nomInated a 'links person who will act as liai on between stores and adults, cadets and who may be working on fundral'>lIlg activities

The will be on local fundnusing events but to gain maxImum naLional publicity there will be one or two core events which every '>tore will be able LO take part in Thl'> mal include sheltered shoppIng WIth the cadets or .,omething imtlar. Briefings 'Nill be forthcoming from HQ when thi activity finaltsed , The introduction of linJ..s' .,hould Iron out any to who should be contacted regarding afewa) tores Thi,> project IS belllg coordinated by manda MarJ..s tel: 0712355231

Arresting Bertie

Bertie Badger certainl y caught the attention of thi pa in g policeman during a photo e ion in London recentl y . A imilar Bertie co tume can be ordered from

On yer bike!

Halfords (the natIonal biJ..c and car accessories retail chain) hopes to ral e (150,nOO for t John \>, ith a fundrai"ing partnership lasting UntIl the end of 1990.

The money will be raised in three wa s - starr rundraising, in-store promotions on products and Halford's head orfice sponsorship or prOJects.

As a highlight of the stafr fundraising, and to celebrate the 150th anniversary orthe invention or t he peda l biJ..c, Halfords arc sponsOrtng ateam or professional c clists to ride from Dumrries to London this month.

The cyc lis ts wi ll stop over a t local store'> and special fundraising eVents will be organised to oincidc \>, ith their arri\ al.

RESUSCITATION

Basic points for basic life support

Dr MAH Webb O s tJ MFOM DIH Senior Me di cal Officer, the Post Office Occupational Health Ser vic e South East Area , ha s written the follo w in g amend ed version of an article b y AK Mar sden MB C hB F R CS published in the British Medical Journal on 12 Au gu s t 1989. Mr Marsden is a Deput y Chief Medical Officer of St John Ambulance.

The British Medical Journal publi shed the revised recommendation of the R esuscitation Council (UK ) on both ba ic life support and advanced life support in August2989.0bviouslythearticle were written with a medical audience in mind , but many of the recommendation on basic life support should be read by enior first-aiders.

In this review of the article , I hope to highlight the points which I feel every competent first-aider should know and practice, without hesitation and with complete efficiency.

BAS I C LIFE SU PP O R T simply means maintaining an airway and supporting breathing and circulation without any equipment.

CA RDI AC ARR ESTS are the result of ischaemic heart disease, when the heart muscle itself does not receive an adequate blood suppl y. 40 percent of sudden deaths occur within one hour of the onset of symptoms.

In middle aged and younger men thi s figure rises to about 60 percent. Over 90 percen t of the deaths whi ch happen ou ts ide hospital are due to ventricularfibrilation , when the heart muscle quivers and no pro pe r heart contraction occurs

Ca rdiac arrests, particularly in younger people, may be d ue to other ca uses such as acute asthma, drug overdose, electrocution , hypothermia, etc.

I t is the first aider's duty to continue

giving re u citation until told to di continue by a health care profe ional.

THE R EFO R E RE U CIT ATIO

SH OUL D BE STA R TED IN ALL PATIENTS WITH UDDENLO OF CONSCIOUSNESS AND AB ENT BR EAT H ING AND PUL ES.

AIRWAY

Initiallythefir taider houlddemon trate unrespon s i vene by haking the ca ualty and a king " What ' happening ?" or "Are you all right ?" If there is no re pon e, the first aider hould commence the ABC of asse sment and re u citation

Opening the airway by the combined manoeuvre of head tilt and chin lift will u ually lift the tongue from the back of th e throat. Obviou obstruction, uch a broken or displaced denture , hould be removed but well-fitting denture s help to maintain a mouth sea l during ventilation and should not be removed.

BR EATHING

Once the airway ha s been opened, the fir t aider hould check for breathing by looking for chest movement s and Ii tening for breath sounds.

If there is no breathing, resu citation should start with TWO SLOW EX PIR E D BR EAT H S OF AIR. Each breath should be sufficient to cause the

ch s t to ri e, and the c he t hould faJ between breath Each of the initial bre ath: hould la t from one to one and a ha eco nd . Likewi e, uc eeding breaili, mu t la t lon g enough to make the che, n e.

(The re i now evidence that gili four rapid inflation causes air to enter thi stomach, and thi increa es the po iblli t of regurgitation and a piration of tom ar co ntent ).

Fir t aider s hould not be afraid 01 performing mouth-to - mouth re pirat iol It carrie no known ri ' k of tran ml Ie of th e HIV or hepatitis B viru It i worth rememb ring that upto' percent of cardiac arrests occur In U. home and involve people who known to th e fir t ai der or who migh tt family members. neighb ur, or c10Sl friend

Any fir t aider who ha perfome re u, citation and, depite rea uran ce concerned abo ut the po ibilit ) di , ea etran miion, hould eekfurth ' medical advice from their Gener Practi tioner.

CI R CULA TION

The pul emu t be checked properly Th carotid pul e hould be felt for at leal five seco nd to en ure that the circulatHli ha stopped.

For che t com pre ion to be effecti ve and delivered without undue fatigue , rate of60 - 80 perminute i recomm endea Thi rate can be achieved by counti ni aloud "o ne and", "two and", etc.

There i no change in the compre IOf to ventilation ratio - for one fir t aideri PI 15:2 ; for two fir t aider 5: 1.

R ECOYE R Y POSITION

The uncon ciou patient whose airwa )'ll clear and who is breathing pontaneo usl l should be turned into the po ition. Thi prevents the tongue fall in!

back and reduce s the ri sk of inhalation of gast ric content .

There i no univer ally tandard recovery po ition , but any po ition that sec ure the ca ualty on hi or her s ide i accepta ble provided the following requi rement are met: -

The procedure hould minimi se the move ment of the ca ualty.

The ca ualty' s head, ne ck and trunk hou ld be kept in a traight lin e.

The po ition s hould permit gravi ty drainage of liquid from the casualty's mo uth .

The po si tion hould be table - that i , thecas ualty hould not be able to fall over or topple into any other po ition The positio n should be uitable for a casualty being carried on a tretcher.

TheRe u citation Council ha adopted the po ition de cribed in the fifth edition of the Fir t Aid Manual.

Particular care hould be taken when as pinal cord injury icon idered. In uch

IRESUSCITATION

circumstance the head and neck s hould be kept in a s traight line without twisting or tilting and, usi ng at leas t three helpers, the casualty should be "log rolled " on to hi or her s ide.

C HO KING

A consciou ,c hoking casualty hould be encouraged to cough. The person choking hould be bent forward - forexample over a chair - to enli t the aid of gravity.

If coughing fails to dislodge the obstruction the casualty should lean forward and blow s s hould then be delivered to the middle of the upper back.

The trained first aider should al 0 admini ter a erie of abdominal thru t (Heimlich manoeuvre).

Alternatively a erie of four back blows with a erie of four abdominal thru ts may be an effective procedure

An uncon ciou ca ualty hould be treated with abdominal or che t thrust

Resuscitating patients with Tracheostomies

There i an increa ing need for fir t aider to be aware of the en larging number of people who e breathing i maintained thro ugh a tracheo tomy (an opening, u ually permanent, made Into the trachea ju t above the top of the ternum ). About 700 people have removal of the larynx (laryngectomy) each year, u ually becau e there i malignant growth in it. The Lary ngectomy A ociation will have given advice to th e people and thi hould be found on an advi ory note kept in the Indivi dual' pocket/wallet.

Several po int n ee d to be re m e mb e r e d : by direct compression.

1. When 100 ening clothing at the neck, en ure that it i undo ne down to the top of the ternum. Thi will e po e the trac heo tom y.

2. When uch a per on i uncon ciou and not breathing mouth-to -mouth ventilation will not be effective. There no connection between the mouth and trachea , or if there Isit is much reduced in ize. Mouth-to -tracheo tomy ventilation should be performed Checking and clearing the mouth i till good practice, and light exten ion of the neck will make it e . aSler to blow through the tracheo tomy

3. When uch a person i uncon ciou but breathing , care mUst be taken to en ure that the tracheo tomy i not ob tructed In the recovery po ition. Thi i probably be t done by u ing a rolled blanket down the front of the body ( ee Modification , p25 Manual).

R EMEM BE R

BASIC LIFE SU PP O R T is a practical skill and it mu s t be practised regularly to ensure that the technique is correct, effective and done without hesitation. Only in thi s way will life be saved.

ACKN O WLE D GEMENTS

Guidelines for Cardiopulmonary Re s uscitation

Revi se d recommendations of the re usci tation Council (UK)

B AS I C LIFE

A.K. Mar den

BMJ 1989 ; 299; 422-8

Reprints are available from the British Medical Journal , BMA House, Tavistock Square : London , WCIH 9JR

4. When applying dre ing elevation ling etc., care mu t be taken to prevent any ob truction of the tracheo tomy Similarly, dre ing end mu t not be left 100 e and thu po ibly be inhaled.

5. It hould be remembered that people who have had laryngectomie cannot peak normally. While communication often effected by "co ntrolled belching' , thi may be impaired by injurie which often affect the che t or abdomen.

DR MAHWebb

Senior Medical Advi er outh Ea t Area The Po t Office 0 cupational Health Service

1. Wh ich ca ualty

4. What would you detect at thi point?

2.Which ca uaJty would you place inthi po ition,withthehead lighLly rai ed?

3. Identify th e mus Ie

County and Division News

Ambleside

Division swapped its IS yearold econd-hand Land Rover ambulance fora brand new vehicle recenLly.

The diviSion rai ed £ 16,000 for the new Land Rover ambulance over a five year period. The \..ey.., were handed over loDrBemadette Dalton, PreSident of the dillSlon, by Albert Gregory, Land Rover SVOMarketing Manager, at adedication ceremony In March.

The new ambulance conforms to the Joc\..ey lub rule due to come Into force In 1991. Defibrillator, monitors, re uscltatlon and Intubation equipment can all be found on the vehicle.

Belgrave

S. You are out walking with five friends, one of whom be omes hypothermic , how many people ' hould you end to obtain help ?

6. Under which circumstances would you carry a stretcher in this manne.r?

7. When examining the eyes - for what would you check the white orb?

8. When treating a per on who is having a major epileptic fit. Should you re ' train the ca ualty.

a) Alway

b) Sometime

c) Never

The Belgrave Badger are Che ter' fir t Badger Set. Formed la t October by Katrina Weller, the Belgrave Badger now have 26 member and a waiting 1i t. Shown here learning fir t aid from Che ter' Divisional Superintendent Alan John on are Stewart Frampton, Joanne Carr, imon Kay, Hannah Pickup and Lla McDonald.

(Phorographcolirresyo/GcojJ

arah Curtis, A on Norton Radstock Cadet wa on duty at a motor cycle scramble when she complained of severe abdominal pain and nausea.

Divi ionaJ Officer Eddie Bowkett and Jean Paxton diagno ed u pected appendicitis and an ambulance crew took arah to the Bath Royal United ho pital.

Eddie located a rider with a portable phone and arah' mother wa contacted. Sarah wa operated on that evening.

Sarah is pictured abo\e a week after her operation being supported b)' members of her divi ion.

AROUND THE DIVISIONS

Cornwall

Divisiona l Officer Geoff Francis, St Ives Q Div ision, is pictured on the right wit h the wheelc h air donated by the Lion's Cl u b of St Ives.

The p a t ient is Peter R owe, Lion's C l ub Presi d ent.

Dorset

The Dorset Divi ion of St John Ambulance recently received a cheque for £500 following a clay shoot for gamekeeper from throughout the South West.

The sporting shoot at Melbury Park, near Dorche ter,organi ed by Dawn WaIT and pon ored by J. Bibby Agriculture brought in £1100 for local chari tie

K i ng 's Lynn

Pictured on the right arc the fir'>t SUI Badger'> in the King\. Lynn Set rece Il, their pottery badger'> and the Count} Badger Leader, bue

The Super from left ron. are; Joanne Mitchell, Knslle Ro c Ma: aspall, Julie Robinson and Cressey.

Would you like to see more coverage of divi ional news and events in the pages of 51 John World. Write to the editor, Carole Richmond, St John World!1 Grosvenor Crescent, London, SWIX 7EF and lei her know!

AROUND THE DIVISIONS

London District

"Never can an honour have been so richly deserved as when Catherine Stretton was awarded the OBE in the New Years Honours List" writes Tom Gibson London PRO.

"Recently she made the trip to Buckingham Palace to receive the insignia from Her Majesty the Queen when she was able to talk of the members of the Royal Household that she had trained in recent years.

"Catherine joined St John as a Cadet aged JO in Durham. She later moved to London to train as a professional nurs e and transferred to Dulwich Division 111 1954.

"Very active in competition work, Catherine al'>o set up a new Nur.,ing Divi ion in Peckham ""ith one lady bus driver as the first member.

"Since 1970 Catherine has been District Officer and involved in many area,> of St John activit}

"She been a member or the Aeromedical ..,ervlce.., ..,lnce It.., Inception and remember" her fir..,t journey - b} train, not air - to a transit camp in Vienna for refugee" frol11 the 1956 upri"lng in Hungary.

"Catherine brought a train load of 600 people back to London with the I elp or one Red Cros" worker

"She was responsible for feedlllg the refugees as v.ell as lendlllg injune., . A bab) was delivered during the jOllrne).

"Catherine now DlrectorofTrallling for London District."

The tockton Heath Badger Set made a clean sweep of a local fire engine to complete their Re ourceful Badger certificate.

To earn their certificate the Badger had to clean a ,ehicle and they decided that wanted to tackle omething lightl) more challenging than a bic)cle.

With the generou a i tance of the local fire tation, the Badger pent one Saturday morning helping the watch clean their tender

Pictured on the left are orne \ wet, very bu) and very Stockton Heath Badger .

Stockton Heath

..

AROUND THE DIVISIONS

Windsor

Pictured above i the pre entation of a cheque for £450 a a result of la t year'.., day at the Safari Park, Wind or.

The pre entation was made to Sir Peter Hud on by Eric Hearne, Deputy Area Commi sioner and the organi er of the St John Ambulance on Safari day T h i year the fundrai ing day will be on Saturday September I st and once again the proceed from the day will be plit with the Ophthalmic Ho pitat.

Also pictured i ASO (T) Cliff Petti fer recently returned from New Zealand.

Wallasey

Pictured on the right lookin g into the future with a s tronaut Bert Prince are Pre s ident E Murph y and D. Blaine.

Bert wa s in the Mer s e ys id e village of Walla se y to join in Tran s olar Tra vel Agenc y ' s 25th birthda y celebration s There ha ve been celebration s of a different kind in the Moreton Division when And y Beed blew out the candle s on hi s lOOth birthday cake.

And y wa s a founder memb e r of the Moreton Di v is ion , no w 50 years old.

Ine -yea r-o ld Timmy FrancI'> (pictured above) i" a member of the Badger In Llandudno. HI" other hobbie s art unicycli t/juggler.

He has put hi" talents to good use b) entertaining children for two days In the temporary accommodatIOn In Bodelwyddan astle. The rcfugee 11\In( there had been forced out of their homes by the flood disaster In Towyn

While Timmy worked hard to keer the f100d victim" Splflts up he was enough to be introduced to the Pnnce ol Wales.

Questioning the questioner

Dear Carole,

Re: St John W or ld April 1990.

On page 21 the "Do you know your manuals?" appear as usual, yet again there is a mi take.

Tnque tion I you appearto have mixed up the sp leen with the kidney!

K W. Grantham Div i ional uperintendent Che ter-Le-Street

YO Il are right Mrs Grantham and you can liow rest as /Ired that I know the difference beMee n the spleen and a kidney! Ed.

Coping with the disturbed

Dea r Carole,

A Officer-in charge at all home matche atWimbledon FC, I and my divi ion were very interested to read the arti Ie about fo otball groundafety in the April World. We recall clearly the occa ion when the ge ntleman concerned wa brought to our fir t aid po t.

The casualty wa pale and hy perventilating and it wa hi friend Who told me that he wa a Li verpool su pporter.

Our very experienced ur ing me mber, Jean Hunt, who uper i e the po t during all matche diagn ed that the patient wa uffering from a nervou ups et and a the weather wa mild I felt tha t fre hair wa in order.

He was placed on a c hair in th e do orway next to hi friend, wrapped in a bl anket and provided with hot tea.

Jean and I felt that we hould talk about the Hill borough in ident openl and a he poke we noticed a mor r la ed and settled change.

After a time lap e of about 30 minute

We asked if he wi hed to retulll to th e ViSitors tand to watch th e r t of th e ma tch. He looked a littl e an iou and I walked to th e entry gat which IS located near the fir t aid po t and a k d

the security taff as to the possibility of the supporter watching the rest of the match in the family enclosure.

This enclo ure wa ideal because we could casually keep an eye on him and there was adequate standing room.

Permi ion was granted immediately and he wa invited tojoin the Wimbledon upporters in thi mall enclosure.

A the enclo ure is only separated from the pitch by a hort metal fence he wa in a good po ition to view the game and there wa nofeelingofclau trophobia.

He wa . told that at any time he wa welcome to return to u for a cup of tea and a chat. He and hi friend watched the re t of the game and made no return to our po t.

I commend Jean Hunt for her initial approach to thi agitated patient. Her careful handling and open conver ation relea ed ten ion and anxiety which prove that ometimes 'W ord are of more benefi t than action.

Perhap more traini fig on dealing wi th mental anxiety and the di turbed ca ualty would be an advantage in Ba ic Fir t Aid training.

Keith Edward Divi ional uperintendent. Wand worth

Thanks Keithforthis graphic aCCOlll1f of a casualry well-handled.

Do YOII think ambulance members should h(.1l'e more training on holt' to deal with the menially disturhed as well as the phy ically injured?

If you hGl'e similar experience fa the one described hy Keith or strong \'ielt's 017 the needfor more training write 10 St John World, J Cro venor Crescent, London W J 7EF. Ed.

In defence of competitions

Dear ir,

In reply to Area Commi ioner R. Bradley' lett r in our pril i u of the St John World on the benefit deri d from Fir t id competition.

Fir tly, I would take him to ta k over his idea that members should be " pecially" trained for competition.

All StJohn member hould be trained to a e , diagnose and treat a made-up ca ualty,either inglyorinpair (a when on duty perhaps).

Why cannot thi training then be a e ed, marks given for demon trating their kill andasabonu awardatrophy?

But thi is then a competition!

During thi training all member hould act a judge ,ca ualtie ,by tanders and make-up.

Secondly, I would ugge t that not all Area event are profitable, but member can benefit greatly by their experience a participant, judge, teward, ca ualtie or make-up etc.

I it not al 0 a time for all the Area to meet together? Should we not pend money on our member?

Thirdly, public relation are maintained by in iting the local pre and a dignitary to pre ent the prize, the e keep u in the public eye, so important on Flag day.

Finally, I feel it i nece ary to reeducate all concerned that competition work i a method of training, trophie hould not be won by competition technique but b Fir t id kill Competition hould be F Ian E. Grigg Area Commi ioner olihull and outh Birmingham We t Midland

You can write to John World about anything. ou like. nd here' a question to et you thinking. When you write would you like your letter to appear with a reply from the department any query i addres ed to or would you rather the letter appeared without comment and that any an wer appeared in the following i ue?

(Reader view and opinion, although publi hed, are not nece arily endor ed bv the editor or the O'rder of t John and its foundation. Although reader may ign pub Ii hed letter with a pen name. writer mu t upply their name and addre to the Editor,)

CHIPS

Apply yourself to getting the right job

Hello and welcome to the June edition of CHIPS. I have been requested to introduce myself to you.

I am Andrew Bull, aged 27, Scorpio star sign and currentl y working for Sainsbury's Savacentre , as a Training Manager responsible for the Graduate and A level Management Training Scheme. I joined St John as a cadet in 1973 , followed b y transferring to an Adult Division when I was 16 - all thi s taking place in the rural county of E ss ex.

I have since moved to Hampshire , as part of my career and am currently looking for someone who will have me in their Di v is ion - this is not a plea, I have been too busy at work and writing CHIPS to find out!

When Jim Bond asked me if I was interested in writing CHIPS , I set some objectives for the column and I hope that I ha ve achieved them over the past year.

I want CHIPS to be informal and humourous and let Di vis ional Officers know about the more wide ranging area s of y outh work.CHIPS also has an important role to play in promoting St John as a youth movement for the ninetie s This month CHIPS examines the tricky task of getting a job.

Findin

th a ll the ta lk a bo ut the d e mo g r a ph ic time b omb a n d t h e thou sand s of jo bs j ust wa iti ng for young pe ople to f ill th e m . Wh e n yo u do m a nage

to f ind th e jo b yo u wa nt , an d goo d o ne are s till at a pre m i um - yo u have to clear th e hurdl e of th e interv iew.

You hav e to ge t it ri g ht fi rst ti me - yo u won ' t be g i ve n a sec ond c han ce.

How eve r yo u d o have o ne thin g in your f av o ur at a ny j o b interview - yo u are a St John me mb e r a nd as s uc h s ho uld know how to s tay cool , ca lm a nd co ll ected in th e mo st tryi ng ci rc um sta nces.

Th e followin g notes mi g ht he lp yo u

ge t th e job of your drea m s, but do n 't for ge t th a t your c aree rs te ac he r sho uld be abl e to help you too .

If po ible addre your letter to a named per on Putthejobtit leatthetop of your letter. ay why you think that you would be good at the job and remembe rtr Ii ta llyourintere t andhobbie -making ure member hip of S t John i at th e

Keep a copy of your application , \0 that you remember what you aid wou la make you 0 good at the job

If you manage to get an interview -be prepared before you go.Find out a mu a you can about the firm. Think whal que tion you may be a ked

The interviewer will want to I why you want the Job and why you thln l you hould get it.

Make ure you have om que tion to a, k. What doe the job involve ? I the re any training? What are the pro pee ts" Where will you be working? Will you be moving about a lot ?

Check the time of the interview ana how you are going to get there.

Plan to arrive fifteen minute earl)

Ore manly and be clean and tid y.

Putting time and the World in a box

Late in 1989 a group of Cadet from Staveley Work s Divi ion in the Derwent Area of Derby hire a ked their Divi ional Officer John Hardie if they could prepare a Time capsule' for ope ning in the year AD2040

Thi project oon became an Area effort with Keith Ward , Area Staff Officer Cadet s becoming involved.

Che terfield Borough Town Council agreed to have the ca psule placed in their archives.

The cap ule wa made by Stanton PLC , ba ed at Staveley Works. It mea ured 60x30x20 cm and wa made of tainle s tee I.

It had a hinged lid with a rubber eal around the top and two ca rrying handle A plaque wa ' ca ( in the Foundry with all relevant detail relating to the depo , it and opening date.

Item placed in the time cap ule include photograph, pre cuni ng , Ore s regulation " Badger Buzzz, copie of St John World, variou leaflet ,coin and tamp

The capsule wa interned with great ceremony after being accompanied through the , treet of Che terfield by 140 Cadet an d Badger.

CHIPS IN BRIEF

"lew rule , go erning the ale of oft toys - or their use as pnze in tombola , and raffle , are now in force

ent to an examining body for rigorou te ting, which can co t a much a £300 a toy.

One way round the problem i to buy toy in kit form that have already been te ted

Is the job paying enough? You are going to have to cover rent, Community C harge, food, fa res, clot he an d holiday o ut of yo ur sa lary. You won't be happy if yo u are not earning enoug h to eat!

Personal information

If yo u are ph oning for a n interv iew ma ke su re yo u h ave a ll yo ur perso na l in fo rm atio n read y as we ll as a pe n and pa pe r to wr ite down th e addre s a nd time of th e in terview.

If yo u have to write a n ap pli catio n do seve ral ro ug h co p ie befo re the f in a l o ne.

T hi s is n 't a was te of ti me, th is letter w ill be the fi rs t th ing a pros pective e mpl oyer sees. Th e sa me rul e goes fo r appli ca tio n fo rm s.

Ch ec k the quali f ica ti o ns s pec if ie d in th e job adv e rti se m e nt be for e you a ppl y. If you a re th e wron g age and ha ve n t sa t th e right exa ms then you don't tand a chance and it i a wa te of time app lying.

l[ for any rea on you are not able to keep the appointment, or you are hel dup. phone the employer immediately and tell him.

I t i be t to be relaxed durin g the in terview so if you need to fre hen ur when you arrive a k the receptioni t whe re the cloakroom i

D uring the interview Ii ten - don 't interr upt or c rack jokes.

Be intere ted and hone t and not tOO mode t.

B eware of a king q ue tion to whi cn

yo u a lready know the an wer but make ure yo u get the an wer you need

T ha nk the interviewer for eeing you

W e ll , there yo u go, s im p le is n 't it. I th at omeoft headvicegiven he rei of use

to yo u

I wis h yo u every good fo rtu ne in your searc h for work - be positive and never g ive up

Since January I , all toy old in Europe mu ,t ati , fy a new, , tringent et of afet regulation

And the ru Ie cover women and men making toy at home to rai e fund for charity, a well a commercial Co mpanie

Any lOy mu carry the new CE mark Failure to do 0 ca rrie a ri k of a £2,000 fine

Or six month in jail.

It is po ible for anyone making toy at home - ay to se ll at a Cadet Bazaar or t teto have the toy checked and to make ure they conform to the new EE req u irement deSigned to bring the UK into line wit h Europe.

But th i can be a co tly affair. Eac h product m u t be

Hallcraft Ltd of Ha ting both upply kit or a range of oft toy for ale or to be u ed a raffle prize on a ' ale or return ba

They can be contacted on 0424 443787 or at Unit 6, Farley Bank Industrial E tate, Ha , ting ,East u ex. T 35 5QF.

Sport for all, the Sport Council guide to coaching cour e and activity holiday for 1990, i now available.

Ju t write to The I nformation Centre, Sport Council. 16 Upper Woburn Place, LONDON W CIH OQP . It f ill ed not only wi th ho liday locat ion buta l 0 with ontact addre e for ju t about any port you are to mention.

And I fr e!

CARE IN THE COMMUNITyl

Helping you to care

More and more member s of St John are b eco ming involved in what used to be called welfare work and now is known as 'Care in the Commun it yl. Some will b e caring as part of their St John voluntary work - others will care for a ick friend or relative on an eve r yda y ba s i

In this adverti s ing feature St John World look s at so me of the products and idea s available to help tho se who care for the disabled , elderly and s ick.

One in four people hav e ome fonn of di ability. Accident , illne andoldagecanaffectallourlive Evenminordi abilitie can cau e fru tration when trying to cope with th e si mpl e ta ks of day to day living

There are many item available to aid people with a disability which can help them become more independ ent. Finding out what these products are and where they can be obtained from i difficult and time consuming.

Keep Able is a new company that ha produced a free catalogue which contains hundred of item - from wheelchair to bathlifts , from overbed table to folding walking ti ck.

Each item is clearly de cribed in the catalogue and illu trated

with a photograph Catalogue can be obtained from Keep Able Fleming Close, Park Farm, Wellingborough, orthant s NN i 3UF.

M ore information about with mobility can r.e found in a new leallet publi s hed by Ilclp the g ed

En titl ed Mobility, the leanet looks at of mobile throu gh exercise and a healthy as well range of help and ad ice available.

ections on diet and exercise are followed by infoI1l1ationon aid to mobility s uch <.1-' wal]...ing)li ks and frames, whe elchalrl, s tairlift. and personal vehicles.

Tran port schemes and ben fits ,>uch as Mobility Allowance are a lso covered and there is an address list for further infonnallOn.

Copies of the Mobil ity leanet. sponsored by Lannah are available from th e Information Des].... Help the Aged. SI 1amesWal]"',London CIROBE(please e nclose AE , minimum ize 9" x 6").

One company well used to helpin g tJohn transport disabled people is VF pecialist Vehicles. Over the last 15 years thl company has supplied t 10hn with 350 re condilloned

STEEDRIVE PASSENGER VEHICLES

• Passenger carryi ng veh icles to accom mod ate both wheelchai rs and able bodied persons.

• Particular attention offered when positioning handrails and step heights forthe elderly and infirm.

• All passenger areas include sound and thermally insulated wipe clean moulded panels ..

• Vehicles conform, where necessary, with current legal requirements.

• Fully comprehensive specifications can be provided on request. For more details write to:

CARE IN THE COMMUNITY

ambu l ance ' , some 20% of which have been ror welrare work. Mo t makes of panel van can be con en d into passenger vehicle by Steedriv ofMa clesfield. The company has over II y ar e perience in manufacturing and provid e no obligation quotation and infonnation on the lega l a pects or passenger tran portation.

For Divi on who are investing in Care in the Community and who are con idering buying a new vehicle - Land Rov er Special vehic e Operation c have 40 year ''-ill and experience in thi field and will fit any of their vehicle with the eq uipment that you choose.

If you ju t have to wony about getting people up and down tair a chair lift might be the an wer. The battery powered Stainnatic provide a comfortable ride up and down stair. It au omatically lock on each tep and is suitable ror mo';t stairca e and urface. It operated by the attendant with th pre of a switch.

A product de igned by a di abled man i ' now available to he p people with mobi l ity problems ge t in and out orthe sea. Called the swim chair (pictured on the light) it can cope with and and pebble and can be taken into the sea to a depth th at allows the rider to move off the chair and swim away.

The chair i functional,fun to u e and very popular with nondi abled people - particularly children.

T h e design i an ingeniou launch and recovery chair which acro s between a deckchairand agolftrolley.lt i collapsible, makingitea ytotransportand omeairline willcarryitfreeof

charge if it i<; describ d a" a wheelchair. The frame is made f tubular "taillle .., tecl and the can \JI seat i.., adjustable (by lacing) for ..,maller u"ers.

V.F. SPECIALIST VEHICLES I

Buy with confidence based on 15 years ' experience

Recondit i oned ambulances , welfare vehicles , four-wheel drive ambulances

Why accept second best?

All vehicles w ith engineer i ng report and warranty. Guaranteed rebuilds. Remember we deal only in Emergency Vehicles

Video available showing how thorough our work is

CARE IN THE COMMUNITY

Since the chair was initially produced a further model has been developed ror u'>c as a one man operated strctcher in order to transport patient over opcn ground. This model uses the same frame design and incorporate'> a choice of larger and narrower wheel,> with pneumatic or solid tyres.

The whee\<., are interchangeable and the frame can be manufactured from a variety or materials e.g aluminium. Consequently the chair can be adapted to suit a wide range of applications.

rurth r details are available from David Godfree, Tel: 081 6739.

Age oncern is staging a conference in July of this year I,hich dea\<" with the theme of Age Di,>crimination. Aimed at everyone who worb with or for older people the conference is being held at the orLondon In <,titute of Education on the 23 and 24 July.

The Barone'is Phi wi II open the conference and sessions Include di..,crillllnation in employment, voluntary work , consumer arfairs, the media and health and care.

Special discounts arc available to member<; of voluntary organisa ti ons and further information can be obtained from helen Tovet, Conference Organi'>er. ge Concern England. Road, Mitcham, urrey R43LL.

The R lB ha just launched pr duct designed to help the bhndand vi..,uall, Illlpalredlead an active and independent life. Technical innovation,> include a new"'paperthat blind people can read. Thi i the first time that blind people in the K will

ISTAIRMATlc l BATTERY POWERED MOBILE STAIR RIDER

THE GO ALMOST ANYWHERE STAIRCHAIR FOR CARERS & THE CARED FOR LOCKS AUTOMATICALLY ON E VERY S TE P Baronmead International Ltd 39 Elmer Road , Middleton-on-Sea West Sussex , P022 60Z Telephone: 0 243 586692

have access to the full text of a day's paper.

In the pilot <;cheme, the text of The Guardian is broadcast nationally over the independent television network by AirCall Teletext. It is transmitted on the day of publication and is received in the blind person's home using a Screen Electronics decoder card in a per onal computer.

The R IB Technical Development Department has come up with software which allows the user to read the paper using a speech synthe siser or a transient braille display.

The latter option i<; particularly useful to deaf-blind people whose access to any kind of information very re tricted.

Another innovation from the team at R IB is a tactile danger warning - although this won't be available until 1991.

The increa ing u e of dangerous ub tances in and around the home pose great problems for a vi ually disqbled per on I iving alone. Thi is made wore by the increa<;ing standardi ation of containers.Superglue was old in an identical containerto eye drop until it \0\ a brought to the attention of the manufacturer that a visually disabled per on had accidentally put uperglue 111 hi<; eye.

Although ome package had been marked with braille it ha become obvious that a new tandard of marking had to be introduced. Aftermuch di cu ion an agreement \0\ a reached to use an embos ed triangle in a pecified place on the packaging. To male ure the ymbol i u ed properly the R IB need people to inform the vi ually impaired. particularly the elderl} about it introduction.

STJOHN FELLOWSHIP

Notification of the formation of a branch

Name of branch _. __ _ _ _ _ _ _

Branch Secretary or other contact.

Address , Tel. No Date

To: National Secretary, Miss Sheila Puckle, St John Fellowship, Sl John's Gate, Clerkenwell, London EC1M 4DA

ORDERS OF ST JOHN TRUST

Part time Caretaker / Warden

needed for a compact unit of eleven Sheltered Hou sing

F at for the elderly in Fore t Gate , London E7. Dutie

involve looking after the small garden, cleaning th e hall and tair and collecting the rent plu 'keeping an eye' on the resident. Free accommodation i provided to gether with telephone heating and electricity and a sma ll wage

Would suit a midd e aged per on or co upl e with other occupation.

Respon ible per on/ with kindne ss and e sential. Applicant should apply in writing to Mr. M.W R apinet, Orders of St John Trust, Stayes, orthend, r Henley on Thame , axon. RG9 6LH.

Applicant applying should give full detail of th eir circumstances and name of two referee s. Suitable applicant will be interviewed.

FRANK DRISCOLL. O. St. John

Frank Driscoll was responsible for 240 i sue s of St John Rev iew from his appointment in J 970 to hi s retirement from the po t of Editor in May 1990. In hi s 20 years a editor Frank on l y fai l ed to produce one is sue and that was due to serious ilnes s.

Special mention has to be made of the help and advice he gave in the b l ossoming of St John Review into the World.

We wish him goo d hea l th and success in all his other p r ojects and enterprises and t hank him for all he ha s done for St John.

D r Norma n Paros , Chairman Board of Management

J Mi,;er having finger'; fully nc\,cd (5 - 6)

7.lnitiall clderl) (3)

9. It follow,; fun for one tn poor health (5)

10 Hand to moulh (9)

II incapacitated by dis ease (4)

12 Marl-.. of an old v.ound ( 4 )

13 Person abnom1ally int eres tcd In co rp'>cs and death (5)

16 Modtfled anLigen u'>ed in immUnts Ll 11 0 n (6)

17 c ute IIlfectlou,> of rc'>pirator) Ira c t common in children'-

21. Like a love '>tory of the co unLlJ td c (7)

24. Mentally -i mpaircd person met end Iran ge ly (6)

26. Diver',> contortions (5)

29. a little tn ll g ht 4uarrel (4)

30. Marl-..et for para'>llcs '? (4)

32 Discharge of wa,tc mallcr frolll I he hod (9)

33 Umbilicus (5)

34. Icl-..ness of voyagers (3)

35. DillY blonde (5-6) DOW

I Lacl-..in g finess e in muscular activities (6)

2 First cranIal nerve (9)

3. a mixture of teas (4)

4 Labour brought about by medical action (7)

5 oisy outburs of bad temper in chIldren (7)

6 Moribund (5)

7 Surpass In perfonnance (5)

8 Excesive secre tion of saliva (8)

14 The man,<; bundle of conducting fibre" in th e heart (3)

15 Wind up a contraceptive device (4)

18. Came to th e high point of a fever (4)

19 Reached a ripe old age (4-5)

20. Beref of members (8)

22. Young man from Vladivostok (3)

23. Hurtful remarl-.. necessary in surgery (7)

24 nvalid and dead (7)

25. Friend taking cover is la cking colour (6)

27 ape of th e ne ck is part of menu change (5)

28 B ecome en larged by engorgemetll with

31 Cap found far from the head (4) Allswers (I

COURSES /RECRUITMENT

EAST HERTFORDSHIRE

HEALTH AUTHORITY

Hertford County Hospital RGNs and ENs

THE DENTAL URGERY ASSISTANT COURSE

The Dental Surgery Assistant is an important member of the dental team. The role involves assisting the dental surgeon by preparing materials and passing instruments as well as maintaining records and caring for the patient. This team approach to dentistry makes for smooth and efficient operating and a more relaxed atmosphere for the patient in the surgery.

This two year training course, starting annually in September, allows students the opportunity to take the National Examination for Dental Surgery Ass istants as well as to gain the Hospital Certificate.

Applications are invited from persons aged 17 years or over that have a minimum of 2 '0' level examinations including English Language and Biology.

Application forms can be obtained from the Administrator, The Dental Hospital at Leeds, Clarendon Way, Leeds LS2 9LU.

THE DENTAL HOSPITAL AT LEEDS CLARENDON WAY LEEDS LS2 9LU.

JENRICK GROUP Nursing Division

SPECIALISED IN RECRUITING TRAINED NURSES

RGNsENs F Grade Salary E Grade Salary

TO WORK IN MAJOR UNIVERSITY TEACHING HOSPITALS THROUGHOUT GERMANY, AS WELL AS SMALLER HOSPITALS IN SOUTHERN GERMANY.

Current vacancies in all specialities

* German language preferred , but intensive language course offered in Germany

* Six months renewable contracts.

* Subsidised accommodation

* Free scheduled flights

* Interviews held locally For application form contact : Mrs Norma Sendles, RGN, NDN, OND, CMS Nursing Division, Jenrick Ltd Jenrick House, Victoria Avenue Camberley, Surrey GU15 3HX Telephone: 0276 62466 (S JW)

Grades C and 0 Full/part-time hours/job share

We are looking for RGNs/ENs

WEST DORSET HEALTH AUTHORITY

Ambu® Man

1 5.00

Applications are invited for the following nursing vacancy which currently exists at this hospital : Staff Nurse Grade E

Full-Time, Day Duty Ref: N/193/90A

Required for 26-bedded mixed assessment and rehabilitation ward for elderly patients Appl icants should nave at least 12 months' post-registration experience. ENB 491 an advantage

The Author ity offers a wide range of staff benefits including Day Nursery facilities. Temporary accommodation available

Applica tion form and job description from :

The Personnel Department, Dorset County Hospital , on Dorchester 268742 (24-hour answering service). Please quote appropriate reference.

Closing date : 15th June 1990 (SJW)

Recognizable by:

• Disposable head bag making cleaning unnecessary and eliminating the risk of cross -Infection between students

• Unique, patented personal face mask also redUCing potential for croSS- Infection

• Breathing IS done In lifelike fashion , through nose and mouth , not through another part of the body

• Chest rises and falls , stiffness adjustment simulates chest compliance rang ing from a young child to an adult.

• Lifelike stomach expands If Insufflation technique IS wrong

• Sophisticated Instrumentation monitors Insufflation techniques , pressure and hand positions as well as air volume Display can be read from both Sides proVid ng convenient instructor / student interaction.

An offer this good , turning in your tired , outmoded non Ambu ® train ng doll for £105 reward towards the purchase price of a new Ambu ® Man , can 't last forever So make your move now! Ambu International (UK) Limited, Charlton Road , Midsomer Norton Bath BA3 4DR Telephone 0761 416868 Fax 0761 419429

HE SUSSEX BAG

DESIGNED FOR PARAMEDICS!

Saving a life i n't ju t a matter of ge ttin g your pali nt to ho pital in tilne. It can all d pe nd on th e imn1 ed iat e treatment needed on loc a tion , espec ialJ y for re u citation a nd that 111 ean. ha v in g the be t equipn1ent on ha ndthe SUSSEX BAG.

Only SUSSEX ffer. y ou all thi s ....

*High volume s ilicon e ba g Ininilnun1 600ml fron1 a BS , in g le hand .' qu eze

*Unmatched sensitivity with fa t recovery e nhan c in g your ability to save a threatened life

* 100 0/0 oxygen admini tration l11aint a inin g atn10spheric pres s ur s (Universal l110dels double as Inhalation Units)

*4 lTIodels including Neonate 20ml - 4001TI1 volume: pre . , ur e r li e f adju ted to user preference (from BS45clTI/H 20 or 30cln/ H 20 )

With a full range of Airway and Ma ,' ks , you can build a perf ct partner. hip ....

SUBSCRIPTIONS

Accidentally costing the NHS a billion

Accident, the va t majority of which are preventable, claim the live of 14,000 people a year and co tthe HS £ I billion according to a report from the ational

A sociatio n of Health Authorities and the Royal Society for the Prevention of Accident s.

The report call for a more formal approach toward accident prevention and point out that accident are by far the single mo t common cau e of death between the age of one and 29.

Between 30 and 44, cancer and heart di ea e claim more live, but accident rank third

Accident are re ponsible for more than 500,000 ho pital admissions and seven million visits to accident and emergency departmen ts A ide from the uffering Lo individuals and familie, accidents have repurcu ssio ns on the ability of the HS to deal with illne s, the report ays.

A fall by an old per on re ulting in a broken leg can delay six hip operations because a bed isoccupied, whileahead injury to a you ng person means 10 hernia operations are postponed, ays the report

In addition to environmental factor , such as poor design of road s or lighting, social factors also play a part in accidents.

Children and you ng males are more a t risk, with those from the lower soc ial classes in particular danger.

Death s of ch ildren in fires are more than IS times hi g he r in soc ia l class five than c la s o ne.

Commentaing on th e waste of live s, time and reso urces the report calls for the Depa rtment of H ea lth to discuss accident prevention with regio nal hea lth authorities and give grants for prevention work.

2

NEWS

Our hidde n heritage

jOll1t exhibition by lheMuseUi or London and th e Ordcr or St John is currentl runnin g at th e Grand Pnol hurch, Llohn's quare, Londe Icrkcnwell 1\ one London\ mo"t hlstonc are bordering on mithfield Me Market and the Ity or Londo The area is bell1g c\ten"lvely and archeologl have di"covcred orrom histone buliulngs. mediel decorateellllc", Dell! Illes, pouen hor..,c anti dog rem<.lIns, '>talOe gla anti much more icrkcnwell's hlstor) h beanng on more modem d c\ enh J'> the area sa\\ scene "ioicnce Ollilected \\ Ith the pc ta\ in IJR I \\ hen Wat Tylcrbu rr do\\ 11 the Pllor), ( cc left)

The c\.hibition runs untl;; ugust For i"urthcrdctai Is COni the t John on 071 ;" 66-1-4

Far East Seminar a great success

Sy mpath y re s tored

HIS Royal Hlghnc..,., Thc Duke or Gloucester, Grand Pnor, was in Ihe dnvlIlg scat or a Model A Ford ambulance when he drove Ihe I} re"tored ympath ambulance (pictured above) for the first time ow the oldest cxisltng ambu lan ce In the countr}, Sympathy was dl'>co ered in a Devon farmer's field In 1988. Apprenticesata timl in Grantham, Llncolnhlrc adoptcd the ambulance as a worthwhile training exercISe and the magnificent result I., no\.\ available for use as a fundraislng tool.

Theambulanc e wa" originally

purchal.,ed by th e Idmouth 01 ISlon In 1929 for £250. It wa later by nearby Honiton Dlvlson but eventually \.\ as sold to a farmer In 1946 and reregl'>tered a<, an agricultural good vehicle. fter a nine year '>pel! \\orking on the farm. the ambulance was forgotten and remained hidden In the undergro\.\th for the next fort ycars. [ts age and hi tor} \,\111 not e empt it from work now, however, a the ambulance \.\ ill be authentl ally equipped so that it can travel around the count!) raising money and awarenes<; for t John.

Your help required

NEWS Festival of rescue

DeLegates o th e Far Eas and A lIstralasia Se minar ill Kllala L/lmpur

The 3rd t John Ambulance Far East and Australasia Seminar was held in Kuala Lumpur, Malaysia from the 21 to the 25 Ma y. Billed a the first St John Ambulance International Conference, delegates from twelve countrie spoke on the theme 'The Way Forward'. In his keynote address, Dr Herbert Ellis, Chief Commander, discu sed the three problem which he felt posed serious problem for mankind but which he also thought St John could help to a ll eviate.

The three problem were; the world

popUlation explosion, the ageing population the changing nature of illne ss and di sa bilit ies.

Other countrie namel y Au tralia, HoM Kong , Malay ia, New Zealand, Paki tan , PapUJ New Guinea, Singapore, Solomon I land and Lanka , gave pre entations detailing theirlh Oug hl ' and fear for the future a well as th e varied \\ 3. 1 each country was dealing with the challenge 01 taking t John into the 90s.

The oversea conference and int ernat ional cadet camp will be reported in more detail in forthcoming i sue of ' t John World.

Bruce Coltman, author of "Do You Kno\\ Your Manual '', is no\\ planning a project called "How would YOU treat this lnjury" in \.\hich the reader i shown a picture of an injury and gi en a 'cena rio. The titl e question is aImed at our memb r ship with regard Lo th level they could e pect to be working a t in rela tion to th s nanD I.e. the fir t aider who initially arrive. at the scene: the per ' on receiving the casua lt y at the Fir t Aiel Post or the ur ing Officer or Divisional Surgeon who is in charge of the Fir-! Aid Post or Triage Point. The solu ti on wo 't b I d h " I n e supp Ie , as t e Inill a que tl on hould stimulate re ea rch and di cu ion at all levels

w If yo u have any spare colo llr photographs or negative ' of injuries hlch yo u are prepared to allow Bruce to u 'e, together with a brief note On the H Circum ta nces, se nd th em LO Bruce o ltm an, "Bra ken Fell " 6 ereford COllrt, ewca ti c upon Tync, E3 2XT.

When Per hor e Divi ion in Worce ter hire took del" er)

MEDICAL CONFERENCE

Is St John an octopus with too many arms?

A major feature of this year's medical conference at Nottingham was a forum discussion between the Chief Medical Officer - Dr Cleon White , Surgeon-in-Chief - Dr Brian Lewis, Chief Nursing Adviser - Mr I. Middleton and Chief Nursing Officer - Dame Audrey Emerton. Here are some of the questions raised by delegates at the conference along with the panel's answers.

If you have a point to make about the topics raised here please write to The Editor, St John World, 1 Grosvenor Crescent, London, SWIX 7EF.

To encourage the professional and to a ssi st the ri s in g standard of first aid and nursing within the Brigade, would the panel agree that the role of the doctor and the profe sional nurse is to monitor the training and not to have their talents wasted in sterile administration posts? As a result would the panel then agree to consider abolishing all rank marking for doctors and professional nursing officers, leaving them with their respective coloured epaulettes only?

BL. Th e impl e an swe r i no -whe n yo u have publ ic du tie it is ve ry import ant to kn ow w ho i in c harge a nd I do f in d th e rank markin g quit e u eful at tim e to di cove r what i goi ng o n

How eve r I would g ladl y ge t rid of a ll th o e co lo ure d pa tc heI think the trip s sayi ng d oc tor , nur e and fir s t a id e r a re perfec tl y adequate

Could we ask Dame Audrey to comment on the que tion of whether doctors and professional nurses should be of the same rank?

AE. Fir stl y I think w e should re ta in our ra nk ma rkin g a nd as far as doctors and nur es are c on ce rn e d I ca n see no reaso n why we shouldn t mov e to wa rd th e m hav in g th e arn e ran k .

BL. Until th e En e rg y pro g ramme rea ll y ge t go in g we haven t g ot enough le ad e r ship within th e Bri ga de at th e leve l that we need and that is why a lot of doctor s a nd nur es are be in g used for admin , s impl y bec au e we hav e n t rec ruit ed th e ri g ht number of high ca libre peopl e a t th e di v i io na l and co unt y structure level. Now if Energy we re to work and we brin g in people with a wide ra nge of skill into th e Bri gad e, th e n I ' m ure that the doctor s and nur se will be a ble to re tr ea t mo re into th e profe ss ional s ide.

Does the panel consider that St John is an octopus with too many arms, many of which are already duplicated in other voluntary services? Traditionally we have been a first aid and nursing organisation. Valuable skills in these field should not be abandoned as we branch out and disperse in too many directions.

1M. It is quite true that St John is ba s ically a caring organisation and I think that what we are trying to do is pull together first aid and nursing. There are a lot of other are a s 4

e ncroachi ng upon our core aim and skil h, uch as the Bad ger\ -a gro u p wh ic h i dev loping a lo t of profiCIenc y Th ere is defini tely a p lace for that.

C W: I agree entirely with what Ian ha said We arc ae arl ng orga nisation and if we see a need we shou ld mee t it tthe sa me time J don't wan t us haring off in all direction'> ]f t John i going to mo ve into the L990 and have a fell selected fir t aider accredit e d to u e emi- a utom atic defibrillator wh e n do \\ e en vi age an oth e r pro gr e being made in term ofa piration , mechanical ain a y ,ve ntil ation etc.

BL. T here i ' going to be an ascending programm e 01 mod ul e ad ded o nt o firs t aid a'> and w hen we devise modu lei wh ic h a re safe, whi c h are insurabl , and with which we can reac h ag ree me nt wi th o th e r majo r agencies - pa rt ic ularly the Red Cros -a bo ut how th ey are used.

Wh at worr ies me is th e "co ll ection of toy " phenomena whi c h we cee in a ll vo lunt a ry a id oc ie ties. T he feeling th at so me how yo u w ill be a b iggc r a nd be tt e r pe rson if you surroun d yo ur e lf w ith mo re and more e lec tro nic devices.

Th e thin g a bo ut m os t of th e e device is th at th ey are nev er wi th yo u w he n th e d isa te r ta ke pl ace and th erefore I wi co ntinu e to pr e th at peo pl e lea rn how to use th e ir hands , theI r eyes and th e ir mo uth with a ll th e varie ty of thin gs wh ic h mal be with th em wh e n an e me rge ncy ha pp e n

On many occasions things go wrong because of po or communication or lack of communication. St John need s an HQ which leads and communicate. Could each pan el member give an area in which he or he feel communicati on hould be improved?

C.W. On e ag ree e ntirel y th a t c ommuni ca ti o n a re often not as good a th ey hould be, but ca n I ay th at o n be half of th e A ss o ci ation th at we ar e tryin g to c op e with ve r y fe w ec reta ri al staff a nd fa irl y rece ntl y we we re down to on e sec retary The ituation s hould improv e s oon

Oneofmy own petLhin gs ha s been communi cation between th e Brigad e and th e A ss o c iation. In th e pa s t th e re ha bee n fairl) open ho s tility but now on the medic a l id e I ' ve tri e d 10 ensure

that anythin g we aredoing t he Brigade knows abou t and certain ly Bria n and I do ta lk very fre qu e ntl y.

I.M. I th in k that comm unicat ion is a prob le m within St John and I thin k there are very few peop le who wou ld n ' t agree. Com mun icatio n is two - way and I thi nk that a ll of us have our own individua l re pon ibi litics for it. Make time to get out and see what 's going on el ew he re w it hin the o rganisat ion and then people can ta lk. and begin to find out what really i'> happening.

AE. The nur<;es in particular feel that they a re no t gettin g the comm un ica ti on'> down from H Q You do need a channel to communicate throu g h and sometime there i<; a block in that channel. One of the things we may be able to do to overcome it is to communica te direc tly.

Dr Lewi'i' list of doctors i in the proce'>'> of being updated and likewise the n urse bu t again we arc reliant on the records that comeforward to L1'i Obviou'ily if we communicate directly with each individua l nur'ie it is going to IIlcreu..,e the cost and we ..,hall e"(am ine that idea in tern,,> of cost effectiveness BL. The Idea that we now have a County ursing and County u rgeon<; ' onference on th e 'iame day - meeting separatel J III the morn Illg and then getting together to d iscu the mutual problem that ha\ e aris e n from thi" in the afternoon - is an IndIcation of the mo e In the fight direction. I would like to see SImilar inittati\e taking place at county and divi ional level. The point I do want to '>tre"" IS that I do not want to see a"we are the master ... no \.\0 " principle . We will get the best OLlt of people if we wor).... \.\oith and a lon gside and support them not if we moni tor, observe and generally critici e I ee ever) Ign that thin gs are goin g to get a lot better but II won't he lp if it only happens at the top There i" no point in talking about our communication'> if when you go back. from here you don't talk to the people - not to tell them what to do but to tell them Vvhat you have heard and explore ho\.\o you can

MEDICAL CONFERENCE

improve th ings in your county. I have heard of divisions in the sa me town who never ta lk to each other feari ng that they might give omethi ng away

Are ther e an y national guideline s for i s uing and wearing of id e ntit y card in re pect of major dutie and / or major incident s ? Man y countie will not make a deci s ion without headquarter ' guidance

BL. There does seem to be a wide range of di fferent ID cards across the country but one of the problems in coming up with a nationa l one is the security fear. Our unifonns are already a bit too ea y to obtain and ID cards could be used to gain acce . to very ensitive p lace.

On thi . point r think it is be s t if Count) Commis ioners liaise with thei r Chief of Po lice regarding ID pas e at public duties Ho\\ can we impro ve recruitment to both the Brigade and A s ociation ?

C W: I have worked a a GP trainer and this ha proved an ideal training ground. I have talked to the medical trainees about our work and this ha encouraged at lea t one or two of them to come and join u

1M: I think we need to make the organi ation more attractive and emure we are up-to-date and forV'. ard thinking. In that way we can take advantage of the neVv kill which are on offer.

AE. I think Vve should help our leader hip at divi ional le\ el to encourage the Energy programme move for\.\oard.

BL. The Energ) programme i the key to thi and I'm orry that orne people haven't got into it. The problem in the pa t year ha been that with the ambulance di pute and other thing man) people have been \er)- bu y On the doctor and ide \.\oe mu I be more flexible when young people are mo ing round the country becau e of their career and 0 cannot be tied to the original divi ionaltructure. Ifthi organi ation could keep onl)20 % of it Cadets it V'. ould ha e all the number it need.

Discussing weighty matters!

It wasn't all ta lk at the medical conference - some po i tive teps towards a healt h ier life lyle were taken.!

It was over a particu lar ly ucculel1l lunch that P h lIida Stewart- Roberts, uperintenden t- in - Chief, uggested that Dame Audrey Emerton (C h ief ursing Officer) Dr Brian Lewi (Su rgeo n- in-C h ief) and Jim Bond (D irec tor of Cade t a nd Trai ning) s ho ul d indu lge in a bit of weight watching - for a good ca use of co ur e!

Joine d in th e ir q uest for th e perfect fig ur e by T he Lord Ve tey, a G rea t Off ice r of th e O rder, t h S t John limmer ' are ta rvin g th em e lve to ra ise m o ney fo r a b urca ry c he rn e for Cadet.

Th e heavywe ig ht uffere d th e in d ign it y o1'a publi c we ig hingIn ce remon y at Smith f ie ld ma rk e t( pic tured on th e ri g ht) but , Ira nge ly e no ug h th ei r we ig ht. were no t revea led ! H owever, thei rpro gre w ill b mo ni to red th ro ug ho ut th e co min g month s.

A Mrs St e wa rt -Rob e rt s ays "W e are a n o rga n i a ti o n ded ica ted to promotin g hea lth a nd we ll -be in g. We fee l it i fi ttin g for u ' to take the lead in hea lth y ea tin g".

"Outside every fat man there is an even fatter man trying to close in"

Kingsley Amis

The Specialist Vehicle Builders

People keep coming to us for something special. Th is is not a sin gle success story - we can tell you man y For the success of Pilc her -Gree ne as a company can be cl ear ly see n and accurately meas ured by the success in serv ice of the many different spec ialpurpose veh icles we bu ild and supply

People keep com ing to us for 'someth ing specia l'

And that' s exactly what they ge t.

We have been successfu l pioneer s in the development of spec ially bu ilt vehicles, that are des igned and equipped for various spec ific tasks for well over sixty years now

By tak ing and adapting the rugged and well -tr ied basic chassis of the world s finest vehi c le bu ilders , PilcherGreene have built the ir own su ccess on

I AMBULANCES I

So successful have these Pilcher -Greene 'specials' become, that we regularly • turn some out as standard vehicles In a highly successful range that offers Wide chOice to our cus tomers I flY different areas of human activity But we're ready to bUild to your speCifica tion - If you have some thing speCial In mind Skilful engineering and cra ft smans hip, uni que bodywork deSign, grea t ca re and atten t ion to mee ting performance nee ds - these are the hall ma rk s of our s uccess In th e crea tion of vehic les tha t will ma tch the speCifiC de mand s of th ei r oper ators - during a lo ng, re lia bl e, an d highl y cost-effective se rvice lif e

Help the museum get St John's history taped!

To commemorate St John IS involvement in the Second World War , our mu s eum is launching it own Oral Hi s tor y Programme. Julia Findlater from the mu seum explain s ho w y ou might be able to help in thi s ex citing hi torical exe rci e.

When we tell the next generation it lIas when 1 was young" it is known as the oral tradition. 1n thiS way lIlfOrmatlon is passed on by telling stories rather than liming It down.

It has become a very popular way of learning about the past. Of course thiS does not mean that oral hi tory "hould be looked at as omething to replace the wntten document. It i simp ly another ouree of information will give u adifferent angle on an event.

Oral hi tory is much more concerned Illth the eye witnes accounts of an event. It explores an individual's per onal experience rather than the official er ion of the event.

The history of the t John Ambulance Association and Brigade is an area that lend it e lf we ll to oral history work..

From minu tes and report we can acquire afaet ual history of the Brigade, but po ken or oral recordings allow us to Oe h out Ihoseevents with the persona l experience of tho e who actua ll y playa part from day today in th e h i tory of the Brigade and the A ocia t ion. This i vital informa t ion t hat might oth erw ise be los [ for ever.

Ma ny muse um ' a lready do this and it IS Wide ly recog n ised as a vita l so ur ce of Info rm ati o n abo ut th e pas t

The ac tu a l p rocess is very imp le. It COnsis ts of a n info rma l ta lk w h ic h is

o nt o a rc h ive qua lit y tape whi c h

IS then sto re d in th e arc hi ve a nd u ed by

researcher and writer

To commemorate the anniversar) of the econd World W ar, the Librar; and M useumat tJo h n' Gatei launching its own Oral H i tory Programme.

Thi year it will con entrate on four area that re late to the econd World War. Nex t year it V\ ill e pand to include other areas of t J ohn e perience. I wou ld lik. e to hear from:

1 V 0 who er ed abroad . in Frane

It a ly, Nort h Africa a nd the Fa r Ea ' t during the war, or after the \\ar in connection w ith the repatria t ion of refuge sand p ri soners of war.

'2. Member \\ho ened, particularly in London during the B litz, in Fir t id po t in the underground and el ewhere.

3. Members ho accompanied Lad) Mountbatten or Lad. B red no k on their trip abroad, during and after the V\ ar.

4. mbulance per onnel who en' ed V\ith t he R oyal a\al uxiliary ick B erth R e erve, the R Me. the R P and other Civil Defen e ervice

If any member or re t ired member are illing to give an inten ieV\ plea e writetolu l ia Findlater. S t Joh n ' Gate. t J ohn" Lan. ler keJl\\ ell. London EC 1M 4 0 or r lephone 071 253 6644. 7

RAMSTEIN

IRAMSTEIN

Learning from the Ftamstein disaster

In August 1988 an aircraft of the Italian aerobatic display team fell into the spectator enclosure at the Ramstein Airshow, causing over 500 casualties. The survivors were triaged, treated and evacuated from Ramstein within 96 minutes.

Squadron Leader Terry Martin , from the RAF Institute of Aviation Medicine at Farnborough , was the British Medical Officer attached to the USAF 316th Air Division Clinic and working for the RAF Unit at Ramstein. In the latest issue of BASICS , the journal of the British Association for Immediate Care, Squadron Leader Martin tells the story of the catastrophe , the response and the lessons learnt.

In this excerpt from his article he details the casualty statistics, the problems encountered and points for future discussion.

Casualty Statistics

Within 77 minute, over 500 s urvivin g ca ualties were evacuated from the site of the di sas ter and by 96 minutes they had all been cleared from the airfield. The method used has been described a the " Vietnam " or "scoop and run" concept, whereby patients are moved as oon as possible to the nearest medical re ource

This procedure can be u ed with advantage when the re so urce s are close by and transport is immediately available, though there is s till a body of opinion which would prefer to tran sport medical facilities direct to the patient s. Their plan is to s tabilise the patients on-site before evacuating them to their final ho s pitaJ destination, thus avoiding seco ndary evac uation later.

The Problems

Were th e re problems? Did we learn anything? Undeniably, th e answer to both is yes but , without doubt, the emergency 8

ervices performed admirably on the day. De pite the planning, it i folly to imagine that anyone can ever be fully prepared for a di a ter of thi cale. No amount of training can predict the human respon es and emotion that play such a large part in the outcome on the day.

The problems encountered by the author may have been locali ed and not found to be problems in other area on the airfield. Many of the i sues hav e been described before and ince, but perhaps it is now time to addre them, and to consider their relevance to di aster planning and training in the UK. The problem areas have been c1as ified into seve n groups:

(a ) The C hao s. The accident wa s udden and unexpected There were overw helming number s of casualties in wideJy di per ed groups. The s heer numberof s pectator s and their freedom of access onto road madetran portdifficult in the early minute after the crash. Panic

wa all around and, with a di a terofth i sc ale, one canno t as ' ume that member of the emergency ervic would be immune to it.

(b) o ntr o l and Commu nicati on ommunication wa almost impo si bl e. s inalldi sa ter , nooneappeared to be in overall control during thoc.;e fir t vital minute when decisions needed to be mad e and conveyed to the growing army of helper. Radio net" were jammed and became unu able. The PA sy tern \\a damaged and temporarily out of ervlce

Those on the flight - line had no ideaif I the diaster plan had been implemen ted, whilst tho e at the nearby Land , tuhl Arm) Regional Medi al enter (L RMC ) had no idea of the cale of the di')a ter. With no obviou leader and s many helpe r5II became important to identify ke) peronnel. Doctors were often indistinguishable from non-traIned personnel, as were nure and other wIth val uable ski lis Instructi ns were givento olunteer , but often went unheeded , Many of the helper. (and casualtIes too) were non-English , peaking, and fell from the US emergency ervice could communicate effectively in German or French.

(c) Medical A et. A dilemma faw the medical planner, - where to place the medical a et? It i impo ible to predi ci where an accident might occur and what might be the effect of th e crowd on rou te acce s.

At Ram tein, the majority of the medical equipment and the ca uall ) treatment pack were behind the crowd line and, unfortunately (becau e of the crowd ), in location that were difficult 10 travel from.Supplie tookupto ISmi nutel to reach the disa ter s ite In addition, Ihe large numbers of ca ualtie meant th ai there were inadequate number of tretcher and blanket, whil othe r upplie oon ran out and delays were ca u ed as frc h tock were located.

(d) Ca ualt y Evacuatio n. Ca ualty evac uation wa obviou Iy hindered by the unfortunate de truction of the dedicated CA EV AC helicopter. Al 0, In the early minute , triage failed a vo lunteer and fir t-aider filled incoming ambulance a nd hel icopter Indiscriminate ly.

Thi inevitably led to a number ofT4 patient (tho e not expected to urvive) being evacuated de pite the effort of a small number of doctor to rationali e the orderofevac uation othatpatient witha greate r chance of urvival could be moved a a priori ty.

(e) Cas ualt y Identification. There were not enough ca ualty label in th e ambula nce and ca ualty documentation did not OCcur at the cene of the accident. Volunteer, thinking only of the benefit of rapid evacuation, moved many patient from the cene without clothing or belong ing which may hav e been u efu l for identification purpo e later. ome of the e patients 10 t con ciou ne or died, and proved difficult to Identify.

This caused great distre to the relatives ofthe mi s ing and a great deal of co nfUSton among t the MCC (medical centre) team who were trying to eep track of all the evacuated patient (n Casualty Tracking. Spectator

Sun'iI'ing cas ualties were transported £0 hospital 'er), quickly. had come from all over Europe and, of more ca ualtie to expect. These ame cour e, from many of the nearby US critici m were voiced after the Boeing ba e The large number of ca ualtie 737 dis a ter at Kegworth (1). were evacuated to 21 different medical Plan s that went well facilitie during the first 24 hour. Within De pite the e ob ervation , there i a week, tho e till ho pitali ed were pread no doubt that the combined US military between 47 facilitie in Europe and the and German civilian emergency ervice USA. achieved a rapid evacuation of all Many of the more everely injured urviving ca ualtie Patient orting wa had till not been identified. It wa an wift and efficient at the Ram tein Ba e immen e task to keep track of all the Clinic and at LARMC. There were ca ualti e and to correlate Ii t of mi ing adequate number of helicopter and an with Ii t of tho e victim who had been abundance of wheeled vehicle. po itively identified. Thi wa The evacuation of ca ualtie tarted compounded by the fact that, a eparated within minute of the accident and familie were reunited. the MCC were continued moothly well into the e ening often not informed and name needle I Many of the ca ualtie had received vital remained on the mi ing Ii t. primarycarebeforetheironwardjoumey. (g) peed of Evacuation. What wa. The tandard of fir t aid that was witne ed undeniably , a marvellou effort by all at by the author wa exemplary. Ram tein cau ed problems el ewhere. The Fire crew controlled the conflagration incredible peedbywhichalltheca ualtie remarkably quickly and ecurity force were triaged and evacuated imply hifted oon cleared road for the emergenc "our" problem further down the line Local ehicle ho pital became inundated. Discussion

Our peed cau ed their receivin g area It i difficult to apply the concept oftnage to be in pandemonium Delay in treatment in peacetime and Ram rein howed u wa imply hifted from one location to that untrained helper will alway tr to the next. To make matter wor e, many evacuate tho e that look wor t, often at patient initially arrived with no pre - the e pen e of more treatable ca ualti ho pital care, alma t all had no clinical who then uffer th con equence of documentation , and the taff at th ho pital had little idea of how many delayed medical care.

A di a ter, b definition. e i t when (co ntinued over leaf) 9

RAMSTEIN

(Continued from previous page)

the number of ca ualties exceed the capability to manage them. Under the e circum tances, result depend on the number of urvivors and not , unfortunately, on heroic effort to treat a few individual Medical personnel mu t triage in uch a ituation.

Without effecti e di emination of information, leader hip i difficult, coordination i impo ible, and valuable time is wasted. Communication I es entia!. Medical team need radiotelephony equipment with dedicated frequencie available.

Other method of communication may al 0 be nece ary, uch as tannoy, handheld loud hailer, telephone land-line and me senger runner. Furthermore, key per onnel must be ea y to identify Ambulances should carry plentiful ca ualty identification/treatmentcard and pencils or chinagraph. There i , unfortunately, no nationally agreed triage labelling sy tern, but Robert on (2), in a review of those label available at the present time , advocate the Cambridge Ca ualty Card and other imilar label which are clear, concise, weatherproof andea ilyallowchangeoftriagecategory if the patient deteriorate or improves.

The timing and method of medical evacuation remain contentiou i ue and Nichol on (3) recently examined the advantage of both the" coop and run" and "on-site tabi lisation" concept. There is no doubt that early medical intervention save lives. Trunkey (4) showed that the average time from injury to definitive medical treatment was 12-18 hour in World War 1 compared with 65-80 minutes in the Vietnam War. The mortality rate of those reaching medical care wa 8.5% in the former and only l.7% in the latter.

Obviou Iy , therearemanyrea on for the decreased mortality rate, but Trunkey suggests that the speed of evacuation is of major importance. Baxt and Moody (5) compared the mortality of 150 helicopter transported patients with asimilarnumber of matched patients transported by road. The airlifted group of patients suffered 52% fewer fatalities.

At Ramstein, there were enormous numbers of casualties and yet an abundance of both hel icopters and ambulances. The nearest accident and 10

emergency unit wa only a few away by air, and there were enough medical per onnel there to cope with the initial flow of inbound ca ualtie

There i no doubt that some had to be evacuated early, 0 that the medical per onnel at th e di ater ite cou Id co ncentrate on the re u citation of left behind. The problem appears to be one of identifying the ca ualty chain "bottleneck " , 0 that en ible decision to hold or relea e ca ualtie can be made. In thi way they can be een and treat ed, either on cene or at a nearby ho pital, with minimal waiting time. Inevitably , this mean s that a sensible mixture of coop and run evacuation and on-site tabili ation mustbe reached by the enior medical co-ordinator. He need to know the sta tu of the ca ' ualty situation, not only at the cene of the di a ter, but al 0 in each of the admitting ho spita l

Planner s s hould also con ider that there will be many victim who are not physically injured Po t Traumatic Stre Disorder i now well recogni ed(7), but experience gained at Ram tein and other recent catastrophe ha hown that we hould anticipate psychiatric casualties amongst the perso nnel of the emergency services as well as amongst the s urvivors. Thus, psychiatric ervices need to be available in sufficient number s to deal with the many ca es that are bound to occur.

Ram tein, like all disasters, can teach

The 1710l1lenllhe dlw/\,(('/' hegan ul.,. We learn from the mi..,fortune 01 so a to a oid making the mi takei oursel es. nlike .,0 III e Europe an I countrie (6, .9), d tors have no fomlal teaching in dl<;a<;ter medicine and perhaps now IS the time to 1001--. clo el) al our planning to a more formah ed sy tern of improving our training. The next di a ter, unfortunately, await u I

Reference

1. lien M.J. Coping the earl) stage ofth! MIdi a ter:atthe ceneandonarrhalatho pit a!. Br Med J 1989 ; 298:651-654

2. Robert on B. Medical management at the cent of the accident. Pro v Int Aviation Emerg Management Conf 1989; 1;31- n

3. Nichol on P.J the helicopter in the immediatl care environemnt. J Br A Immed Care 1988; 11:54-57

4. Trunkey O. Towards optimal trauma carl Arch Emerg Med 1985; 2:181-195

5. Baxt W.G. and Moody P. The impact ofa rotorcraft aeromedical emergency care serl'ice on trauma mortality JAM A 1983; 249:3047·3051

6. Bock K.H. ct al. Management ofma casualtill by the emergency phy ician. Med Corp Int 1988; 3:17-20

7. Raphael B.and Middleton W Aftertheho rror Br Med J 1988; 296:1142-1143

8 Labeeu F and Bellanger '. Oi a ter medicine · Teachingat the Univer ity ofCreteil. Acta Belg ct 1986; 138:119-121

9. OunantJ.H. and Rosetti M. Ma s disaster medicine; Teaching in Corps Int 1988; 3:37-38

(The comp e te paper by Squadron Leader Martil was simultaneously in the Journal oftW Royal Army Medical Corps and the Journal oftW British Association for Imm ediate Care)

County and Division News

Gloucester

Gloucester t George Ambulance Division blow up their first aid post every time they go on a duty - and they use a lot of hot air to do it!

The division wanted to purchase a new first aid post to mark their Golden Jubilee year but with only £700 to spare they found the choice very limiting.

It wa while Corporal Derek Phelps and DIS Steve Tainton were on duty at the Three Counties Show that they potted a very interesting display by the Hereford & Worcestershire Ambulance Service housed inan even more interesting "airshell" construction.

However, thi ideal con truction cost £1400, double what Gloucester could afford.

Corporal Phelps' employer - Gloucester Contracting - stepped in at this point with pon orship for half an airshell, and now the Divison is the proud owner of a bright orange first aid post - measuring 9x12 ft.

It ha skylights and a back window with curtain. It can be inflated by electric blower, footpump or air cyllinder. It is big enough to hold two stretchers, a dressing tation and two chairs.

July 1990

Norfolk

Earlier this year Breckiand St John bid a fond and sad farewell to Winnie

on her retirement after 36 years service. She joined the Brigade in 1953 and became Cadet Officer at Thetford in 1959 and Divisional Superintendent in 1960, a po ition she held for 10 year

She was appointed Area Staff Officer in 1970 and Area Superintendent (later to be known as Deputy Area Commissioner) in 1973. She was admitted to the Order in 1969 and promoted to Officer Si ter in 1979. Among the gift she recei ved wa a rose bowl pre ented by the Area Commi sioner.

Cleveland Divi ional Surgeon Dr Ian Holtby ha recently been appointed a consultant in public health medicine at South Teeside Health Authority.

He will also be the consultant in communicabledi ea e control and will advi e local authorities and the health authority on how to deal with infectiou di eases on an individual ba i as well as major outbreaks.

Dr Holtby first developed this interest in public health medicine, and particular communicable di ea e • while working in Nigeria in the 70 . He has been a Divisional Surgeon for 15 year.

Thefinal product generol/sly sponsored by Glollcesterslllre Contracting.

Parslow

,

AROUND THE DIVISIONS

Narthumbria

Pictured left: Div.SuptJoe Carr, Bertie Badger (alias Philip Latham), teacher Miss Hutchinson and pupils of the reception class of Alexandre Road Infants School, Gateshead who have just completed a project, a play (and a cake in the shape of an ambulance) about SJA.

Skegness

Pictured above are the first Super Badgers in the county of Lincolnshire. They are all members of Skegness Bracing Badgers (Skegness is so bracing!) and were pre ented with their certificates and pottery Super Badgers at a recent presentation evening by the Mayor of Skegness, Ken Holland, and the newly appointed County Badger Leader,Jo Ellis

Pictured are Reuben Dalton, Helen Grunhill, Diane Grunhill and Joe Dixon with Jo Ellis.

Leigh-an-Sea

A very proud Georgina Childs (pictured left ) displays her pottery Super Badger.

She was the first Super Badger at the Leigh Bouncy Badger Set and also the first in Essex.

At the same presentation evening five Cadets from Leigh-on-Sea Combined Cadet Division were presented with their Grand Prior badges.

They were Donna Harman, Ann Judd, Claire Batley, Kerry Mayhew and Jennifer Davis.

• AROUND THE DIVISIONS

Northamptanshire

Pictured on the left is Richard White, newly promoted to the Cadets after completing his Super Badger award. Richard was a memberofthe Explorers badger set at Kettering in Northam ptonsh ire.

Richard wa pre ented with his certificate and" Super Badger" award on March 26th by Frank Robert , a former County Commi sioner and now Special Friend to the Explorers grou p. Richard wa the first Badger to win this award in Northamptonshire

Farnham

Clwyd

Over a thou and people attended a diocesan event at St Asaph Cathedral ," North Wales taken by the Most George Noakes, Lord Archbishop of Wales - a ub prelate of the Order ofS!

John

The Cathedral was packed and some people literally fell into the cathedral nav e

Mrs F. Hall, wife of the Diocesan Administrator is shown above beinl treated by Catherine Hughes of the Ruthin Division as isted by Nursing mel11 ber Sheila Brierly of the Rhyl Division.

At the recent Farnham Maltings Railway Exhibition. Brewster Mou e of County Sound fame (Surrey and Hamp')hire local Independent local radio tation) met Kelly Pharo and Deborah Knowle of Farnham Quadrilateral Division.

The locomotive was made by Mike Hayter of the same division - the engine is used a lot to transport boy and girl up and down a man made track to help rai e money for the divi ion

On this occa ion all proceeds from the rides went towards the Farnham New Ambulance appeal fund which i hoping to rai e £25,000.

24 HOUR NEWS

When on duty at a motorbike rally near Farnham, the division put their old ambulance through its paces and it failed ( see right)!

The army was called upon to help cure 'that sinking feeling' and Farnham' old four wheel drive ambulance was rescued.

The incident prompted the cartoon above which unfortunately is lacking a caption - so it's over to you.

The best caption win a year free subscription to St John World! Send your suggestions to Carole Richmond. SJ World, 1 Gro Yenor Cre cent. London, SWIX 7EF.

AROUND THE DIVISIONS

St a fford

Tadcaster

The North Yor hire Re 'cue Competition held at Huby near York wa won b) Tadca ter Combined Division.

Pictured above are John Walton. Norman Clark, Ian Lawrence, DaVid Newton and Richard Oaten - three of the team only joined St John five month ago!

Somerset

Dyfed

The Dyfed Eliminating Round of the combined St John Ambulance and Dyfed County Fire Brigade First Aid Competition were recently held !O Carmarthen. Pictured above is the winning Cadet team from Haverfordwest, it was taken in the Day Room in Withybush Ho pital where Jamie Franci (a teaOl member) is currently a patient.

Left to right are Claire Dow; Jami e with the team trophy; Emma Griffiths and in the back row Robin Shepherd and Kathleen Osborne.

Special case for the disabled

Dear Carole,

Inans wer to the letter titled " Ignoring the Di abled" in April 's St John World - t John Ambulance has had members who have suffered from some physical di ability for many years now.

Speakin g for my se lf I uffer from pooreyesight and have been a polio victim all my life, yet I have had the joy of wearing the uniform of St John Ambulance with pride for 35 years.

I have held the rank s of Diviional Officer and Divi ional uperintendent during that time. In 1971 J wa informed by an eye surgeon that my eyesight wa so poor that I qualified to be included in the partial sighted category and wa ubsequently added to the regiter. I relmquished my poition and became a DI\ i ional Vice -Pre ident. The St John Staff know and value the work I have done for the Brigade

I wou ld lik e to take you back in time to \I, hen [w as a mall boy during the war.

Iknew many people with di abilitie , yet they managed to playa veryeffective and Im portant role in the community to aid the war effort. t the pre ent time, phy icall y di abled people and in fact some mentally handicapped per on are encouraged to work - indeed ome are in full tim e emp loyment and are we lcomed wit hin the community.

St John hould help and encourage disabled per on to practice Fir t id even if only in a :upervi ed way and perhap co ndition al on the di abi lit y he or he may bear, perhap wearing a modified uniform.

For the past 16 year, I have worked for the blind , disabled and handicapped

Cub a a Cub Scout Lead r and now I find as a Divi ional-Pre ident in St John Iam now no lon ger a llow ed to wear my uniform, in which I have rai ed abou t £1 1,000 over th e pa t three year for my Division.

I welcome the Commis ioner-inChief' new working party. Wh e n thi gro up make their report , I am hopin g to ee that they have co mpa ion toward the disabled and modify a uniform for

them marked 'Disabled Member '. As a di abled per on my . elf, I feel strongly that the e member need under tanding and kindne to encourage and upport them in what they would dearly love to do

Tn addition to what I do a described above. I am a member of four sc hool board , War Pen ions Committee , the local D.H.A, Trade Council and many other public office.

I do ask that di abled people are allowed to do a they wi h and to feel that they are playing a normal part in ociety.

Kenneth Green Divi ional-Pre ident toke Central Combined Divi ion

.. and for the paramedics ?

Dear Carole,

We would like to approach the ubject of recognition of profe ional Ambulance per onnel and tho e able then to u e paramedical kill in StJohn Ambulance Ambulance er ice, Health uthoritie, the Department of Health and the Government all now clearly recogni e the kill ' u ed b qualified ambulance per onnel and tho e licen ed to provide paramedical kill.

t John ha recently changed it uniform to include further recognition of profe ional doctor and nur e but profe ional ambulance per onnel and paramedic wer again not included. The prafe ional doctor and nur e in Brigade uniform are in tantl recogni able b other Brigade member and by member of th public, with the u e of coloured epau lette Ie ve ,and name patche on each arm.

The St John vi w of profe ional Ambulance per onnel and adly al 0 paramedic mu t till be back in the 60 We em to be regarded a full time fir taider. Thi is a terrible mi take.

Derby hire , a with many other co untie ,join for e with it nei g hbour to he lpcov rmajorevent Atthe eevent qualified Ambulance per onnel are recogni ed for th eir kill b tho e member who know them per onally, bur

at a large and bu sy public duty, it i inevitable that many will not. OurDivi ion contain many profe sional Ambulance personnel andquite a number are licensed to provide paramedical skill s, yet all but one are Ambulance members, and apart fram thei r proficiency badge on thei r tun ic, are indi tingui hable , e pecially in hirt leeve order, from any other ambulance member.

Thi can cau e unnece sary problems. For example at a recent event, a qualified nur e prevented one of our qualified ambulance member s from carrying a patient who had an LV. in place until they managed to prove who they were with their health authority I.D card.

Thi wa an everyday job to our qualified member. In different circum tance thi type of incident could have been detrimental to the patient, and wa totally unnece ary and could ha e been a oided.

The profe ional nur e i instantly recogni able to our member, yet he wa not in tantly recogni able to her.

A y tern already exi t to cater for profe ional doctor and nur e and would be relati ely ea y to extend to include: Qualified Ambulance Per onnel: qualified ambulance, qualified in orne paramedical kill : qualified ambulance, qualified in all paramedical kill ( H TA ). coloured epaulette Jeeve arrangement could be adopted, imilar to the other with different coloured bar for different Ie el

It i time to let our profe ional mbulance per onnel help bring St John into the 1990 Divl upt. M.Wiggins A.E.M.T.

AI M M.Fuller B.E.M.T.

A I M A. Magee B.E.M.T.

AIM D. Wiggin M. . .Ch., M.B.Ch.A .• A.E.M.T.

AI M M.Fo ter R.E.M.T. (qualified ambulance aid and paramedic In tructor)

View e pre ed b) reader, although publi hed are not nece aril) endor ed by the Editor or the Order of t John and it foundation V riter mu t upply their full name and addre to the Editor.' rite your letter to Carole Richmond, John World, 1 Gro \enor re cent. London 'VlX 7EF

Pictured above are joint winners of County of Stafford Cadet of the Year - Emma Bidulph (Stone Quad Division) and Andrew Holmes (Longton Combined Divi ion). These Cadets will represent the County at all important functions.

Pictured above are Badger pairs taking part in the Wes t ern Area Co m petitions held at St Audries School, West Quantoxhead. Western Area Badger Leader, Margaret Hatcher is judging.

4

2.

DOG BITES

What to do when the dog bites

In

H owever, there are about 6 million dog s in thi country and on an average about 200,000 patient s attend ho spital each year a a re s ult of dog - bite.

Many death do occur, mainly in children , and everyone mu s t be aware of the fact, epecially parent s, that infant left alone with dog are at ri s k of death or injury

W hile the majority of dog-bite are ' minor and predominantly affect t he limb , major injurie s can al 0 occur. The e injurie may be of lacerating , penetrating or of the c ru s hin g type. Severe facial and eye injuries are common.

Damage to the che t ca vity, perforation of the abdominal cavity and compound fracture have all been recorded.

All the above injurie s , including the minor one, mu t be treat e d carefully as there is a HIG H ri k of infection ; about 30 % become infected

F ir t aid and later ho pital treatm e nt hould con s i t of: -

I W a hin g the wound thoroughly with plenty of oap and water. In ho pital the wound and urrounding kin will be rin ed w ith a uitabl e anti eptic uch a iodine or iodine olution . .

2 Remo e c on tricting jewellery from a bitten extremit)

3. It i be t that all bite , including cat and human , hould be treated by a doctor or ho pita! , depending on the nature of the Injury te tanu injection will probabl be needed and proph y lactic a ntibiotic maybe required. ometime blood - to uch that the patient may need a blood tran fu ion and e mergency urger y.

ny form of bite ,be the y dog. human. cat or hor e, when the kin i penetrated. can get infected Thi · infection de elop rapidly in one ortwoday ' , with e ere pain. fever, pu -forrnation and urroundingredne of kinand will require urgentho pital treatment.

It mu , t not be over looked that the family of the child / per on bitten will need rea urance, a with the high media co erage of the apparentl increa ing number of bite from powerful dog ( g Rottweiler ,German Shepherd, Pit Bull Terrier etc ) th tendency for panick reacti n i often pre ent and the calming intluence of the fir t-aid r invo lved can pia an important role

ccording to the R PC dog attack are on the in rea e and people are utTerin g wor, e bite impl becau , e there are mor large dog in the country than e er before The R P ha:i u d guideline on how t beha e to minimis the ri k of dog bite

b ve all don t panic or the dog rna en e our fear and become e cited Don t cream or run. ]f a dog ' niff: at ) our hand ,don ' trai e ourarm . Hema thinkiti agameandjump up Don t tare at the dog - he will thinldhi i a ign ofa g re ion. Try ayi ng it in a t rn oice or walk and back , lowl (1\1, a), k ping a careful e e on the dog

Train yourchildr n to ' tand t ill and quiet and not rai e their hand if a dog approac he '. Tr no r to fright n them a, h terical e ri e or movemen t w ill e cite a boi , ro u: dog.

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WOUND MANAGEMENT

Guidelines on wound management

by

ADRIAN REYES-HUGHES DipN (Lo nd ) RGN LHSM, Divisional Nursing Officer - Ley ton & Leytonstone Division

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V ideo ava i lable show i ng ho w thorough ou r wo rk is

exhausted first aider is no u e to anyo ne and it's such a relief to get into th e oarde nat this time ofyearto pOlleraround , up and eventually ju relax.

But an injured first aider is even les'> use than an exhausted one and two recent repo rts indicate that the garden is an espec ially dangerou place.

According to the hartered ocietyof Physiotherapy orne 250,000 ga rdeners requi re ho pital treatment every year, maIn ly through gardeners bending and lifting heavy objects badly and not wa rming up before the y start strenuou exerc ise

The R IB reports that 7,000 people are likely toend up being treated in ho pital thiS year for e e injuries incurred in the garde n

Both the hartered ociet)' of Physiot he ra p i '>lS an d RIB have publi hed guidelines for safe ga rdeningthe highlights of which we reproduce here. Take note, take care and you'll tay fit for your public dulie !

DIGG I NG N D H OVELL I G

Often injuries ccur because people don't \\arm up before they tart to dig Gently bend ing and your back before you start will limber you up and much reduce the risk of back train.

Digging and hovelling involve ' bendi ng, twisting and lifting. For safe digging:

Don't toop. When lifting or sho elling take the strain with your leg rather than you r back.

Keep your back traight and lightly arc hed. The mu cle in your leg ' are stronger than the mu cle in your back. Don't tay in the same po ition for too lo ng. It puts a strain on your whole body. SLOp frequently and change your bac\... po ition. Eith r do a ta k in the gard n thai require a different working po irion Or have a re t.

When hovelling rubbl or earth, shove l ma ll amount eac h time. Use a long- hand led pade so you don't have to bend 0 far.

WEE DING AND PL AN TIN G

When weeding or p lanting in your garden don't toop down, however tempting it

may be to do so.

Move clo 'e to your work. Kneel down on a mat or u e pecial knee-pad or a kneeler. You could u e a low tool.

Alternatively, u e a long-handled fork or hoe 0 you don't have to bend.

Don't train your elfby over-reaching. Move clo er to the object in tead

L I FT I G

When lifting in the garden:

Keep your back traight bend your knees and pu h up with your leg mu cle

Keep your feet about I inche apart for balance.

Don't reach for the load or try to pull it toward you. It may be heavier than you think, mo e clo er to it in tead.

Hold the load a clo e to your bod a po ible.

Keep your houlder ell back and your aml a rela ed as po ible. ever carr a load that prevent OU from eeing where ou are going.

P U L L I NG

Be careful when ou are pulling up a deep-rooted hrub or tree. Remember to take the train on your leg and ann mu cle rather than your back.

Keep clo to the object and hold it firm ly.

With your feet apart, crouch and bend your knee and lean away from the obj ct.

Pull the object by traightening your leg

Keep your back traight.

Move backward with your knee lightly bent, allowing your leg to take the train.

The RIB' re earch how that eye injurie in the garden have r1 en by 40 O/C in five year. Gardening i the third mo t likel; acri ity to cau e dome tic eye accident after DIY and car repair.

Accident are often cau ed by garden cane piercing the eye. thorn and branche hitting the eye during pruning and power tool throwing up harp object There i danger too in chemical particularl pray and creo ote

It particularlyea y to guard again t lI1June cau ed by garden cane b attaching i ible object like empr yoghurt pot, ping pong ball or pecially de igned rubber tip onto the cane.

RIB Director General. Ian Bruce. aid "There nothing nicer than a day spent pottering about in the garden. But we would a k people to top and think for a moment before tackl ing e eryda garden chore .It onl take ' a moment to put on ' afety gla e b fore u ing power tool for cutting the gra or hedge trimming. prayi ng the ro e or cr 0 oti ng the fence and that moment ould a e thou and of people from e e injurie ."

LIFTING WEEDING & PLANTING DIGGING & SHOVELLING

2

24 L ead thr ee animal s (5)

26 Av era ge ac hi eve m e nt rrom no sec ti o n o f th e o rces (4 )

27. Stud y int e ns ve y (4)

29. Sli g ht affec tion in v ol v in g ove r 50 and a m o n arc h (6)

30 B o il mu s c han ge to se ri o u s t y pe o f f oo d po i soning (8 )

3 1 Min e ral o pl as er o p ari s (6)

32 Di sea e- p ro du c in g o rga ni sm (8) DOWN:

I. Ordin ar y co ld se n se o r ca r o tid art er) (6)

2. han ge in a c ult f o r o ne h av in g seve r e m e nt a l di 'io rd er (7)

3. kin co nditi o n rr equ ent in 14 aero'i'i ( 4 )

4. A c ti v it y p os 'iibl y p arl o r 17 ac r os :-. (5-7)

6. H arm o n y f o r o ne (5)

7. C o n cea o ld b oy's re m ed y (7)

8. Three MO 'i in e'ita bl i'i hm ent ror rh e e de rl ) (4.4)

II Pa ssage o f a ft -co nt ai nin g stooh fro m .., h o rt t oe area (12 )

15 tar m ay be an o ld 'i avo n ic ru le r ( 4 ) 17. O xyge n ow in g t o mu sc l es a ft e r an ae r o b res p irat ion

I T ease o m a n i pul a e a f ra lure o a l owe r l i m b (4 1.3 )

20. Pra i se hi g hl y and b rea h - dow n

CHIEF PRESIDENT'S FAREWELL

Goodbye after six years hard work

\lrsHarold Phillip retire from tJohn this month after ix lears service. She will be greatly mis ed. . "On retiring from t John my la t mes age i one of thanks to you all and the Pre idents \\- ho have made uch an inlaluable contribution on countle occa ion throughout Ihe country.

li My re pect and admiration for your dedicated work in Iheservice of mankind will alway be treasured. I hope you \Ii ll continue t o build o n )' our achivement , with all the support that i po ible and a retiring hairman of t John Ho u e Club I hope you ,,,ill continue to upport it too.

"My man . vis it s to t John over ea haH been hea rt\\'arming and . eeing at fir t hand the wa) in th ey carry on their , .. ork , often under great difficultie s becau s e of lack of fund and g eographical problem.

li Th e 0, e r se a s se minar in Kuala Lumpur in Ma y m) las t \i it a bro a d fo r S t John and there i no more wonderful place than M a la ) s ia for me to end m y ye ar a C hief Pres iden t. "

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• Sophisticated instrumentation monitors insufflation techniques , pressure and hand positions as well as air volume Display can be read from both Sides, providing convenient instructor/student interaction

An offer this good, turning in your tired , outmoded non Ambu ® tra ining doll for £105 reward towards the purchase price of a new Ambu ® Man , can 't last forever. So make your move now!

Mon ey is o ur bu si n ess a nd we lik e t o u e i t t o help those chariti es who ca re for th e youn g, th e elderly, the dis advantag ed a nd th e di sa bl e d.

We also support con se rv a tion , m e di ca l research and educ a tion.

We are one of the largest corpor at e contributors to the community a nd int e nd to rem ain s o . During 1990 we plan to spend £11 million across a wide ranging programme of activities. A large part of that sum will go towards su pporting the worthwhile work of around 2,000 charities .

We prosper on community strength. We aim to ensure that the community continues to prosper on ours.

BADGER

Number 12 SUMMER ISSUE

BARCLAYS , ,

Design a Cake BadgerBoard Factfile

Win a Sylvan ian Badger

Pe n Pal Stop Press

Make Your Own Cyclist s Spot the Difference

Festivals , parties and feasts are a time for people to get together and have a good time in celebration of a religious or sporting event a birthday or maybe an anniversary In Rome , festivals for religious commemorations , anniversaries of military victOries and celebrations of rulers birthdays were common , In fact they had so many that we wonder that they had time for anything else!

A Very Special Birthday

The Queen Mother celebrated her official 90th birthday in June with a wonderful parade through London In which St John Badgers participated Her real birthday, however, IS in August and as Our tribute to her we would like you to design a birthday cake.

Draw us a picture of the sort of cake you think the Queen Mother would enjoy It can be any shape and size and as fantastic as you like The winning design will be made up into a real cake by Searcy's who provide food and drinks for many famous parties and events and the winner will be invited to St John Headquarters in London to see them put on the finishing touches. Please send your entries to Sarah Harris, 1 Grosvenor Crescent, London SW1 X 7EF to arrive no later than Friday 24th August 1990 Please make sure that your entry has your Name, Address, Age and Badger Set clearly marked on the back.

Very many Bntlsh traditional celebrations have been lost over the years but have you ever thought what they do in other countries? We cannot begin to write about all the festivals in the world as there must be hundreds taking place every day particularly in countries like Japan

The Japanese are a superstitious people who still have festivals in celebration of different spints who they believe guard their fishermen or their rice growers or even their dead In Fukushima City hundreds of thousands of paper lanterns can be seen floating down the river at a designated time in August. They each represent the soul of someone s ancestor and this ritual IS followed by dancing and fireworks In Greece they celebrate " name days " rather than birthdays, but you still have one every year and they are called " Paneyeri "

Mardi Gras is America's most famous carnival , and it is held to celebrate the advent of Lent in New Orleans It is a fairly new tradition , only having started in 1857! The towns people throw enormous parties or balls to which they wear outrageous costumes and masks

In the next door continent of South Amenca , Brazil celebrates the same religious festival and in Rio de Janeiro they have the biggest street party In the world which lasts for 4 days and 5 nights Everyone gets caught up in the carnival mood Again they dress up in bright colours and dance around the city ThiS particular celebration is famous for its floats in the procession These are colossal floral structures which are transported around RIO with people on board waving and cheenng at the crowds

June 23rd is the feast of St John not only In Brazil, but also In England In South America bonfires are lit and fireworks set off to wake the Saint whose spirit then joins in the festivities In England a similar ritual was revived In Cornwall in the 1920s and the pagan ritual of lighting fires across the county is still carned out.

Within St John Ambulance June 23rd IS a day to celebrate and we give thanks for our Patron Saint with a parade and festivities

In the last Badger Board we advertised the Stamp Land exhibition which was a huge success , as those of you who came to Alexandra Palace on a very hot Saturday in May will remember I now have some exciting news about the Guinness World of Records Exhibition at the Trocadero , Piccadilly London W1.

Through the use of life size models , videos and the latest audio technology, thousands of world records come alive at the touch of a button Six themed areas depict The Human World The Animal World Planet Earth , Structures and Machines , The Sports World and The World of Entertainment.

The Exhibition runs all year round and they are offering special group rates and one free adult entrance to parties of 10 or more

This is a photo of the Great Yarmouth St. John Ambulance Badger Set Two who held an extra special party for over 100 e derly people from the local community, residential homes and the hospital in April.

FACTF LE

The largest children S party ever held was in Hyde Park , London for 160 ,000 on 30-31 May 1979 and celebrated the International Year of the Child.

After the first year, the Chinese people usually only celebrate their birthday every ten years

A favourite present, the "Teddy Bear ", got its name from U S President Theodore (Teddy) Roosevelt who was photographed with a baby bear which set the fashion for the name.

When the custom of "toasting " a person first began , a piece of toast was added to a glass of wine to improve its flavour

Nowadays to toast someone means that their presence adds flavour to the party

The song " Happy Birthday to You " was written In 1893 by Mildred & Patty Hill and It has been sung more times than any other song in history

The Roman Emperor Nero Invented Ice cream for his parties Snow would be gathered in the mountains by his slaves , then brought back to the royal kitchens & mixed with wine and frUIt. After weekend parties at Sandringham , the Royal Norfolk residence , King Edward VII would weigh his guests to make sure had eaten enough food

C MPIIIIIOI

The first 20 correct answers pulled out of a hat will win a pair o f tickets to the GUlnness World of Records Exhibition and a GUlnness Book of Records

1. What is the most common co ntagious disease?

a) Measles

b) Common c old

c) Chicken Pox

2 What IS the largest hospital m Great Britain?

a) Guy s Hospital , Lon don

b) Stoke Mandeville Hosp tal , Aylesbury, Buckinghamshire

c) St James's Hospital , Leeds , West Yorkshire

3. How long are the largest amb ulances In the world? (known as jumbulances)

a) 18m

b) 10m

c) 35m

Entries should be sen t on a pos tcard to Sarah Harris , 1 Grosveno r Crescent , Londo n SW 1X 7 EF and they should amve no late r than Friday 24th August 1990

You could win a member of the Underwood Family to add to or start your very own Sylvanian Family or alternatively a set of Fluf fits ; unique designer pens which paint fluffy designs on T- shirts , bags or just about anything

The children of the Sylvanian Families are all different. All you have to do is identify five of them from the descriptions we have given , and tell us what type of animal they are

1. My name is Rusty Wildwood I have long ears and a small fluffy tail. What am I?

2. My name is Lester Thistlethorn have Whiskers, a long smooth tail and I like cheese. What am I?

First of all paint the pasta bows , one side at a time with your friend s favourite N

With

When all the pasta shapes are dry pamt them with clear nail varnish - again one side at a time or else it will smudge

Cut a piece of string as long as you want the necklace to be and then thread the pasta bows and tubes onto it. Remember to tie a knot before you start threading!

To make the necklace even prettier you could cut 2 inch lengths of ribbon and then tie them around the middle of the pasta bows

4 My name is Buster Slydale I have a large bushy tail a long nose and I call my home a den What am I?

5 My name is Ashley Evergreen I have no tall , I am cuddly and like honey What ami?

Entries on a postcard please to. Sarah Hams 1 Grosvenor Crescent, London SW1 X 7EF, to arrive no later than Friday 24th August 1990

3. My name is Misty Waters I have two large front teeth , a large flat tail and I like water What am I? A Resourceful Badger can transform some pasta, poster paint , nail varnish, ribbon and string into a fabulous necklace to give a friend to wear at their next party

We have had a fantastic response for pen pals please keep them coming but make sure your name, age and address are clearly written along with the county you would like to write to somebody in

WIN A I

CONTRIBUTIONS

Contributions

LID"!

Stardom for Eric and a dizzy deb!

The tabloid new paper had a field day with thi picture when Eric Hearn re cued Jane Chapman after he had fainted in front of the Queen' carriage. Jane, 18, collapsed ju econd before the Queen appeared at Royal Ascot and there wa n't room to get a wheelchair to her. So 53 year old Eric aved the daybygivingJanealifnothefir t aid po t 40 yards away.

Lack of first aid knowledge kills

A poll carried out by St John ha once again di covered that people do not know enough about fir t aid and that ome parent could actually harm their children through ignorance.

In the poll, parents were a ked four multiple chice que tions on ba ic first aid procedures relating to poisoning, head injurie, choking and evere bleeding. The answers showed very little improvement ince the last major St John Ambulance first aid poll in 1988. 68 percent of all parents surveyed got at lea t one answer wrong.

On hearing the results oflhe poll, St John Ambulance Director General, Rob ert Balchin, said "The importance of emergency first aid cannot be over tated -the poll re ults are proof of this. The most effective way or learning first aid is to do a first aid cour e. Every individual can learn th e basics, and time and time again it is these basic that actually save liv es".

Putting the overseas record straight

On behalr of overseas members, I should put the record straight concerning the text in July SlW which accompanied the group photograph of delegates who attended the recent overseas Sel11lnar. The notably successful 1990 Far East and Australasia eminar was indeed the rirst international t John conference to be held in Kuala Lumpur or indeed in Malaysia. one the less, it was preceeded by other meetIngs whIch havc takcn place from lime to time, in the Far Easl Africa, the West Indies and Canada. The rrequency , however, IS about to bc stepped up because there is no substitute ror face -Io - face contact as members of any closely knit family will know Under the leadership or the DIrector Overseas Relations a 1991 Seminar in Bermuda will enable representatives from orth America and the Caribbean to update themselves in professional, technical and other matters in a spirtt of partnership Wegratefully acknowledge the assistance or all former host country t 10hn organisations and look rorward to the next seminar and the opportunities it will provide for developing our activities world-wide.

Gp Capt Keith Batt, OVERSEAS RELA TlONS

NEWS IN BRIEF

Lady li/.abeth odsal took 01, from Mrs llarold Phillip asChll President on 1une 24 1990 Ld EliLabeth has a slrong 51 Jot background and she has been thl: Brigade ror 23 years Forti past ')cven years she has betl ommlssloner In Ber"shlre

The rollowrng have been III the BIrthday Honours List forw r" with tJohn Ambul anc. MBE ndrew.., ( uerolk )

M r G 1eynd. (M id G lamorgan Mr P axton ( &W Yorks)

The late Paulrne O'Donn el who had Ju'>t last year han dd over her appointment as \1al rnn of the t John Ophlh alml( Hospital In wa\ alse awardcd an MBE nfortun al( she died onl four days before th! publIcation or the LIII

The first concrete sign Ih emergency ambulance ser\ICc' could be amalgamated v,llh rtf' brigade.., hal., emerged wuh th, new..,ofa pilot '!cheme 111 Lond on

The fire brtgade In Intends introducing an eighl -I\ W paramedICS training course fire fighter" to provide them \1 111 "kills normally assocIated \1 iIi ambulance "tall.

The Lady Mayorc'!s's Conee O. organised by the MUSical SOcle and "ponsored by all on al Westminster Bank. lak , ,lace" The Guildhall, London on I) l:ptember.

Tickets COSI £ I00 each and the evening 01" MO/arl featu[i \ performances by Emma Johns on and the ngl ish Chamber Orchestra.

HEALTH AND SAFETY EXECUTIVE UPDATE

New guideline s iss ued for Fir st Aid at work

The Health and Safety Commi sion has jusL publi hed a reVised Code of Practice and Guidance which deals with firstaid in the workplace.

Called 'Fir LAid at Work', the new publication was launched by Dr Tim arter, Director of the Health and Sarety Executive's Health PolIcy DiVision.

He said at the launch "The Importance or first-aid 111 the workplace cannot be over estlmaled. Each year over 150,000 suffer serious injury at work. Fir taId pla}s a vital part In earl)-

treatment and in reducing the toll or deaths and disability.

"This new Approved Code or Practice and Guidance is based on everal years experience and reflects the change in emphasi toward assessment of the actual risks or injury in each workplace and providing the skills needed LO deal with them."

The main changes in Lhe revised Approved Code or Practice and Guidance are:

- Employer , hould make an asse smenL or the hazards in their workplace when deciding on the lype or first-aid provi ion and the number or fir L-aider should be ba ed on that a e menL and not just the number of employee.

- First-aider should be Lrained to deal with the pecific hazard or their workplace ratherthan having a more general training a an occupational fir L-aider.

- When deciding on hi provi ion,

an employer should take account of regular foreseeable absences or fir t-aiders, like annual leave.

- On training, the length of the three yearly refresher COUL e has been increased from one LO two days.

- Change have al 0 been made in the criteria for approving the training and qualifications orfir Laider and their trainers.

In addition to the e main changes, the Ii Lof item for fir taid boxes and kits ha been modified to reflect experience of actual u e; and the training syllabus will now include protection again t Hepatiti Band HIV.

Fir t Aid at Work,co t £2 and i available from HMSO and book hop.

(All County DirecLor have received a letter rrom the A ociation detailing the implication for St John).

Your St John Ambulance

Membership entitles you to 6 weeks free • car Insurance •••

' " take advantage of one of the be t , low -cos t car Insura nce policie you can get and, becau e you are a membe r of t John Ambulance, and con idered to be an excep tionalJy careful and re pon ible driver, you will al 0 get the first 6 week of cover absolu t ely free. The Car-Line Motor In urance Policy offer you a of car in uranc , either

at no extra cost. cl Optional extension to this policy include a no dalms bonu protection , I gal protection and a 24 hour a ay Road Rescue Service.

s' For an imme d iate, no o b ligation, free quote, ShlllP1y Freephone 0800 289 578. Written confirmation ouid b e with you the very next day.

Every employer hould have a written policy to deal with drug abu e, the Health and Sarety Executive ay in it recently relea ed booklet 'Drug Abuse at Work (pictured above). Drug abu e can cau e accident , time off, low morale, bad work and 10 t profit but employers can minimi e these by introducing workplace policie ays the free booklet. It i available from area office of the Health and SafeLY

COUNSELLING Counselling with care

After the tragedy of Hillsborough it was proved that counselling by fellow members of St John was the most effective way to help those that had suffered trauma. Regular counselling courses are held at HQ by Dr Clifford Smith and In this article he gives a basic introduction to the subject.

Thi feature i not intended a guidance for tho e who are coun eHing in a profes ional capacity. It attempt, rather, to explore the i ue of coun eUing and to give elementary guidance to tho e of you who are ometime approached by a per on wi th a problem

If a problem is very erious and/or you do not feel able to help, refer the person to a profes ional agency or to someone who you feel has more experience.

In thi s feature we will cover six topic : Whatis coun elling?; A coun ellor' qualitie; Hazard to coun eHing; Setting Up; Technique and Assessing whether the coun elling ha been successful?

What is Counselling?

Counselling involves helpin g a person to look at their problem from all view point s, weigh up alternative and make their own choice about the action to take All thi hould happ en in a safe, supportive environment.

Counselling i not about giving advice. A we are not really in the other perso ns 's hoe and cannot ee all the ubtle pre sures that are operating in their lives, it i difficult to give accurate advice. Mo t people just need so meone to talk to, and to help them organize their thoughts.

Also , the experience of working a problem through themselves will help them to find their own olution next time. What qualities does a Counsellor need?

In orderto provide the 'safe and s upportive environment for effective co un selli ng, the Counsellor needs to have certain qualitie s, some of which are outlined below:

Empathy - the ability to put oneself in the counsellee's hoes and to see things as they do

Respect - unconditional respect for the co un sellee.

Warmth - again, this should be un conditional a nd genuine.

It is very important that the counsellor is aware of hi s or her limitation s - if you feel unable to cope with a Counsellee then contact an agency who can e.g. Marriage Guidance, Samaritans, Abortion agencies etc.

4

A knowledge of your own values, prejudices and emotions

i vital. To achieve real empathy a counsellor mu s t be open. minded about their coun , ellee - they hould therefore be aware of any bia they may have in order to judge whether it i lik elv to affect their ability to help. If in doubt , don't helpomeone who can.

A coun ellor mu t have the ability to Ii- ten and there are many things which can affect thi ability. Hearing what we want to hear (bia or prejudice can make LIS hear thing s incorrectl y): thinking of what we are going to ay ne t and daydreamin gare ju t omeofthem.Acounsellormu tbeawareofthemandw orK to en ure that they do not interrer with their ability to Ii ten

Counselling can take a great deal of time and patience and the coun ellor must be willing to give thi s. Th e counsellormu talso be confident in their ability to help

What are the hazard to oun elling?

A coun ellor must be aware of potential haLard and en ure that they do not hamper their abilities. It is po sible for the cOLIn ellor to become too invol ed/emotional and tre ed th mselve:. The coun ell r must be able to handle anyituallo n calmly.

Prejudice or negative feelings are hUl3rd" whi h wtll redu ce objectivity, warmth and empathy.

Lack of time can aL 0 pose problem ·. lfyou do nothaveu me to devote to a person who approache: you tell them 0 and make an appointment for a date when you do have time

Di traction , uch a" tiredne .. , bein g c Id or hot and bemg hungrywilldi tractyoufrombeingabletoli tentothecoun ellee

You will be ab orbed in your own thoughts about and chlpl and warm fi re

The telephone ringing and people bar g ing through doors will di rupt the flow of conver aLion and make the coun ellee feel uncomfortable. It al 0 how a ba ic la k of con ideration and respect toward the client.

J have explored whatcoun elling i , thequalitie acoun ellor need and ome of the hazard to coun elling. What about the coun eUing interview it elf?

Setti n g up

When etting up the interview , en ure that: -

You can ecure uninterrupted privacy for the time peri od agreed.

The coun e ll ee know how long you have et a ide for them , The interview i confidential and that nothing they ay will be repeated

Thi isvital!Theclient' revelation houldb etreatedinthe st ricte st confidence, regardle of their nature. You are undern o legal obligation to pa s OTT information to the police or any other authority. If you do not feel that you could maintain confidentialit) in s uch circumstances then you should not coun el.

You s hould e tabli sh comfortable sea ting po itions. Whari preferable will depend upon the circum lance and the feelin gs of the cI ient. However , as a general guide, u e two chair atslig h l angles to one another so that there is a comfortable eye-line and do not place a desk between the chair. U e a low table ifrhe

COUNSELLING

who uffered

clie nt feel ill at ea eatnotbeingabletohidebehind omething.

Tec hnique

The following technique , help to en ure that the interview i succe ful: -

U e open body language - how that you are intere ted and are Ii tening to encourage them to talk.

U e open que tion - again, to en ourage the client to talk free ly.

Active Ii tening - really Ii len to what i being aid. Show tha t you are Ii tening - nod , smile, lean forward, e tabli h co mfortable eye contact etc. Remember the hazard to Ii tening tha t I mentioned before

Summarize what the coun ellee i aying to en ' ure that you are hearing correctly and to help them clarify theirthought e.g. "So what you are aying i ", "So you feel thaL ", "In other Wo rds you would like to .'·,

Reflect feeling - reflect the feeling of the cou n ellee to show that you under tand how they feel, eg "Yes, it mu t be annoying when that happen " or "I can under tand that you Would want to react that way".

When reflecting feeling, try to u e the word that the client ha u ed but paraphra e them to make what they are aying clearer.

Form tentative theorie about why the co un ellee feel the they do - put them forward a ugge tion , ego "Do you hmk that the way your father treated you may have " or "Do you think that you feel like thi becau e".

Th Pre ent choice for them to ex plore a po ible action to take. ese hould ju t be ugge tion - encourage them to e plore

them for them elve and to put forward their own idea Their final choice mu t be their own.

A uccessful re ult?

Sometime one e ion will not be all that i needed, ometime it will.

The final outcome. regardle of the number of e ion, hould be that the client reache hi own ati factory concIu ion about the cour e of action to take.

Short cour es in counselling are run by Dr Clifford Smith at Headquarter from time to time but there is a move to take a coun elling cour e to any County that ,,,ould like to run one. For further information telephone Nick Suggit, 071 235 5231 ext 216.

The low -key "h uddy huddy" coun elling described abol'e may be appropriate for most itllarions bur some may need the help of prafes iOl1al counsellors.

Howel 'er. it i often difficult to know where to tum local/.\'for the help you may need Rec og nising this fact. the ational Association of Bereavement Services. assisted by a £16,000 donarionjrom the TSB Foundarion is compiling a director)' of herem'emen! a socialions

The direclory will be al'ailable lIexl year ro local hospitals, funeral parlours, police andfire stmion where it willnol only he accessible to people most likely to counsel the hereaved , hilI will also he close 01 hand for the profe sionals Ihemselves /11 the meantime anyone wishing to find OIl! aboUl local associalion should call1he alional A ociation ofBerem'emenr Services on 071 3 2153 or wrile 10 tilem or 6 Cilairon slreet, London NW1 lJR.

5

Member

the trauma oj Hill sbo rough were s ucces sfully counselled by fellow members of Sf John.

WORKING WITH HELICOPTERS

Helicopter Rescue

It might not happen very often but there is a chance that a first aider at a major duty may have to work with a helicopter ambulance. This piece appeared in a recent edition of 999 Emergency Services Publication. Written by R.Liddle, Senior Training Officer, Greater Manchester Ambulance Service, it gives useful guidance on how t o work safely with helicopters.

The u e of helicopter by the variou emergency ervice rapidly growing. Casualty evacuation, the tran portation of medical and re cue teams being ju t orne example. Mobilisation

In the ca e of medical evacuation (CASEV AC), before the decision to u e a helicopter i taken a number of factor. need to be considered.

For example, the time involved in flying to the incident may well be better used to transport that patient by normal mean, i.e. Ambulance etc., advice of the e timated flying time can be obtained when the original request for the helicopter i made However , if the location of the incident i uch that recovery by normal method would further endanger or aggravate the patient's condition it may be justified.

Other factors being the patient's condition in relation to the weather conditions.

Call out

The call outand co-ordination of helicopter rescue i through the National Rescue Co-ordination Centre at Edinburgh who are contacted through local emergency ervice control centre. They and the flight crew will require :

a) The location of the incident or cho en landing ite, using an Ordnance Survey s heet number and grid reference, or a description of the s ite.

b) A brief account of the incident together with the type and number of casualties.

c) A location of the hospital that is be t suited to treat the patient's condition, e.g. it may be better to tran s port the patient to a specialist hospital unit , by -pas ing the local ho pital ; how ever, the extra flying time together with the patients condition will be a determining factor.

d

) Detai ls of weather at the incident , i.e an estimate of the wind velocity, cloud base and visibility (this is notessential and may be omitted if it would cause delay as the RAP have acces to nation a l Met. facilities). 6

Landing ite

lmprovi ed landing ite mu t be clear of ob truction ,i.e. tree , telephone cable and pylons, etc.

In addition an ar a approximate ly half the ize of a footb all pitch will be required with a clear approach.

The ground should ideally be level or of no more than an approximate 10 percent slope and needs to be of firm tandin g

It hould be c lear of all loose articles and objects that rna ) become a hazard upon arrival of the aircraft.

Pia tic bag can provide a major haLard if blown up into the helicopter rotor.

Do not u e an "H" pegged to the ground the powerfrom the rotordownwash will di lodge the peg and the material the n become hazardou

Radio contact with the aircraft can be made u')ing a s tand ard call ign of "Rescue Helicopter" (or the appropriate nigh t number) and" harlie" for the ground VI IF 86.3125mhz being the emergency frequency ued . Arriva l

The helicopter crew will be na igating toward your gnd reference but a e can be provided by the u e of mok e, flare or blue fla:hing beacons

If the e are a ailable then they hould be deployed when th e aircraft can be fir. t seen.

The overhead rotors will "sail" when the .i closed down and care s hould be taken durmg thl operatlO n'!' most operations the re c ue helicopt ers will leave the rotor s SI frol11 running, therefore not pr e e nting a ha zard, although adVice the aircrew mu t be followed without question.

WORKING WITH HELICOPTERS

Avoid firing flares directly at or in front of the aircraft for obv iou reasons.

At night a blue beacon i vi ible for some distance and this often s uffi cient, the pilot will use vehicle lights to judge his ap proach and height and thi. point shou ld be borne in mind on uch operations.

Mo t search and rescue helicopters have sufficient landing lighting to enable them to land without a sistance and the provi ion of ground vehicles u ing headlamp is unlikely to be req uired.

Landing

Upon touchdown of the aircraft DO OT APPROACH until sig nalled to do so, indicated by a "thumb up" ign or at night a na h light.

Always approach the aircraft from the tarboard front quarter so as to be within the crew's angle of vi ion and EVER approach the aircraft from behind due to the danger a ociated with the tail rotor.

In addition the " We ex" type of helicopter pre ent an additional hazard of approach pre ented by the hot exhau t (300 degrees centigrade),

Em plaining and DepJaining

Approach the aircraft when ignalled to do 0 and go directly to the cabin door, k.eeping all looe object uch a map, etc., ecure. When close follow dir ction , from the aircrew about whe re to step, stow equipment and it.

It i advisable to witch off any radio equipment when boarding the aircraft, ground communication being be tobtained thro ugh the aircraft' own y tern which utili e both VHF and l HF multiband radio.

When leaving the aircraft take advice from the aircrew whe re to wait or tand

It may be that to avoid the rotor you will be advi ed to wait clo e to the helicopter, due to ground lope , until the aircraft ha lifte d away.

Parking of vehicle

[n order to allow people room to work around the helicopter as well a for afety rea on , it i advi able that all vehicle remain out ide the area of the rotor di c.

Ambulance hould be driven parallel to the helicopter \ ith their rear door level with the rear left-hand pa engerdoorofthe helicopter.

NEVE R PARK CLOSER THAN 15 FEET TO THE HELICOPTER AND NEVER R EVERSE TOW A RD THE HELICOPTER EXCEPT UNDER STRICT GUIDANCE.

Winching

Winching is a relatively slow process in relation to landing and u e a lot of fuel.

Therefore, it i better if a landing can be made and it may be beneficial to move the patient a short distance to a more suitable ite.

However, if winching i required then re cue team hould be aware of the tronger downwa h from the rotor when the helicopter i overhead during this operation.

Once down, the winchman will give in truction how to operate the" trop" or tretcher ba ket.

Concl usion

Helicopters are a valuable method of tran port that com bine peed with acce to difficult location

However, their u e hould be accompanied with are pect for the problem a ociated with them and orne general principle of afety hould be followed.

UMMA RY

Alway:

I.Obey the winchman in truction

2. Carry long equipment horizontally.

3. Secure 100 e item, e pecially headgear.

4. Remain trapped in, if appropriate, until otherwi e instructed.

5. Lower your head in the rotor area.

Boarding:

Kneel in line with equipment ecured at the two 0 clock po ition 30 metre from the aircraft. Do not approach aircraft or enter the rotor di c area without permi ion by ignal, i.e. 'thumb up'" etc. from the aircrew.

ever:

a. Smoke within 50 metre of aircraft.

b. Enter or leave the rotor di c area without permi ion

c. Throw equipment, e pecially harp or hea y item on board, d. Touch handle identified by yellow and black marking e cept for emergency egre

Acknow ledgement

Mr. R. Dearnley, training Officer, Greater Manche ter Ambulance er ice for hi a i tance with the diagram , F It. Lt. M. ounter,202 quadron AR., RAF Leconfield for hi a i tance in the preparation of thi article.

OPHTHALMIC HOSPITAL

A first encounter with the Ophthalmic Ho s p it al

Earlier this year Lady Milton-Thompson visited the Ophthalmic Hospital in Jerusalem for the first time.

As the wife of the Hospitaller Designate (Sir Godfrey, who takes up his post in January) she knows that her connection with the 'jewel in St Johns' crown' will be a long, involved and happy one.

Here she writes about her first encounter with the country and hospital that will soon mean so much to her and her husband.

We met at Heathrow on the morning of Sunday April 29, some of u known to one another but many meeting for the first time, united by a common interest in St John - it origins, its history and its work in the present day.

Together we flew to Amman, leaving behind u a gloriou pring day and our familiar territory. For orne thi was to be a retumjoumey, but for many a fir<.;t-time reali ation of a long cheri hed dream. For some it was the trip of a lifetime, never to be forgotten, other will come back and add further dimen ions to their first impre ssion

A five-hour flight brought u to Amman airport, and a s hort coach ride to our hotel. The next day we were bowling down the King s' Highway , making for Petra. Our first s topping place was at the summit of Mount Nebo, the iteofMose first view of the Promised Land , and here the Revd. John LJewJlyn read to us from the Book of Deuteronomy a we s urveyed the panorama of the Jordan valJey with the Dead Sea visible to the left and the J udean hills beyond.

After call ing at Madeba to see the famous mosaic map on the floor of St George's Church, we drove across the plains of Moab to Kerak, a hilltop town growing out of the remains of a huge Crusader castle. This wa the first of 8

everal Cru ... ader <,ite., that we \ 1.,lted in Jordan and brae!. They cau.,ed great interest amongst the group. and gave u<, a real in ight into the historical and topographical conditions knov. n to the early Ho pitallers.

The approach to Petra begin with low hills lifting from the plains. At the top of a ri e we come upon a .,udden vi.,ta of strange volcanic rock formations. Our hotel is et against a giant backdrop or high ragged ridges - the curtain we will breach tomorrow. Sun et i udden and dramatic, quickly darkening to night.

Next morning we file on horseback through the narrow cleft into the interior of the mountain range, the rocks above us deepening in colour from ochre to rust red. At the end of the pa sage way we are confronted by the magni ficent col lonad ed facade of the Khazneh , a Nabataean tomb al 0 known as th e Treasury.

Petra goe on and on. Wa lking, clambering orclimbing along rough-hewn paths, craggy boulders or steep hill s ide, the choice of route i end Ie ,a nd all lead to amazement.

Huge ornamental tombs are everywhere - the Nabataeans re erved their finest architecture for their ance s tor. Onlythemo tpowerful familie presumed to make their living quarters in the hall s of the dead. The interior of the tomb are

plain, contrasting with the flamboyan l carved facades, but in <,ome places tht natural rock reveal<; ihelf in layers 0 aSLOni..,hing colour, banded in yellow,gre) and reel.

In Petra I !cIt no en<,c of the pal' inhabitant of thl., anCIent place, onll rcel11lg of great age and gLi ietude. Perh;p all echoes of a teem11lg and no doub t violent <;ociet) he\\ c been ab..,orbed byth t ... tones.

The other highlight of our time w Jordan \Na ... the receptIon gl\en for aUf group by the Queen of Jordan. Th l charming lady IIlw..,ted on ..,peakIng tO UI all and apologl ... ed forthe Klng'.,absen c, Howe\er K11lg Hu",,,,cln lild appear at the end of our time \\ tth the Queen and lI e were all able to .,ha1--e hand vdth him on leaving.

Our Jordanian gUide, C1lcm, had accompanied u , and v.a.., o\erJo)ed "1 the opportunity to mcet hi KlIlg face Ie face. We \Nerc never allo\Ncd to hearl he la'it of hi ... nev.. claIm to fame . Crossing the Jordan tcel ... a deeph <.;ymbolic act. There i.., allthe noslalgl J OI past history and song overlaid by Ihe ... ense of present trouble ... and divisions .ln fact the river it..,elf at Allenby Bndge JI tiny and unintere.,tlng, di ... appointing all e pectation<.; of grandeur. The whole operation of pa sing through the fOU f checkpoints - two Jordanian and tll O Israel i-amid a vast and colourle expanse of de ert no-man's land seems unreal : more like Alice's Wonderland than anyt hin g eL e .

We drove into the West Ban1-- inane ll bu with a new guide,Jo eph, a Pale Orthodox Chri tian very con cious 01 having refuge e tatu in hi s own countD

The unaccu tomed green of the Jordan valley doe s nothing to miti ga te the heal O I Jericho (now Tell e ultan ), butthi s isan oasis area fed by a s prin g in the Jude an mountain, and we were refreshed by the ight of bougainvillea , oleanders and

Jacaranda tree in full flower.

Then we moved on to azareth which has grown ince Biblical time from an inSignifica nt village into a large town of mainl) Christian inhabitant, and ha a thriving pilgrim indu _try.

Impre ive though the Church of Annunciation wa with it five uperimposed churche from different period, more memorable wa the excavated cave dwelling, po ibly an inn, dating from the time of Chri t: Thi clearly howed the arrangement of living quarter; the chamber neare t the entrance for human eating and slee ping , the central part for grain and water torage, and the innermo t rece forthe animal .

It made for a much more accurate and humane image of the Bethlehem tory, in which one could imagine Mary and J0 eph being allotted the inner room where animal were normaJl y hou ed for rea on of privacy rather than callou ne

Our fir t full day in Jeru alem fell on a Sunday, and a large number of u attended morning ervice at the Anglican Cathedral. Afterward there wa an OPPOrtunity to see the mall chapel of the ?rder of St John and there wa a pleasant Interlude in the Cathedral courtyard when Sir Stephen and Lady Miller, who as Just arrived at the Ophthalmic HOSpital.

OPHTHALMIC HOSPITAL

On Monday morning we did a tour on foot of the Old City of Jeru alem. Unfortunately for me, Jeru alem doe n't match up to the ideal carried for 0 long in one' head. It eem uch a jumble of culture, the hifting boundarie of the city mirroring the long cycle of iege and battle , victory and defeat, rna acre and religiou fervour enacted here through the centurie and continuing today.

The en e of unreality brought on by treading the path and eeing the ight of the Holy Land come to a head in Jeru alem.

Seen from afar, the holy, golden city of men ' dream and a piration eem after all a cardboard cut-out, unnounted by a golden dome which look oddly out of place It hard to credit that here i the greate t concrete reali ation of godline for three great rei igion

Neverthele , the walk along the Via Doloro a and the vi it to the Church of the Holy Sepulchre hou ing the traditional place of crucifixion and tomb of Je u doe much to re tore one per pective.

After aJI, i He came to live on earth it i perhap fitting that He cho e thi mo t trife-tom and fought -over portion of it in which to perform His mini try, and that the ideal of Holine till cling to the land, tran cending man' mi u e of thi remarkable heritage

On the arne afternoon there wa the

Working at the hospital in Jerusalem fir t organi ed vi it to the St John Ophthalmic Ho pita!, attended by half the group. A ceremony for the laying-up of the banner of Keith Lyle, a former Ho pitaller. took the fonn of a hort ervice.

Thi wa followed by the pre entation of prize and certificate to the nur ing taff by the Ho pitaller , Sir Stephen Miller. Sir Stephenga e u a briefre ume of the hi tory and aim of the Ho pita!, and mall group were conducted round the ward and other area

We were all impre ed by the general air of cheerful efficiency and dedication throughout the Ho pital. and the determination of the taff to maintain an optimum tandard of ervice in the face of taff hortage and an ever-increa ing workload. The following day the In e titure and pre entation of longervice medal to taff member took place.

Thi impre i e ceremony took place in the Ho pital courtyard in wann un hine, and eeing the robed proce ion of St John Ho pitaller in the area of original 11 th centur Cru ader ho pice wa a fitting clima to our tour of the Holy land.

Tho e who have a peciaJ intere t in the Ophthalmic Ho pital felt cheered and encouraged b what they aw and will continue their work with renewed fervour.

FUNDRAISING

Racing towards another million?

The Racin g Luncheon atthe HyattCarlton Tower Hotel in June rai ed over £54,000 for the Order of St John.

This event wa fir t held in June 1989 and it is hoped that it will become an annualocca ion.

Approximately 300 guet attended the luncheon which was pon ored by HH Sheikh Mohammed al Maktoum and organi ed by the Gala Committee.

Mr Charle St George, who i Vice Chairman of the committe, wa largely re pon ibleforthe ucce oftheeventa he and her hu band have uch clo e contact with the racing fraternity.

Christine St George

Gue t at the luncheon included John McCririck, the well-known TV racing per onality and Henry Cecil (trainer) a well a a number of other prominent

per onalitie from the racing world.

The gue t. arrived at 12.15 for a champagne reception. They al 0 had a chance to view the auction lot and ram e prize.

Merseyside

The auction wa conducted by Charles Ben on.

ince the beginning of the Centenary Appeal in January 1987, the St John Gal a Committee ha organi ed a number of event including banquet. at Hampton Court and Blenheim Palace, a Greyhound Eveningat Wembley tadium, a reception at 10 Downing Street and the St John Ball each December.

The Racing Luncheon take net profit from special events organised by the Gala Committee ince the beginning of the Centenary ppeal to over £ I ,000,000.

EARLY RESPONSE FIRST AID KIT

Allows a simple but obvious choice of FirstAid itemstobe quickly and easily carried to an (Supplied complete with contents).

Treating a casualty at Paul McCartne) 's concert. (Photo:

Surrey

Alternative fundraising

Following Halford 's offer to raise £ 150,000 for St John Ambulance, afivestrong team of amateurs from the "A lternative Cycle Club ' cycled from Dumfries to London between 3-13 June. There was a grand finish with a photocall featuring Colin Moynihan in Hyde Park.

On route the team called at 20 Halford 's stores and at each store a celebrity photocall was arranged to attract people to the store and get press coverage. A chequefor£l 0,000 wa presented to Lord Westbury pictured above).

All the money raised is being placed in a central bank account a nd fifty percent will be returned to Divisions. The remaining half will be retained by Headquarters to fund national projects and help develop future partnerships with commercial companies.

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Surrey St John Ambulance Badger<; 'Went to Polesdon-Lacy recently to take part in aTeddy Bears picnic(pictured beloW). It lias a fundraising event for the National Trust and toddlers brought along tedd) bears of all and Slles to be bandaged.

The County Badger Leader Alma Williams made <;ome very small tnangular bandages for this.

At Paul McCartney's Let it be Liverpool concert St John on duty with ISS members, 16 nurses and four doctor I SO casual tie were treated and two were tran ported to ho pital - one with a seriou spInal injury.

Four ambulance . ,a radio control unit, five fir t aid posts and a medical centre were aloin attendance.

Wolverton

From left to right they are: Lucy Pedley, Abbiegale Poole, Karen Griffiths, Emil) Poole, Sarah Griffiths. They are pictured with Divisional Superintendent Glady Mayo who has since retired.

Pictured below are five SuperBadger from Bruce's Badgers of Wolverton. Buckinghamshire.

AROUND THE DIVISIONS AROUND THE DIVISIONS

Queen Mother's Birthday Parade

There was a magnificent St John turnout for the Queen Mother's Birthday Parade in June as these photographs show.

Gloucestersh i re

Anoriginal fundraising event took place during May at the International Centre for Wildlife Art at Wallsworth Hall, nr Gloucester.

St John took over the hall for an evening and entertained a hundred paying guests to wine and light refreshments. The guests were allowed access to all five main Galleries, a wildlife and sculpture garden and the library.

£500 was raised during the evening. pictured on the left are the Bulgarian Ambassador Dimitar Zhulev and his wife,Major Nick Warry and Divisional uperintendent Allan Hawker standing by a metal culpture of an Eland.

Leicester

The St Alban Nur s Ing 01'v1 10n celebrated their 50th birthd.l} \\ ith an afternoon part} attended by 80 past and present members

The caJ...e patterned with the St John Badge was cut by Conl11e Rowe a founder member of St Albans Oivi..,ion pictured above).

The SO years certi ficate was presen led to Divisional Superintendent Olwen White by Commander. Lt Col John Wilson.

toast was to the nc t SO years!

Falmouth

Falmouth St John' big took place in a car park behind their hall. \Hites K. Baker of Falmouth. Thi wa the occa ion of the dedication of Falmouth' new ambulance (pictured aboH).

The officer in charge at Falmouth. Ton) Yendle. thanked the repre entathe of Colour Ltd. Mr S. Valance. for the company' donation of a complete re pray.

The formal 'hand on' service continued \"ith Ton) Yendle. the pre iding officer, County Commissioner Maj. Gen. Jerram and the Chaplain The Yenerable T. Barfett taking part. Di\ i ion President N. Trefusis and Divi ional member were out-numbered by the support hown b} the Area taff Officer and repre entati\'es of other local organisations and charitie - the e included the Deputy Mayor of Falmouth. the Chairman of Local District Council, Chairman of St John Council. Lions and our local Red eros nur e .

...

AROUND THE DIVISIONS

D udley

G Knowles , Dudle y Ar e a President , write s : "During an inspection of the local Oldbur y and Langle y C adet Di vis ion it came to m y attention that one of the cadets had written a poem n memory of the Bandmaster w ho had died.

"The Oldbur y and Langl ey

Recognise their profession

I found the letter in July 's iss ue on ambulance per onnel and paramedic very mteresting.

The facts about Paramedic UK

MrLee

We will al w a ys remember

Our Bandma s ter' s nam e

He wanted the be s t

That's w hat w e became

We met on a Frida y

A few year s ago

Mr Lee with his whi s tle

All raring to go

With Jonathon's help

The y taught us to pla y

We played on the s treets

Some time in Ma y

With booking s most week s

We even got better

And soon we received from London, a letter

We travelled to London

We all went by coach

Our in s trument s cleaned

Royal Famil y our ho s t

Sons and grandchildr e n

All lending a hand

But it will alwa ys b e

MR LEE'S BAND

Loraine Hadle y

Combined Band wa s formed fi ve years ago and Mr J Lee became the bandmaster and helped the band for four years. He died la s t year but Loraine Hadle y ' s poem is so lovel y that I think it d es er ves publication. " 14

Berkshire

Pictured above is Cippenham s Badger

Set' first SupcrBadgcr - Victoria Tokta

She being presented with her award by Lad; Elizabeth Godsal (then Berkshire County Comml loner)

Also in the photograph are Angela Newby-Stubb and Rebecca Binns who received their Grand Prior awards.

Suffolk

Suffolk's Casualt) Union was out in force with members actmg as patient for the annual first aid competition organised by St John Ambulance (pictured below).

County Durham

Pictured above are the first Super Badgers from Horden Kirkup. The) are pictured after the presentation with their Set Leader Josie Johnson.

Ambulance per onnel often have more working knowledge in fir taid than many nur es and doctor Ambulance per ') onnel with extended training are even more knowledgeable in certain a rea of treatment and tabilizing of patient It is about time the e people were recogni able to all member s not ju t by name or fa ce to member of their

DI V i ion

I woulda y that nearly all Divi ion have ambulance per onnel in them and I think it is time St John recogni ed their profe ionali m.

Andrew ali bury Oxenholme

Please don't stick a label on th

e disabled

I am writing with regard to the letter IItled " pecial Ca e for the Di abled " in Ihe July i ue A a tudent nur e for the mentally handicapped, I wa di gu ted with the comment regarding the po ibility of a modified uniform for the di abled which would be marked Di abled Member'

A a nur e in training , I am taught a great deal about upholding people right, whether they be phy ically or mentally handicapped. Why hould a di abled member be labelled in uch a way? Surely, We should be keeping within the pirit of St John and not di criminating again t any member with any type of handicap. Any change in the regualtion regarding th e handicapped need careful Consideration.

Kevin Henry (Student Nurse R MNH) S& W Yorkshire Co u nty

ROTHE R HAM AREA

Dinnington Q u a d rilateral Division

WhyFAW?

I under tand that St John per onnel are not allowed on public duty un upervi ed without a current FA W certificate. Due to other commitments I wa unable to attend 100 % of a recent FA W cour e and therefore wa unable to take the ex amination

Ijoined Stjohn in 1983 and have been a member of three divi ion The fir t of the e divi ion g ave me experience in dealing with member of the public on public dutie The econd, the peciali ed area of porting injurie at a ational Sport Centre Indeed I con ider my elf to be very lucky at having been able to link theory to practice in uch a pre tgeou concern I have now moved on and am again working with member of the public on public dutie I would like to hare with you the comfort I gain from being upervi ed by member from my divi ion with the FA W certificate while on the e dutie

It i indeed rea uring to know they are there to help and upprt people like my elf, the Ie qualified member of St John

J. Meldrum

RGN, RMN, PDNCert., RCNT, DipN, DipNEd, RNT. Div. Nur ing Officer

317 Hither Green Di ision

Thank you

In June I took part, a a member of the contingent of the Royal Society. in a parade to honour the Queen Mother. I felt faint and wa taken care of by your ambulance men. I wi h to tell you how grateful I am for the care and efficiency with which I wa treated and would be plea ed if you could pa on my thank to those concerned.

Prof. Albert Neuberger CBE FRS

May I set the record s traight with regard to the comment made by Div / Supt Wiggin AEMT (July St John World ), on the ubject of paramedic tatu s.

Any Brigade member with a current fir t aid certificate is eligible to join Paramedic UK a a BEMT (Basic Emergency Technician )

Thi organi ation is a multidi ciplinary non-union apolitical one, specifically formed to promote and enhance the tatu of critical care practitioner and to achieve the highe t po sible s tandard of pre-ho pital care. There are four grade of member hip : BEMT (Ba ic fir t aid ); EMT (Advanced Fir t Aid/ln tructor ); AEMT (IVls and Intubation ) and REMT (Cardiac Care and defibrillation ) The la t two hold paramedic tatu and require annual certificate of competency. ot all ambulance member , or indeed officer are holder of anything more than a FA W certificate plu X year experience In orne area , e g London Ambulance Service , urpri ingly few profe ional ambulance per onnel ha e recei ed full training to paramedic tandard.

He may be right in hi comment of the way St John view it member, and the need to identify tho e who po e pecial kill Ho\ e er let u get the ba ic fact right when we publi h opinion and not mi lead reader into thinking that letter after a name mean more than the really do.

It i of cour e unfortunate that within St John there i till the male / female di tinction of nur e and ambulance member, given the public perception that nur e = profe iona!. wherea an ambulance member doe not.

Perhap que tion on equal opportunity and e di crimination need to be a ked, why not one Di i ion v hieh include male, female and A ociation member. Or i that a king too much thi century?

Mer yn R eddi n g, EMT County Director Es ex

5.

2.

ST JOHN IN POLAND

Knight of St John honoured by Poland

4.

3.

In 1977, Arthur We ton OBE KStJ BEM, Secretar} of the Civil viation Centre, organi ied the first of man} pilgrimage to Poland by ex-prj oners-of-war. \ i iting the site of camp \'vhere they had endured privation, and honouring the memor} of the man} companion \\ ho had died in captivit}. During the e year, contact \\ as renewed with Polih familie \\ ho had helped them in the dark. days of 19.+0/.+5.

19 9 a\\ a pecial pilgrimage, marking the 50th anni\ er af) of the inva ion of Poland. and 0, thank to generou donation from man} ource. Including a contribution from the 10int St 10hn/Briti h Red Cro Committee. it \\a po ible for the Band of the Queen Own Highlander to accompan) the pilgrimpIa} ingin arious centre including highlight in ictory Square. War a\\: Krakow Military Cemetef}: and in Lam dorf. the ite of the large t POW Camp.

t Lam dorf. a <.,pecial \\ reath \\ a laid in honour of the Briti h Red Cro sand St John. b) \\ a) of gratitude from tho'>e \\ ho owed their sun i\ al to parcelent b) tho<.,e charitie during the \\ ar years.

A happ} ' equel to the e e\ ent · occurred in London earlier thi year. \\ hen Hi E\cellenc} the Poli h Ambaador in\ e ted rthur \\ith the Commander Order of leril of the Republic of poland in re ognition of hi out tanding contnbution to nglo/ Poli h relation.

nnual ub cription to the lub i £:!5 and members pa) 00 for a single room and £52 for a double t£'+O for ingle occupancy). lon1ember ar al 0 welcome - they pa) £.+3 (single) and £6- tdouble). Further derail from rhe \ arden. t John Hou e Club. 50 Eaton Place. London W 1 P Tel: 071 2352732.

WORKING WITH THE DEAF

Making contact with the hard of hearing

Keith Edwards

Divisional Superintendent Wandsworth

An es ential ingredient in admini tering fir t aid to the injured is comm uni cation and we all rely upon a clear two way conversation in order to gain information which will assist u to make a good diagno sis and provide the be t treatment for our casualty.

Communication with the di abled who have peech and hearing difficultie requires a lower and more caring approach and when a normal two way dialogue between the injured and the first aider is not possible alternative methods of communication must be tried.

A casualty with partial hearing or complete deafness is such a casualty who require a very s pecial approach. Natural speech involve control over rhythm, speed, pitch and volume. A per son who i unable toheartheirown voice will be able to speak with control over peed and some rhythm but pitch and volume might not be present. Therefore understanding the spoken word may be difficult. A friend or family member may offer considerable assistance in acting as interpreter but on a one to one basis there will be a communication barrier to cross.

Deaf people communicating wi th each other will use hand-signs, lip reading , body posture changes and facial 18

expre ion. All the e assi t in providing a language with meaning. The sign language taught and u ed in the United Kingdom i referred to a the Briti h ign Language (BSL) and it i u ed by over 30,000 people in Great Britain. 0 af people from other countrie have developed their own , ign language and con equently tandard , and technique vary con iderably

The average fir t aider will not know what to do when confronted by a deaf ca ualty Communication can be made in a number of ways - peech; writing; the A-Z alphabet board; finger pelling and lip reading.

peech

Mo t partially deaf peech i po ible to understand, although it may lack olume control and pitch. Careful Ii tening on the part of the fir t aider and the request to repeat when nece ary may overcome the dialogue problem

Writing

Thi method of communication may b ucce ful if all other attempts to communicate fail but it may be largely dependant upon the fact that the act of writing if injured i phy ically po ible

Be aware that some people may hav trouble writing anyway. Thi method of communication may be low but i u, ually effective.

The A-Z Alphabet Board

The Alphabet board i widely u ed 111 hospitals and home when peech I. impaired by cerebral accident, injury or a degeneration in the central nervou y tem a i found in multiple clero is The board how the alphabet in capital letter and entence are built up by finger pointing to individual letter until a word i formed.

Thi is a very ba ic method of obtaining information -s low but successfu l if the injured per on ha minor injuries and full thinking capacity. Finger spelling

This is the first and basic step to learning sign language and is the standard manual alphabet. It will probably be used by the deaf person and can be learnt by the first aider. Alphabet cards can be obtained by writing to RNIO, lOS Gower Street, London, WCIE 6AH.

Lip Reading

Lip readin g by the deaf may be a

considerable advantage when the de af person reads what you are asking andean act upon your requests or instructi ons.

But lip reading is a difficult kill to learn and young hildren and the elderly Who have become partially or ompletelydeaf due to the aging proce may not ha ve acquired thi skill. uccesfullip readi nl oft n involves a certain amount of gue\\ work and natural talent.

REMEMBER

ot all people are fully ompetent In written or s poken English.

- Do not patroni7e omeone just becau se they ar deaf. Treat them a" you would any adult of norn1al intelligenc e.

- To aid lip reading sit or tand at the ame level a the per"on you are with natural sunlight on your fa ce if possible. If you are indoors make sure that the Iight is behind the dea f person and not you. hadows acro your fa ce ean make lip reading difficult.

- Do not cover your face with your han d, and do not smoke.

- peak. normally with connected pe ech.

- Do not shout, eat or hew gum.

- Facial expres ion is used widely in deaf to deaf per on communication, use xpres ion if it helps

- U e phy ical ge tur - i.e u e your body by pointing or touching to indicate pain. e body language a ' much a\ you can.

- Act in a careful and con iderate manner, if you are becoming annoyed or up etor angry becau e making contact i difflcu ll you will convey your attitude and mood quickly to the deaf per ' on.

- Be patient.

- If the deaf per on i with clo e family or friends they may be of a, i tan ce In communication - u ' e them

- Keep a copy of the standard manu al alphabet or an alphabet card or chart in your ambulance , mobile unit or first aid post - it cou ld prove very u eful.. On the facing page there i a reproduction of the standard man ual a lphab et. The vowels of the alphabet afl contained on each finger (including ,ne thumb ). A i the thumb, E is the inde finger, I is the econd finger, 0 is finger and the little finger i U. When 1ne hand is held uprighteach fingeri inwardstoen urethattherei noconfu JOn in reading each letter.

WORKING WITH THE DEAF

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5AFEWAY - 5T JOHN WEEK

course for £500,000?

The partnership with Safeway goes from strength to s trength As a meas ure of the importance placed on the link with t John, Safeway devo tcd a major part of their tore Manager 's Conference last month toap resenLation by olin Sm ith, Financial Director of Safeway, about our growing partnership Hcre' what he had to say; Ladie and gentlemen, you will remember that we chose to s upport Stjohn because they are a national charity with high public recognition and we felt that our contribution would be important to them as they equip them<;elve'i to meet the challenges of the new decade and beyond

There was abo the pro"pect of the active involvement of our staff and In .,uppon of our initiauve

" ow. a year on, what ha<; be en achieved and what plan s have we ior the future. 1989 the fiN full year of afeway and St John "Ork lOg together. 1989 wa<, a ycar of learning. both for Safeway and St John.

"Fo r Safeway, It was the first experience of working wllh a major chanty over a period of time and there ha') been the need to fully 'mderstand how we can as,>i'it t John nationally and through ourstores. pal1 lcularly as 10 al t John divisions are not used to belI1g involved 10 centra lly organl\ed fund ral<,ing. Their member already have Ilgnifican t on their time for first aidupport and other comm unityacllvllY ·

For t John 1989 has been a year of learning how to relate to a major corporate donor and hov. to implement central! agreed progra mmes throughout II organisation.

"Much ha becn achIeved whIch has laid the groundwork for the luture.

'DurIng 1989 we made a corporate donation or £ I 00.000 to help \UPpo rt tho'oe acu Ities and new programme,> that t John might not otherw i e ha e been able to afford.

"We have .,upported the Badger with Badger BU717: the cadets Wllh the launch ofthclr nev. magazine tan and th spon orshlp of the Cade t Leader of the Year. We have also sponored "C hallenge for Life" a new Cadet programme.

"These and many ther acti\ Itie'> will al 0 beupponed dUring 1990 When we shall make a funher donat ion of £ 150,000 19 9 was also an aetl e year for afeway taff and our cu tomers We etourse lvcs the objective of doubling Ihe company's contribution and rallng a further £250,000 before the end of 1990

"We had a stream of activitie right acro the bu· ine : 'The t989 London Marathon raised £7.000 Fundra'sing week last year raied £70,000 including £t t,OOO to Sup port the laun h of Badgers in cot land

·Support for Badger at new and nver ion tore laun hes ontributed £5.000.

'Awide range of tore, di tribution centre and head office a tivi t ie raIsed Over £ I 0,000.

"All making a total of £93.000 well on the way to our target of £250,000 before the end of 1990.

"Thi year we had nine runner in the marathon and set our el e the ta k of rai ing £25,000. We actually rai ed £50,000, mor than dOub le OUr object ive.

"The money raised from mara thon pon or hip normally form of St John' general funds But thi ' year' ntribution will got to und deve lopment of a major new community care projc which i eXpected to become a major activi ty for t John in the 1990 '

"Variou o ther initia tive in luding a 'Give and Take' promotion,

where cu\tomer

a

take a di count. and the ale of firt aid kit through Safev. ay tore will take place throughout 1990.

" Where will all thi fundrai ing acti ity lea e us at the end of the year? Well, in additIon to the £93,000 rai ed la t year v. e have £50.000 from the marathon £25,000 from the fir t aid kit. £50.000 from our banker to. uppon rhe ue ofIMP (a ale promotion agency). £200,000 plus as a target from the September LOre promotion and a target of £25,000 from ongoing store and RDC activitie halfofwhich ha been ral ed already.

" Ladl e. and gentlemen. we are et to oar pa t our target of £250.000 and if we have ucce fulactivitie inSeptemberwe hall be on our way to haifa million. v. hich would bea tremendou achle emenl. "For afe\\ayand tJohn, 19 9wa a year of leamlI1g. 1 hope you share with me the con iction that 1990 v. ill be ayearofreal achie ement as are. ult of our working together. I mu t end by telling ou what the ommi 'io ner in Chief aid to me v.hen we were di cu ing \\ hat v.e ha e achie ed over the la t year. he aid Don't undere timate the imp rtanceof afev"ay'scontributionro tlohn-moraleha impro\ed through the knowledge of Safe\\ ay' , uppor! and interest and through ure to the profe lonali m of afev. ay' people throughout the bu ine .'

mbulance/ afev.a) Fundrai , ing week run from 15-22 eptember and a Colin mith said in hi , pre entation. we hope that joint acti\ ities throughout the country will raie thou and of pound for t John.

Link People have been nominated by each county office to act a a liaison between a parti ular tore and any Adult Divi ion. Cadet and Badger who ma be working on fundrai ing acti\ itie.

La t year' fundrai ing effort 'Working Together rai ed £70.000 in one week. A befor the Link \ ill be a ked to approach their , tore manager to di eu an parti ular idea the might ha e but it i hoped to al 0 introdu e one or two 'core' activitie which evel) tore v. ill be able to participare in.

Thi ma in lude heltered hopping ( pe ial late opening hour for the elder! or handicapped helped by Cadet) - you will be briefed by HQ when thi event ha been decided Rem mber that all charitable profit rai ed by your acti\ itie \\ ill b for the direct benefit of our divi ion and all the mone) rai ed \\ ill be hannelled traight back to th people who worked 0 hard to get il.

M AN D M A RK p ecial Proj e ct a nd B a d ge r Man age r 21

These nine afeway r u nners made £50,000 for SI J ohn.

gi e

donation and

REAL LIFE DUTY

CADET LEADER OF THE YEAR IN GERMANY

Cold and very wet in

Beds

Bedfordshire isn't famous for its coastline - in fact it's about as far awa y from the sea as it can get but that hasn't stopped Kempston Quadrilateral buying ( and using ) a rescue boat. Divisional Superintendent, G. Willis tells the story.

( If yo u' ve got a s imilar real-life dut y to de sc ribe , se nd it to the E ditor , St John World, 1 Grosvenor C r escent, London SW I X 7EF. )

The Kemp ton Divi ion con. i L of Ambulance , Nursing, Adult and cadet and i approximate ly 40 trong and i extreme ly active. We have an ambulance, first aid caravan and rescue boat.

The re cue boat was obtained from St John in Guernsey orne fifteen years ago and is a 13ft Dory fitted with a 25HP outboard engine. The crew of qualified life aver (RLSS Bronze Medallion) provide re cue boat facilitie on the Great Ou e in B edford for any event on the river. We also provide re cue/medical boat cover at the lo ca l powerboat racing club.

The boat is used approximately 20 weekends a year and upport i provided on land by the rest of the divi s ional member s. Here is an account of two completely diffe rent duties where the boat was involved over aten day period thi year.

Early in 1990 we tarted planning for the "Bedford River Festival", an eve nt which take s place every two year over the Sprin g bank holiday weekend.

The fir t aid duty is organized a t area level with the Area Commissioner as duty officer. A the title ugge s ts the eve nt i centred around the River Great Ou se in Bedford and is covered by a number of divi s ion s, operating (thi s year) four first aid po sts, two on eac h s ide of the river.

Due to two of the first aid posts being 22

virtua ll y inacce ss ible by vehicle , it was decided to u e the re ' cue boat a casualty tran port acro the river as well a afety craft from the river event. Thi was carried out ucces s fully overthe weekend and the eve nt went off without major incident. Thi s year no tretcher cases required transport acros the river. Each po t wa elf s ufficient but under th e control of the Duty Officer who was ba e d at a control caravan/fir t aid post where an ambulance was alo ba ed.

One fir t aid po t, manned by per onnel from Kemp ton Divi ion wa ' operational from 1700hrs on Friday unti I 2000hrs on the Sunday, the ot her three po t were operational from 0900hr to 2400hr on Saturday and 0900hr to 20000hrs on Sunday and there were approximate ly 30 per. onnel on duty during the day, thi wa reduced at midnight to 7 people.

The first casua lt y arrived s hortl y after 1700hr on Friday , th e last just before 1245hr on th e Sunday, with some 200 plus casua lti es treated during the event. The injuries ranged from cut and bruise to one young gi rl s uffering a total bodily reactio n to an in sec t bite of some kind.

The fo llowin g week my division was again in action at a major eve nt , this time it was Inte rnational/W orld Championsh ip Powerboat ra ci ng he ld at Stewartby, where we regularly provide fir t a id and re c ue boat cover.

The eve nt s tart ed on Thursday even in g

when s me mem bers of th e dinlC started to "et up the first aid pot an organile our pr ese nce on it e. Due to the '>iL of th e duty it II. organi7ed using c ro,> county liai son,ther were two ambulances, re ue boat, doctor and two "T ME " ounty tarr Office r on si te for th e weekend as well u Diviional memb e rs. Friday and aturday were rel ative l: qui e t due to poor weather condition· reducin g the number of race , on unda the organi/ers requested an early Slart 0830hr , a ' the} had to get tw o racing (29 heats) into one day

The day tarted quietly until aboul 0850hr when the fir s t driver fell outo his boat, he wa n t injured, but as th e da went on more and more boat sank 0 collided and drivers needed re rai ned, the wi nd blew and it got cold. OUI to the tight programme lun ch wa ealel "on th e go" in the boat. The cen tr e wa kept fairly busy but fortun atel there were no erious injurie

The First Aid post was manned 2200hr on Thur day until 21 OOhrs Sunday tr eating approximately casua lti es.

The weather was cold and weI. W first aid team a nd boat crews werek e , bu y but I think we all enjoyed it, the onl criticism being that th e first aid manu does not te ll u the nam e of injuriesar tr ea tm ent in Hun garian, swed l) Czecho lov akia n and Poli h!

Michelle's German Diary

In June the Co mmissioner-in-Chief and Michelle King , Cadet Leader of the yea r, visited St John in Germany. Part of the fabric of life for the British families of the Ar med Forces overseas, St John Ambulance there boasts seven divisions scattered around the garrison tow ns and RAF station . Wit h the security alert because of recent terrorist activity Michelle's vis it was an enjoyable but slightly nerve-wracking one.

Friday June 15

I was met at the s tation by Tony Barrett , amemberoftheArmyMedica l Corp. He had spent over an hour trying to recogni se me as he only had a photo from START magazine to go on.

Before I wa allowed to get in the car, it had to bechecked underneath forbombs. I wa initially cared but I realised it wa ju t a formality and was part of being po ted abroad.

My driver, known to hi s friend s a Luigi , told me that the car and he a my dri ver, were as igned to me for the re t of the weekend which made me feel very pecial and very welcome right from the s tart.

I had a chance to learn about St John in Germany becau e we got 10 t everal time on our way to Sennelager where I wa to tay

I met the couple I wa to tay withWarrant Officer Steven Ma all and hi wife Mary. They made my weekend great fun,

In the e ening we went to a barabeque at the home ofDa id and Wendy Human There were lot - of people there from the divi ion including Debbie Smith 'v\ ho repre ented Germany in the Cadet Leader of the Year competition and orne member of the Malte e Hilfdien t. I e en managed to practi e orne German b} charting to "orne of them. They all made me feel very welcome. What s truck me was the clo ene: and friendline they hare with each other ven though they aren't all from the arne di i ion

aturda} June 16

1 pent the \\ hol e morning at the Rhine

51 JOHN

Army Summer Show where I was able to meet the Cadet s and other mem ber s who were on duty. I was very impre sse d with the organization of the dutie which worked on the basis of a shift system. The military training of orne of the members was clearly eveident. I was also impre se d with the turn out and enthusia m of the Cadets.

They had organized a tent for mother to change nappie and feed babies and toddler , which I thought wa an excellent idea.

I asked to be given a guided tour of one of the ambulance belonging to the Maltese Hilfdienst having been intrigued by the Commi ioner-in-Chiefs comment that "i t wa more like an operating theatre than an ambulance". It had every po sible gadget in it.

In the afternoon a few of the Cadet gave short pre entation on the town and divi ion they came from.

They had all put a great deal of work into them and I wa impre ed that 0 many Cadet were prepared to stand up and peak or help in orne way, and to do it 0 well.

Sa turda y June 17

I had the morning to pend a I wi hed 0 I returned to the Rhine rmy Summer how and took Luigi on all the ride I had hoped to go for a flight in a Chinook helicopter but in urance couldn't be arranged.

Everyone wa 0 determined to make my vi it reall} pecial 'v\ hich touched me a great deal. When 1 left I had 0 man) goodbye to at - I felt a ' if I'd kno\\ n them all for age rather than ju t a \\ eekend.

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SAMARITAN AMBULANCE CONVERSION

NEws l Coming soon - the St John Roadshow

The John Ambulance Exhibition Vehicle, alia the roads how trailer, has already excited much comment in the countie and the good new "it's on its way!

After month , of careful con truction worl-- the roadshov. unit. compri ing a four wheeled, mobile box trailer caravan and a Land R over 'Discovery' die el prime-mover, will be ready for use in he not roo di tant future

Thi unit will be suitab l e for all kind of activitie from recruitment drive to Fir t Aid demon tration

I t was funded by the George Moore Foundation and George Moore himself took an active n tere t in the project. He felt that he money he is donating (£50,000 a year for the next ten year )

sh ou l d be u, ed for specific project which would haveadirect effect at County level.

T he trailer i an impre ive piece of equipment and will be available to all Countie by prior booking and allocation. It isn't suitable for small local events though, and any booking will have o be through the County O ffice.

The road how trailer ha already been een at the formal presen tation on St Joh n Day at St Pau 's and the B rigade Fina s at Croydon. It ca u ed so much exci tement tha t bookings have a ready been r eceived for 199 1.

H oweve r , th is i a project h at has o be or gan ed p roper l y and thi s w hy he r oa d show tr ai er i not avai l abl e fo r hire yet.

" W e ho pe to emp oy a d r iveroper ato r to move the r ailer around thecou ntry' says H ug h W itherow, of h e C h ief Com m ander's

Sec re ar ia t , "a nd, of co ur e, th ere

m ay be occasio ns w hen it s imp ossi bl e t o m ove th e tr ail er fro m one part of th e country to an ot her in tim e for any pa rt icu ar

eve n t. W e w ill be con idering

pl ans to m inimi e uc h prob ems.

NEWS

NE W S I N BR IEF

The ul1enntt:l1dent -in-Chlt Ph) 1\ ida Stev. art-Roberts, sentti following me"'oagc to Her Maje'l The Queen Mother on tn OCC<.I"lon 01 her 90th bmhda) "On the occa'olon of the bIrthd" or ller t\1<IJest) Queen IIlalx The Queen lother Ihe upenntendent - in 01 John rnhulance BrIgade. \\ humhle dut), ha the honOUr! "ubmIl lOyal greeting" to he' MaJel.,t J the C()lllll1andent - In hid ( ur"lngl.1 rom all \1ember" "

From the Editor

This was going to be called 'Apologies from the editor' because J do seem to have a lot of apologies to make. However I'm going to tart with an appeal for information - the Dronfield t John Ambulance Band ':Itill exist? Pictured here at the Royal Tournament in 1981 the band obviously presented quite a And who i':l that charming, freckle faced fellow in the front. I he nowahighlyembarra able Cadetoradult member.lfyou know let me know.

ow for the apologies. Firstly to Elizabeth Cracknell. the artist re ponsible for last month's cover - her credit got jumbled between the typewriter and the finished magazine and some reader might thinl-. her name i Ii/beth cracknell - it n t! I al 0 want to say sorry to all those who have written to me complaining that their contribution to the magazine have been ignored. II contributions (and there are thou and) are kept and hopefully

First aid kits

B ookings for the rai er will have to made well in advance, probab y no es t han four mon ths ahea d Itm eas ures6.7m in l eng th , 204m w id e and 3.7m i n heig ht ope nin g o u o 6.7m x 6.7m disp ay. T he ve h ic e w ill be se fcontained wit h generator etc.

T he disp ay l igh t-weight and ca n be a emb ed by one

" Th e t r ai er is a ve r y expe nsive pi ece of equ ip me n t and coun ies 2 will have to be sure that they have nomina ted personne l who are prepa red to take real respo n ibility fo r its we ll being. At the moment we are working on a proced ure to en ure th at everything runs as smoot hl y as po ib e. W hen we've gottha t right, the road how trai er will be available to anyone who wants it."

person but it is easier i r there arc four All assembling and dismantling will be done under the driver's supervision.

The display caravan can be as embled and arranged to suit a variety of different uses (walkinground exhibition, talk studio, video projection or rest area). One side can be open to expand the di play onto the outside ground. A basic fee will be charged for each booking. This is necessary because the George Moore grant is finite, and t John Ambulance will have tocover hcmaintenanee co ts in the future.

Further details will be forthcoming from Headquarter to all County Headquarters.

All 'fron tlIne <lmbuiance,\\hl deal \\ Ith elllergenc J call \\1 eljull1pt:d \.\ Ith defibrillator, th year Kenneth C1arl--e the ecretar J , announced recent" orc than hal f of cmergen ambulances In ngland hawlhe machll1cs. I1m\ Ided b) chaflli -,uch a.., the Brlmh He ar. Foundation. but Ill" plannedth all 2.35--1- ambulances them v.. hIll' announcing Ihl defibrillator" Mr JII expre-,,,ed the hope that one L' tv. 0 ambulance cre\.\ s would trained as paramediCS. able It admirmter drugs, give blo(\) transfu"ions and be able to UI more sophisticated defibrillall1f1

The Royal aval Medical Brane Ratings and ick Berth St af Association would lil--e to from any John member relired member who served \1 11 the Roya avy in the medlcal sick berth branch, before. dunn and after the World War, Man St John members erved II, di tinction in the medical and\III berth branches and man) olU' want to renew old friend hlps a r 'old ships'. Please write to Mr C r Whee er, 122 Blaekbrook R03 u Fareham, Hants, PO 15 5'8Z,

LETTERS

Talking with colleagues to help stress disorder

I

in

Thi

There

conference

Over

Occupational Mental

Group

w o uld r og nis e em o ti o nal pro bl em s.

I d o no t co nsid er it wo uld be poss ibl e t o add thi , tr ainin g to th e' F irst Id at W o rh. ·

CO UL

the I r L from t h Ir RIG II T. W.J Pa d g ham

Ch ri t c hur h ' ornb in e d Oh i io n

The Etlllo/' rcp/ii'\ : )0/1' rc rig/if (o/' 1 illejf?) lIl/c/lII\' w( n 'l i\ oul.

Idltlll', \I'llill IOIl'('o/'I/tC IIIlllen\ clII/Jmiti{'/'cc/ II/lit hl! lind 11 '(1 11.. he c Ol/ \{ ii' ,\ hC{'1/ (/

bl! hOI hill'/Y, hili I c/o hlll !' (0 (c/l you (hal I hare IlCI{'/' han uhfc ((I (('/1 l/te difference

( It's I £1011'1 time) .' !f {)\\,el·er. o(/ter people do ('hec I.. lite for me and (/tel dlc!Il'll/ouc (' efllter. \\ Ille h (11/) 10 prm e II hOi \(Jllle III (he Coulllles I!al 'e wid a/l - II Q c/oew ' l I..//(HI 11\ /eji ji'Ot1/ fI\

Uniform response

required

I am 0., IT) to bring up the of unilorm in the column.., of 't John v orld agaIn but 1 tce the tandard 01 nur ing and nuring adet u n iform I in '>ome a"es appalling WhJl" t attendIng 0 7 R egloll'> F and urslng ompetition held In '\ e\\ qua) dUrIng ] .1\' terrible e\ample of uppo ed uniform In uding: blach.. culo t te,>: blac h.. -. h. lrl with a 6' deep ro\\ ofpleals ar uno the hem: \\ hite blou<,e \\ th Pe ter Pan colb1r and erIe.., of pin tu b d \\ n the front \\ om \\ nh rhe blach. bo\\ tl : blac h. llllni h. irt far roo tight for

procedures: black \\ ith pin and front edged \\ th Lip fa , tener : blad, trou er \\ rn b) member \i, eanng LI letto hoe: blac h. "a ndab.

I hasten to add the e Item were worn b) member eIther

based on 15 years ' experience

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T h e Car - Line 10tor ln suran e P li offers r)U \ho ice of ar in uran e , it h er comp r e h c nsiv e, that pr o t e t ou only again t aim made by third 'a rtIe fo r bodi y i n jur ' or damage [0 prop ThL a ms in the event of damage [0 or 10 - of your I\ n car by fire , t h eft or a ' identa l d. mag , LOW COST HIGH BENEFIT INSURANCE INCLUDING FREE LEGAL ADVICE.

In addition to thi , \vh n yo u ' elect ompr h en iv Ol'er, yo u al o get a va l uab l e £10 000 ac ident , er, per Ona l effect. over, ne'\v -for -n v replacement up t o on car o l d) winds -r nand gla s ov r , and ar ent ert ai n ment over, all at no ex tr a 0 t I' Opti o n a e ten ' ion

SUPERINTENDENT- IN-CHIEF

Enabling St John to loo k forward to an exhilarating future

W h at sk ill d oyo u b r i n gto tJ o hn a nd

h ow d o yo u ee th e up e rint e nd e n t- in -

C hi e f r o le?

I hop e to be see n an e nabler and a" so meone who prepare s th e path for othcr" to achieve their goals.

I tarted life in the voluntary "erviccs at the age of 22, when I worked for th e local family planning c linic , and b th there , and in th e other organi"ation" that I have worked in, such as C Y, I ha e learnt the value of listenin g.

I think it can be the d ea th ora voluntary organi ation if the senior volunteers are unaware of the concern" of the grass root" members and the pre ss ure on them.

Phyllida StewartRoberts has bee n Superintendent - in - Chief since the beginning of this year. She has , however, been involved with St John for over twenty years. With her experience as a JP and of work with other voluntary organisations she brings ideas , enthusiasm and integrity to St John . Here she explains why we should look to the challenges of the future with optimism . 6

My re pon ibility is to the me mber" of the Brigade. I am their repre entative on many occasion, and, as su h, must he aware of their needs at every level. I also vi it a many counties as po ss ible - which i one of the great plea s ures of the job.

A Superintendent - in -C hief I also make the effort to promote first aid awareness and the work of St John at every opportunity The univer al importance of fir t aid wa brought home to me when I joined CSV

Two yo u ng vo lunteers had been worki ng a t he arm . and legs of a severel y di ab led man who wanted to live indepe ndent ly in his own Oat. He tragically c ho ked to deat h one day as he was being fed by t he vo lun teers and they did not know how to ave his life.

T hey had been given no firs t aid tr a ini ng. I was obv io us ly ab le to suggest St J o h n as a tra ining organisation and now t he sit uation i much better. Basic fi rs t a id t ra in ing is now offered to many

CS Y vo lun tee rs b ut th ere is ti ll some dista nce to go.

Wh a t d o yo u thin k th e futur e ho ld for tJ o hn '?

I thin" th e futurc i" wonderful. e hilaratlll g ami challenging. Thcchange \ in "ocicty will demand a lot of u" and b! that I mean the ge neral ageing of th e population and the grov. IIl g numbers of les" able-bodicd pe pic v. ho will be \\ Ith u,>. Ye'>, we arc goi ng to ha c to hc lle\lble and rerhaps c han ge "ome of our \\a!l Life in thc future I'> li"cl y to be 4uil e different from anything we cmi,>aged We are an organi""llion dcdi ca ted to lh e service of mankind and a ,>uch mU'Itlook to h oww c an<.,er c tilccommunit)ralher than ,>ay how we , a nt to "crve the community.

We ha e made our name and built our organi"ation on FiN id , and thaI will remain one of the principal plan"" of our future structure. But the time has come to grow beyond that vital inner ore and to develop a range of com munity care ''ills which will rank on a par WiTh our original vocation. This is an area where our own third agers - members of the Fellowship can get back on active Sef\ICe again. They can offer . upport se rvice s 10 those in their community that need it

The wealth of ta lent we have in St 10hn i quite staggering. We hav e members aged from six to 86 and accesS to every s tra ta of socie ty - I honestly think th a t St John cou ld do anything it put ill co ll ective mind to. Members of St John are members because they care - the) have tha t extra dimen , ion and we mus make the mo t of t hat.

I th e r e a d a n ge r th a t th e ca rin g and s upp o rt r o le fo r S t John mi g ht be cen a s a Ie se r on e within th e or g ani sa ti on?

There i tha t danger but I think it IS

one weare aware of and will guard against. A Ihavea lreadymadeplain, everyone' contrib ution i important.Thi que lion of attit ude rai es ano ther point.

Ourdedication as member ofSt 10hn totheca ualties in ourcarecan ometime blind u to the need . of our fellow members, who may be overworked or under train. howing the compa ion we have for ca .ua ltie to each other lead to St John being trengthened. And everyone hou ld aJ 0 look to them elves toen ure that they are not doing 0 much that their contribution is dimini hed becau e they are tired or overwroughr. Has th e Bri ga d e turned th e r ec ruitm ent co rn er ? Will we ha ve th e m e mb e r hip necess ar y fo r our ex p a ndin g car e dutie ?

The an wer i an emphatic ye With the excellent training package , like the Action Pack and Link, coming out of the training department J think we offer any new member an exciting and vibranr opportunity. In many area Energy ha been a greatucce and i proving that the more you put in the more member

SUPERINTENDENT- IN - CHIEF

you get back.

I think young people are very caring now, and in some wa yare natural Iy more like ly to re pond to new initiatives within St John than tho e who have been first aid members for ome time. The future offer job s and opportunities for all sorts of volunteers and there has probably never been a better time to joi n u Many people fail to reali e that we are in fact a fa t growing youth movement, with thre quarter of our members under 25. It i the e youngsters, for whom our leadership training programme are de igned, who will take the lead in year to come.

Perhap we pend more time than we hould worrying about the future.It is po ible to talk down our organi ation, 10 eight of the valuable work we do and in 0 doing dimini hour role.The general public i becoming much more aware of what we have to offer. It would be a hame to 10 e thi opportunity to promote our elve and our me age becau e we have become too inward looking

T h e r e lation hip bet wee n HQ and th e C ountie ha impro ve d. H ow c an

Bur s arie s to help St

John' s profe ss ional nur s e s

When Stephen Ba ingham-Mulvaney involved in an horrific road accident he vowed that ifhe urvived he would devote the re t of hi life to nursing. urvive he did, and 0 ucce ful ha he been in hi cho en caree r that he wa awarded one of the two t John ur ing Bur arie pre ented earl ier thi year.

The£250 bur arie ,known a the ational A ociation of Eighteen Plu Group Award for Profe ional ur e. are given 0 that the recipient can tudya ubject of their choice which will benefit their work with Sr John.

Stephen, a Oivi ional ur ing Officer with t John mbulance ha cho en to u e the money to further hi teaching ludie He will be taking the City and Guild 730 Further and Adult Teacher Certificate Cour e and intend to become are u citation trainer. He i a taff nur e working on the acute medical ward at the Brompton Ho pital, London. The other bur ary wa pre ented to Yvonne We t, Oi i ional Superintendent for the Onneau Cadet Oivi ion in orthem Ireland She is curren tl y taking part in the Sovereign' Award and a part of her practical project he i planning a vi it to the Ophthalmic Ho pital in Jerusalem. The bur ary will help fund thi trip.Yv nne feel that not enOugh young people know about the ho pital or fully under tand the Work that is being carried out.

The pre enta tion evening when Yvonne and Stephen received their award al 0 included the Moyra Browne Tru t Award. Thi i given to a profe ional nur ing member of t John for an expen epaid trip to the Medical Conference Lady Moyra wa pre ent to aLnnounce th i year' winner - Terry Jone , RG ursing Officer for ondon Di trict.

we continu e thi s tr e nd ?

We have to communicate and be flexible. I would al 0 l ike to say that no decision that come from HQ ha been reached lightly. I have been very impre ed by the care and thought that goe into everything at HQ but I reali e that it must be difficul t for some at County level to recognise thi Of cour e, you do have to relinqui h local loyalties when you enter Gro venor Crescent, however much you value , a I do, yourtie with the County from which you came. You are an werable to the Ambulance a a whole not ju t individual Countie

Looking to th e future do y ou think the differ e ntiation b e t w een nur s ing member and ambulanc e member ( men and w omen ) can continu e?

Per onally I think that this differentiation i di appearing and we are talking more and more about St John members. There i uch an interchange of skill now between the exe - for example male nur e and female ambulance driver - that I feel it can be only a matter of time before the different term di appear.

LINKS

Making the worthwhile link with Universities

each student. We somewhat ove r e . timated the attendance but b) theend OI BL wed. over 160 students had covered the syllabus for mergency Aid .

Week three was devoted to tw o e enings of "Introduction to t John " again at the tudents nion, an d represtntatives from both atlonal HQ and London District set up tan ds publ ici/ing the Duke of dinburgh ward. the hallenge, the Energ) programme and the Radi , adet, Trainingand Publi c DUL) departments.

There's no doubt that the recruitment of young, bright , well-educated people is a good thing for 5t John. Here Moya Flynn , University Links Co-ordinator for London District, tells the story of one successful Links project with London University.

Members on duty in London District during the la t six month may have encountered a hitherto unsighted variant of our black and white species. Scanning the igning-on sheet in an attempt at surreptitious identification they will di cover that the stranger comes from somewhere called "Links"!

The Links scheme has been piloted in London District since October 1989 when we attended the Students' lntro-Fayre at the London University Student Union.

We put up a display of po ters showing St John activities. We showed videos; "For All the Right Rea ons", "Energy", the Badger video and one the Weybridge 8

Division made at the London Marathon in 1987. We also handed out leanets on absolutely everything StJohn ha LO offer.

The tudent interest wa overwhelming! Over three evenings Owen Thomas, Paul Herbage and I rarely had a quiet moment. Approximately 500 tudents completed questionnaires and eemed keen to do a firsL aid course.

Back at London HQ the student deLai Is were transferred onto the computer, categori ed according to subject of study, and a oon as the three-hour Basic Life Support sessions were set up at the Univer ity for every evening of Lhe following week we sent an invitation to

Retrospecti cl) I consider that the demands thi made upon the alread) \efy busy reprc)entati es \\ ere out of proport ion to the impact we we re able to make In future we \\ ill wait until the student Links group has establ ishcd It self before inviting a department to come and spend a \\hole evening With a COllllllitt eO and t John oriented group

This sh uld hay c the advantag e 01 allo Ing each department LO reall) do itself Ju<;!ice with students who will, that time, comprehend how the van ou\ departments fit into the t John enllt)

The remaind rofLerm wa,> given ol er to t\\O parallel five -e ening fir t aid courses during which 56 student l perfected their CPR and covered the id and upplementary First id modu le\ of th En rgy programme. These coursel conclud d with a practical examinatio n

During the initial weeks of this pilol ll wa . impo ibletopredictthenumbw\\ e would have Lo cater for. We always had 10 over-estimate so demands on instructors, equipmenr and tran port were very gre al indeed. The Commander, ommiioner and department heads were g nerous with both practical and verbal support of Links. Association Manager Iris Bundle and many Divisional Ofricer lent equipment without which the fir ta id courses simply couldn'L have taken plac e.

The two instructors, wen Thomas an d Paul Crichton, were professional and

enthusia tic and kept the students' interest -a vital recruitment need.

When the pring tenn commenced in January 1990 we held the first meeting of theUniver it ofLondonLink)group 25 tudents attended and admini trative officer. were nominated. The key pot of Secretary and Trea urer were, thanHull), filled by two panicular! reI iable and Intelligent ' tudent ; Barr ,a medic, who holds the di tin tion of being the fir t Link tuden! to go on Public Duty, at Trafalgar Square on New Year' . E e, and Peter whose time at the London choolof Economic ha given him 'creative accounting' and fund-rai ing id a that have bought their financial ituation from absolutely zero to comparative wealth!

One principle that di tingui he a Link group from a traditional divi ion i that the tudent decide their own activitie (Within certain parameter ).

However we found that pub crawl etc. figured very in ignifcantly and th group had training and public dutie a their priori tie They spent their own money on pecial duty uniform and 000led first aid kit which a tudent.' nlOn grant enabled them to purcha e During their fir t term they went on theatre dutie , to Cruft , to the London

LINKS

Arena and to the Royal Albert Hall. tall time they wereupervied by a CF W holder and r am grateful to a handful of upporti e member who didn't complain when a k.ed toupervi e tudenr 11 time at Le Mi..,erable !

Link tuden! came out in almo t full force at the London Marathon. two of them attended a "Go For It" leader hip course at re thusa and four of them have affiliated to Tidewa Divi ion and worked on the re u boat Three member of the committee came to the Link Work -hop at ational HQ where they gave \ ery articulate de cription oftheire perience in t John 0 far. They made many valid poine ofacon tructivenatureandenjo ed meeting the delegat - from thercountieand hearing the heme di cu , ed from the ariou Commi ioner' iewpoint. The first group in London Di trict ha b en a ucce The ha e worked hard to fonn helpful conta t at HQ and \ ith nearby di i ion and thi v. ill tand them in good tead. From the out et they ha e conduct d th m elve imp cabl on dut with long- tanding member and now are weI ome at many venu They have paved the way for future tud nt member.

We ar pre entl planning our recruitm nt trategy forth 1990/91 inrake

and ha e ome experience nov. of ho\\ to economi e effort for ma'\imum effect. We \\ant to make e\ eryone aware of Link: hov. it \\ark in the inter-di trict -en e and how it can benefit young member coming to u and going to their niver ity ountie, thereby developing a ympathy for the problem and advantage that contra ting area of the country e'<.perience. Link i a marvellou recruitment idea. Ourorgani ation attract the altrui tic. practical and re ' pon ible tudent \\ ho are already proving a great a et to the Brigade. Man) of them admit that t John mbulance ha given them a I [ba k

We plan to laun h Link ' in three more e tabli hment thi October and it \\ ill be tremendou Iy hard work. Howe\ er four group a good a the London ni\er it) group \\ ould cenainly ju tif)' the effort and upply a real urge of energ) for London Di tric!.

If ou want to kno\\ more about the Link heme plea e conta t:- Claire Mowbray, Cadet and Trai n ing Departmen t at ariona] HQ. eamu , Kell): ' i rant Commi ' ioner at London Di trict HQ. Moya Flynn: niv r ity Link.s Coordinator at London Di tri [HQ. 9

YOUTH LEADER TRAINING

New training scheme for youth leaders

Peter Crook , Youth Leader Tra in in g Developme nt Off ice r, has just comp il ed the new training scheme . On secondment from the Prudential Corporation , Peter has used his business experience to create an open learning style scheme that's easy to follow and can be studied at the student's own pace . Carole Richmond asked him about it.

Why do we need a Youth Leader Training Scheme now when we've never had one before?

Until the introduction of thi . cherne t John Cadet had the rather dubiou di tinction of being the only national youth organi ation not to have a youth leader training cherne. I appreciate that that in itselfis no rea on to have one as sometimes it can be an advantage to be different. However, it did indi ate perhaps that we hadn't recogni ed the importance of youth work to the well being of the

By youth work I don 'tmean aglorified baby- itring service but a positive contribution to the :ocial education, per onal development and upport of the young people in our care. There i no doubt that other youth organisations are offering their young people more and more in the way of opportunities for such development and we will fail to attract and/or keep members without an improvement in our youth work

How did you make ure thi i a cherne that Countie will find u eful?

Before putting the cherne together I vi ited e eral Divi . ion around the country to get ome feedback from the gra -root a to what they needed to en ure a far a po sible that the scheme would be u eful.

Why i it compulsory?

No matter how good a training cheme may be, human nature being what it is, if it' optional mo t people would opt not to do it. If the training cheme i to have any impact in improving the quality and effectivene of our youth work on a national ba i it is imperative that it i undertaken by all those concerned. Why wa this particular formatcho en?

Our youth leaders are very bu y people and the open-learning format mean lhat leader can do the bulk of the tudying at their own pace and in their own place.

Further, as the scheme is portfolio based the tudents don't have to tart at square one and work right through to the end.

Rather they identi.Fy with th eir Personal Training Advi er their current trength and then se lect tho e units which are most relevant to their need

What sort of person will be able to use it?

With effect from September I the

Training Scheme replaces the exi training nece ary before the appOintmen l of member IN Os/or officers in charge of Cadet Divi ions. Thi mean no l7ek leader can be appointed unles and Unt they have completed Pha e I and II Existing leaders will enter the cheme al Pha e III which c me into operat ion with effect from January I 1992. How long will it take to complete th e course?

It i difficult to be precise about tim e· as the amount of time that can be devoted to studying each we k will val) from student to student. Iso, they ma l well be tarting at differcm place in th e scheme. However. for someone tartin g at square one and working through all th e nits in Pha es r and If it could take in the order of 18/24 months.

What do ou think are the trength of thi package?

I feel that it greatest strength lies In its ne\ibilit repr e ented b the ope n· learnin g styl and portfolIO base (a mentioned previomly)

Will the compul ion to tud thi cherne be retro pective, meaning that people who have been in charge of adets for ear will find them ehe outlawed?

Whilst the whole scheme i mandat Or} ror new leaders, exi ting leaders will hale automatic exemption from Phase I an d II. Those Pha cs are of cour e available to our e i ting leaders either as background reading or even to ta kle n a rull baSI should they be 0 in lined.

Do you think that better trained Cade t Leaders will increa e the attractivene of t John adet to young people.

The youth work in t John Cadet has been a bit like the curate" egg - good in part. In ollle Divi ion the Cadets are encouraged and enabled to undertake the wholegamutofa tivitie -fromabeilin g tozoovi it In orne other ,unfortun atel) , its a case of first aid ad - infinitum! If th e Cadet movement i to grow and pro pe r (and by doing 0 provide a tron g base fo r th e Adult) it is essentia l that our youth leaders are encouraged and indeed trained to ensure that, in accordance with our General R egula tion , Stjohn provides all the facilities of 0 national yOllth or8onisatiol1

County and Division News September 1990

Leicester

Jmagine a chool. a village eliool with a thousand pupils, which has one black board, a few desks and chairs and ab olutely nothing else. one of the most basic educational needs - such as 'A riting books. paper, pen, pencils or reading books - that children 111 England take for granted. Thl i a school where the children ownapairofshoe ifthe} areluekyandan orange i regarded a a football not a fruit. It i in Romania.

St John'<; Involvement with thi school in SatchInez. nearTimisoara, began when Kate Bailey, Superintendent of Belgrave Liberal Cadet. heard an appeal on Sound FM radio.

She knev. her on had a bedroom full of things he no longer he reali ed that her cadets probabl) had equally large amount · of thing to donate. The Idea pread to all five Cadet Diviions \ ithin the City ofLeice ter and oon the original idea of boxe v. hich 'Would be full of imp Ie thing donated by Cadet. gre\\ to incorporate donation of medical eqUIpment and chool upplie from local companie . The culmination of tl\e \.. eek work came \\ hen an amazing mini mountain of bo\e and bag \\a deli\ered to ound F 1. In the \\ord of Chris Morten SO Cadet it \\ a an ideal opportuni t) for the Cadet-; to Itve up to the motto. Pro tditate H01ll1l1um. in an entirel) different \\a) than the u",ual one of putting plasters on

Slough Town

on the left are the lough To\.\.n Cadet competition team after the County Competition They are Martin Hatch, Au tin Crabbe, Paul Ree , Paul

Pictued above \\ith gift for Romania are Clive Langle), Da\id L1o)d, Kate Baile), Brian \\att· and members of Leicester ,",ur ing Cadet, Belgra\e Liberal, Lord Roger \orth Evington Quad and Co-op Combined Dh i ion.

Pictured

Hawkin. -\mojit amota, Gillian Crabbe. Lorna Lennox, Nicola Robin on and Marcia MaJ. II

AROUND THE DIVISIONS

Dorset

Nursing cadet Lisa pritchard of the Cefn Mawr divi"lon make... friend, \\ ith members of the dance and "ong group that vi'>lted the international musical Eisteddfod at Llangollen Lisa assisted behind the cene.., in the Great Marquee and made much of the unique oportunlty

to meet many people from overseas \\ho

visit Llangollen for thiS renowned mU..,lcal occasion.

Dunnington

The following Super Badgers recei\ed

Area Staff Officer, Ouse Area, North Yorkshire. (The) were the first in the Ouse area and first in North Yorkshire to become Super Badgers). Nicholas Cochrane, Noel Preece, Jonathan Martin, Kate Jenkins and Jennifer Bone.

South West

Mark Perry joined as the South West's Regional Youth Development Officer on September 1. He has been appointed to support St John Youth initiatives in the region and can be contacted on 0380 720126.

• AROUND THE DIVISIONS

---

Wales

Gareth Da\ ies of Maesteg, Mid Glamorgan is a Security Officer at a caravan park and member of St John. During last summer he saved the lives of two people and assisted at the birth ora baby girl and his acts of meritorious first aid ha\ e been recognised at an award ceremony in Wales.

In the first incident, Rachel Prince was itting on a roundabout outside Gareth's place of work \-\hen four youths drove past and deliberately prayed her \"ith a fire extingui her. '1is Prince had a se\ ere asthma attack and collapsed. She also topped breathing. Gareth started artificial resuscitation and continued until the ambulance arriHd.

In the second incident, Gareth wa called to a caravan \ hich \ a occupied b) Vincent Rondall. Mr Rondall was suffering from chest and tomach pain and became unconsciou"i and stopped breathing. Gareth immediatel} tarted mouth to mouth until Mr Ronda" tarted to breathe on hi. own.

Gareth \\as again called to acara\an to be told that a woman \ as about to give birth. On ime tigation the birth had taken place. (.areth assisted the woman and remained with her until medical help arrived.

Judith Reed. a member of Caldicot Di\ision, al 0 recei\ ed an award at the same

This Ma) while returning from London by train, Judith' journey \ 3 brought short an announcement appealing for help. A carriage had been shattered by a boulder dropped by three youngster

She dealt \\ ith h\ 0'" omen" ho" ere in shock, and covered the eHS of a third with gauze s\\abs. The most seriously injured man had been leaning with his face on the shattered "indo\\", and she applied dressing pads to try and control the bleeding. Both seriousl) injured people were kept in ho pital

Great Yorkshire Show

t John Amhulance covered this shO\\ for three da) in July. and a very time the) had, \\Ith a three hedded hospital and mobile Ambulance Point to staff. as \\ell a all the preparations beforehand. The) dealt \\ ith over450 casualtle<.;. One \\ as a herd,man \ ho \\ as bltren on hiS anlde He had left the InJur) for 24 hour b) \\. hleh time It \\ a vcr) s\\.ollen cllld painful. On the other hand a girl came in \\ ith her \er) first diabetic attack. and tim needed great k.no\\ ledge LlIld care. There \\ a<.; a confim1ed coronar) and three suspected ones

The \\hok ho\\. \\as a trul) co - operati\e effort - beSides four doctor and three RGN nurses. members from Richmond. Thlrsk.. Northallerton. e\A. Ear. \\ ick.. Ripon. tarheck., Harrogate. k.ipton. Patele) Bridge. ettle. Hub) and elh) \\ere all on dut).

The Count) Comml'isloner Mr lmeson visited Brigade m mber on dut). as did hIS predeccssorT Broughton Mrs P Hall. rea Commis .' ioner. a\sisted b) 1r B Whlfe. the ASSistant Area Commissioner. \\ responsible for the organsiation 13

St John on duty at a rather wet Poole Marathon ( Photo courtes) of the E\ening Echo).

Clwyd

Wallasey

Yvonne Coveney-Boyd, Deputy Chief Executive Officer St John Ambulance, British Col umbia met up with Badgers, Cadets and members of the WalJasey Division while on holiday in the Wirral (picture above).

Judith receh ing her a\\ard.

AROUND THE DIVISIONS

Brigade Finals

Results:

The De"ar Shield - Fir t Aid (Adult) East Howe (Dorset) 380 marks, Lonsdale (lancashire) 364 mark, Barnet (London) 362 mark, (Markham, S& W Yorkshire, Hingston Rose Bowl).

The White Knox Cup - First Aid (Cadet)

Grimethorpe, S& W Yorkshire, 707 marks for the White Knox Cup, 399 for the Jarvis Cup and 108 for the Ne" Zealand Cup. Barnstaple (Devon) with 689 for the Schooling Cup and 323 for the Barne Cup. Canterbury, Kent with 683 for the Pownall Cup.

The Dunbar Nasmith Cup - First Aid and Nursing (Cadet). Horden (Durham) 757 marks; Lisnagelvin (Northern Ireland) 721 marks; Chelmsford (Essex) 647 marks and Rochester / Strood (Kent) were presented with the Phyllis Birch Trophy.

The Perrott Shield - Nursing (Adult). Southwick (Sussex) with 389 marks came first. Croesyceiliog with 386 marks were awarded the Corbett Fletcher Cup, the Chalmers Cup and the Ellis Cup. Rugby (Warwickshire) scored 375 to be presented with the Stewart Cup and Mountbatten Trophy. Ormeau (Northern Ireland) won the Golding Trophy.

The Specialist Vehicle Builders

People keep coming to us for something spec i al. This IS not a Single success story we can tell you many For the success of Pilcher - Greene as a company can be clearly seen and accurately measured by the success In service of the many different speclalpurpose vehicles we budd and supply People keep coming to us for 'something special' And that ' s exactly what they get. W e have been successful pIOneers In the development of specially built vehicles, tha t are deSigned and equipped for various speCific tasks, for w ell over sixty years now By taking and adapting the rugged and well - tried baSIC chaSSIS of the World's finest vehicle builders , PilcherGreene have built their own success on

I AMBULANCES I AMBULANCE

the careful attention to detail required In creating purpose-made products to meet demanding specifications or fulfil special roles

So successful have these Pilcher-Greene 'specials' become, that we regularly turn some out as standard ' vehicles In a highly successful range that offers wide choice to our customers - in many different areas of human activity But we're ready to build to your speCification - If you have something speCial In mind

Skilful engineering and craftsmanship , unique bodywork design, great care and attention to meeting performance needs - these are the hallmarks of our success in the creation of vehicles that will match the specifiC demands of their operators - dUring a long, reliable, and highly cost-effective service life

2.

4.With

7.

5.

l).

8.During

11. What advice could this device giveyoul relation to anaphylactic shock.

NURSING

Practising autonomous professional nursing in the community

Robina Massey, Deputy County Nursing Officer, Buckinghamshire and Principal Lecturer Nursing Studies at Buckinghamshire College of Higher Education, asks whether St John's professional nurses should get formally involved in community nursing.

Oi trict ur,>ing. Community ur ing, ommunity are - all familiar term ' to the general population. With the ever increa<;ing demand on a health care ,>ystem (the ational Health Service). it is evident that re,>ource'> are limited in term of the people to care and the money to finance the service.

In the many report on care in the community. such a the Griffith report and the Cumberledge report. the focu on these report':l ha been to 1001-.. to a more efficient way of pro iding health and \A.elfare are to a community and ha ,>ugge ted lhar there be a much closer \A.orl-..ing relation hip between the formal ervice pro ider::, and the vol untar; agencle

One _ uch .,y'>tem ha been adopted in the nited State \\ hereby a ional pra tisingcommunit) nur e iii r pon ible forabl cl-.. fre idents Theequivalentin thi untr) would probabl) be se\eral ..,treets or roads, or a illage. Th nur e is a resident of the communit and referral. aremadedirectl toherbyan meillberof the public living in that area. he an then utilile the s rice - \A. hich need (0 be pro ided for the particular re ' ident who is ill, infiml, clderl) ordi:abled ororganis h Ip for a relative \>, ho is pr \ iding that care and needs ome re pite for a few hOLlrs . This modcl for prm iding are is not a nc\A. innovation. B fore tIl inceplion of th H man di ,trict nursc mid\\ i\ s pro idedthi sortofser iceinaninfomlal way to p opl in need. Th philos phy behind thi m del i ' that an ighbourho d rganise and provided for the car of its residcnts through both formal and

infonnal channel

It ic., nece ary for a community nurc.,e to meet 'With all intere ted member and co-opt Church member Boy Scouts. Rotar Club. Women In titute member. tJohnAmbulancemember andtheRed Cro

The profe ional nur e and pos,>ibl) a local general practitioner under the au pice of the ational Health Service \\ ould therefore be able to plan care. and meet in accordance \A. ith peciali t need of the pecific mall community. n \\ ering que tion on health matter i the fate of an) nur e in mo t neighbourhood . . \\ hether Johnnie" cut head needs titche or \\ hether Grann) hould eek medical help for her blood pre ure.

Client, paid profe ' -iona!.. exi ting private. H andocial \\ ork: tafT a well as the mall) willing volunteer .could all offer , en ice help and upport to that communit). rather than con\' ning the whole plethora offonnal agencie ,\\ here the indi\ idual needs get lost in a tangle of bureaucracy.

I hme no doubt that thi article \\ ill bring a hower of criticism from m) s:ional colleague. However. if the) refle t for a hort period. mo t of them will realize that the) are po " ibly doing this already in a \ery fragmented and LIn Y remati \\a).

an the t John Ambulanc Brigade spread their aml further to become a: efficient in caring for the ' ick a the) are in meeting the demand for Fir:t id. Once again a challenge for u all to on ider and r tl ct up n as v\e approach the 21 st cenrul,).

ALZHEIMER'S DISEASE

ALZHEIMER'S DISEASE

Caring for the those with Alzheimer's

disease

There is no prevention or cure for Alzheimer 's disease, but early recognition of the signs, and information about available support can make the carers life easier, says Bel inda Harding SEN at the Royal West Sussex Hospital, Chichester.

(This article first appeared in Nursing magazine).

Alzheimer's disease destroy the brain celis, it is an insidious di ease that ultimately leads to senile dementia . Symptoms are slow but remorseless in their development, and the disease is most commonly found in people over the age of 65(1). Short-term memory loss and confusion over small details are usually the first signs, and eventually the per on will need round the clock nursing care.

Alzheimer's disease is now officially recognised as the fourth most common natural cause of death after heart attacks, cancers and strokes (1). Changes take place in the structure of the brain which lead to cell death. The onset is gradual and the decline slow and regular.

The disease was discovered by a 18

German neurolo gi t , Aloi Alzheimer, in 1906. A middle -age d woman, who, si nce 1902 had hown what Alzheimer de cribed a 'prog re ive jealou 'y', a gradual memory los , di orientation and hallu c ination , eventually died at the age of 51. What perplexed Alzheimer was that she had uffered ymptom which were mo t commonly found in people in their 80s and 90 Alzheimer opened the woman' kull and examined the brain ; he noticed it wa everely withered, almo t a ifit had been dried and hrunk. Under a micro cope he aw that the outer layer of the brain , the cerebral cortex, wa riddled with tangled nerve fibre , which had a g radual winddown effect on the nerve cell He aL 0 noticed that the outside of the nerve cell were grouped around a fibrou core (1).

Some 50 year after Alzheimer di covery, three Engli h cienti t , Tomlin on, Roth and Ble ed (l) took up where Alzheimer had left off; they elected 50 patients over the age of 65 who were obviou ly "10 ing their mind ". When the e patients died they carried out po t mortem on their brains. The brain of28 people of the arne ages who died in the same period but were not demented were also removed. The cienti ts found that the brains of more than half of th e demented people had undergone the pathological changes which had been identified by Alzheimer.

Thecharacteristic s found in the brain of the demented patient s were exactly as de cribed by Alzheimer - enile and presenile dementia had to be the arne thing.

They howed evidence of tangled nerve fibre before th e age of 65 and tho e who developed the problem after that age all hared the di ea , e which now carries Alzheimer' nam e.

Alzheimer' di ea e affect between five and ten percent of all people overthe age of 65. Among tho e who have been diagno ed a having progre ive dementia, Alzheimer' account for between 50 and 60 percent. It appear to trike more women than men ( I ). Until early adulthood, the human brain i till growi ng. By the age of 20 it ha created orne 10 bill ion non-reproductive ce ll Havin g reached it peak of production by thi age, th e brain then begin to age and 10 e orne 50,000 neuron daily which are not rep la ced (I).

Scienti t hav e di covered that Alzheimer' pati e nt have a greater 10 of large neuron in the cerebral cortex (a ociated with thought and memOl) ) than in a cortex that ha ' aged norm ally

There have been orne advance inthe tudy of the chemical make -up of the brain and its po ible connections with Alzheimer' di ea e. Nerve cell ecrete a sub tance called acetylcholine (a chemical transmitter) which is one of25 chemicals that help end me age from one nerve cell to another. In making acetylcholine the brain u e an enzyme calledcholineacetyltran ferase; thi fades away in the brain of the elderly and be decreased by 90 percent in the brains . a of Alzheimer' sufferers. Thl mean f substance vital to the proce 0 neurotran mis ion is reduced leadin g to

poor communication between th e ce lls Researchers conc lud e th a t thiS result., in destruction of memory , learning and judgement.

It ha s been <., uggested th a t diet might have a link wi th AILheimer 's di'>ca'>e.

Stress cou ld a lso be a contributing factor (I). Drug have so far becllunable to help prevent it, reverse it or ., Iow it d.ow n.

Aluminium has been found In larger than expected amounts in the brain of ,ome people with I/heimcr's. \Ianganese is known to be associated Illt hother forms of dementia (2). It seem,> more likely Ih at the presencc ofaluminiurn IS a re.,uIt of whatcver is causing the deme ntia rather than a cau.,e of dementia

There i., 110 cvidence that cooking with aiu mllliulll, taking antacid., or using deodcrants (all.,ource., ofa lurninium ) are aca u'>e of dementia (2). P ople who have been cxpo.,ec.J to much larger amount'-) of alu I11lnium ha e been ,>tudied and result... ,ho\\ that expo<.,ure doc., not lead to dementia. Ollle ,>tudic.,of drugs that assist In the elimination of aluminium from the bod) are being conducted to clarify thi'> area further.

Inve.,tigati n., .,ho\,,, that ",omen are more prone to the eli ease than men (2) but more m n are prone to Illulti - farct dementia. Thi., rna) be bccau.,e men are more likely to develop ascular di.,ease, \\h ile women tcnelto li\ e longer, and the Incidence of I/heimer'., increases "" ith age (2). n adult's chance of developing the disease is about one or two in 100 at the age or 65, but the odd increa e if there is a family history of the di , eas hiclenee th a t I/h eimer's may be related to other di.,eases su h as Do wn's Syndrome, kn o\ n to b cau d by defects Inchrornosome'>, Ids ienti ' ts to suspec t that th ere may be a ge neti c factor in AlZheimer's. genetic factor may mean a person ha s inherited a tendenc to be more vulnerable to th e di ' ease, but not that he will nece arily d v lop it.

The onset of I/h e im e r's di sease is very gra dual , so gradua l that a relariv living with the , uffer er finds it hard to reme mb r wh n th p rson was last normal. Me mory problems, especial I lo ss of ShOrt - te rm me mory are usua lly th e first sym ptom s to be noti ce d; thi s is often put down to old age or ab e nt -mindedn ss. As thc di sease be haviour ma

Illu tration from Elizabeth For} the' excellent book' ILheimer' Di ea e' • publi hed b} Faber and Faber, 0.99 become much more erratic.

Restlessness (worse in the e\ ening) and dio.;orientation may cause the sufferer to wander and get lo'>t. Getting up in the early hours believing it is lunch time and .,tarring to preparee it. i., not uncommon

The .,ufferer may fail to re ognise hi'i carer, though not nom1ally until the later ,>LUge., of the di.,ea e. Hallucinations are not common unl ss th r isacomplicating acute confusional s tate or.,e ere auditor) or visual handicap , the diea e develops, apra\ias ma) develop in kilL su h a. washing and dres ing: in addition the moti ation to pelfom1 the -e ta ks may fade comp let el), ,,\ hich \\ ill further limit that p r on' ability to live independentl

D phasia an lead to frustrating difficulties in communica tion : often th e sufferer may onl b able to sa on or t\ 0 words and it can b diffi ult for both car r and sufferer to communi ate sa ti sfactori l . rinar and faecal incontin nce u uall de clop lat e in th e cour e of th e dis ase. Ho\ er, if comp li ca tin g factor such a poor m bility, inconvenient location of th toil torurinarytra tinf ctionarepr s nL suc h problems ma oc ur arli r. D mentia is not usuall y a caus of

death by it. elfand aufferermay ha\ e the di eae for everal year. before dying from orne other cau e (3).

The fir ttepofmanaging lzheimer' is to recognise it. Member of the famil) and friend may recogni e that there are some cognitive impainnent. -uch as failure to recogni e people. loss of shorttenn memor), or forgetfulne before there is fom1al recognition of lzheimer' di eae lil d dementia i diffi ult to diagnose, e \ en moderate ea ' e are often mi ', ed b) peciali t. Scottish tud) of unreported need of the elderly in 196-+ howed thatfouroffiveca e ofdemenria diagno ed during home inten ie\\ were unrecogni ed by the famil) doctor (-t.).

There are , till good rea ' ons for attempting to reeogni e ea e of Izheimer' in the community. Famil member \\ ill have een change - in beha iOLlr \\ hi h can b di turbing at time but rna) not ha e under:tood th em. Dem entia can be made \\ or b) cer tain t) pe of medication. Izheimer's im olves a d fi ienc f the ch linergic s) '>rem. and c rrain drug -" u h as ami-Parkin on drug hm e a di ruplive effe t on the cholinergi ' ) :rem, \\ hi h can greatl) \\or s n dementia.

Re cognition of dementia \\ ill also help 19

ALZHEIMER'S DISEASE

the doctor to under tand and manage epi ode of delirium which are not uncommon in th e demented p rson. In delirium episodes the person': confusion become greater and hi awarene , of the environmen t i le 's ened: thought and language become incoherent and thesleep -waking cycle may be disrupted.

A. yet there i no effectiv treatment for Alzheimer' There ar a large number of drug that are uppo sed to increa e the blood upplytothebrainortheeffici ncy with which it work , but none ar of ufficient value to be recommended routinely. As mentioned earlier, it is the cholinergic ),stem that i ' affected in the di ea e, and attempt ha e been made to improve dementia by giving ufferers choline or lecthin which the body can convert into the neurotran mitter acetylcholine. Unfortunately these attempts ha e not produced re ults ufficientl y encouraging to justify everyday use. Other medication are currently being evaluated which mimic the effect of acetylcholine in the brain, but so far none of these have proved to have a major effect on the course of Alzheimer's di ea e.

Medication that i prescribed is used to control particular problem rather than to treat the di ea e. Drugs u ually pre cribed are benzodiazepine ( edatives and night edation), neuroleptics (major edative ) and tricycle (antidepre ant)

Mo t people do not think twice about looking after their loved ones or clo e relatives who become ill, and recent tatistic show that families still care for their relative as much a they ever did (6). Caring requires patience in lar ge do es, and it i not often po si ble for the carers to devote them elves fully to the demands of caring.

The sufferer from disease may become anxious and depressed at time if he realise what is happening to him. He has four main problems

- Memory loss, a declining power to think and general confusion

-D ifficulty holding conversations and expressing himself

- Embarrassmentand frustration about his declining abilities

- Lose of physical co-ordination

These problems may be minimised by the carer by:

- Keeping things normal

20

- Retaining the ufferer' independence

- A voiding confrontation and crise

- Establi hing routine

- Making thing imilar and Mer

- Maintaining a en e of humour and general health

- Keeping communication channel open and u ing memory aid.

Ithough there is no research on the be:-.t type of environment forthe sufTererwith Alzheimer's disea s , the preference appear. to be to keep the '>ufferer out in the community being cared for by their familie foras longa , possible. Demcnling people have problems adju..,ting to a changing en ironment because ofleaming dirficultie

There arc three main types of hospital care

- Long-term, becau e the carer can no longer cope at home or the sufferer has another illne (infection, dehydration, pneumonia, etc)

- Re pite care - to give carer a break

- Day ho pital placement.

When first admitted to a hot.,pital \.\oard, the patient \.\0 ill not hav e a feeling or belonging and can become agitated because he wishes to leave for his roml er home. It take.., time ror the sufTerer to change his routine and have a feeling of belonging when udmitted to a ho'>pitai, but this will neve r replace hit., home.

The of respite admi..,slons is to gi ve re Iiet' to the carer, wh se men tal and state deteriorate.., owing to continuous stress, lack of sleep and everyday Respite act as lifeline enabling the carer to cope with looking after the t.,ufferer. The le ngth of stay varies according to requirements, but is two to three week' duration.

The psychogeriatric duy hospital was opened by Bier in 1946. The DHS (7) recommends a provision of two places per 1000 of the population over the age of 65.

Day hospitals are firmly established as an important part of the NHS and are one component of a comprehensive ystem of psychogeriatric and geriatric services. Their primary aim is to enab le the sufferer to stay at home for as long as possible. Sending Alzheimer's surferers to a day hospital will relieve the strain on the relatives who look after them.

For the Alzheimer sufferer the support service playa vital role.

The GP, di trict nurse, cOlllmUnlty p s y chi a ric n u r S e , g e ria t ric ia;, physiotherapist, 0 cupational therapi st, p syc hologists and incontinence services are all important to the carer. Th e social ervices, especially the social worker. who is the gateway to such se rvi ces a\ Meals on Wheel, hom e helps , laund!,) service, da centres and homes for the elderly, all ontribute to kecpin g the u fTerer in I he COIllIllUIl it)- for as lon g a\ hi condition allow lot of research is being carricd out into I/heimer's disease The Institut eof Psychiatry is cun'ently canying out tnals v.. ith tetrah y droaminoacridine which i thought to impro c acetylcholine function, u'> the ..,ubstancc appeared to have produced a dl fference in some people with demc ntia Tli i.., a toxi c ,>ub<,tance and re ults '>0 far have been encourag.ing , but It will probabl} be sc\eral years before re..,carcher.., knO\ if TIl i.., helpful andll patient.., will re'>pond to it ( ). Po,>itron cmis ion tran a\lul tomography (PE ) i., a tcchnlque which enables ..,cienli..,l. to <,ce part'; oflhe brain \.\0 hich are active \\ hen carrying out certain task..,. ompanng the re\ult<; of sufferer.., and non -.., uff'erer,> ..,hould gl\e scicntt..,t.., clue.., a.., to area" that are not working in the brain.., of people With delllcntin g illnessc..,. Hopefully before long a cure r treatmcnt will be found.

Rererences

1. (; id te) I, R. ( 1987 ) A n\lin

2.l\1ace. N.L, Rabin, M O, B. ' ,i\lcE\\en, E (1985) The Si'\ I-l our I)a.\, Hodder and Stoughton ,lith \ge Concern).

3.HealthEducation 'are\? Hea lth Education Council .lorm A.F (1987 ) nderstanding Senile Dementia, Croom Hetm

5. .l.P (1988 ) Conrusion in Otd Age, Equation.

6. ing upport Sen ices (1988) Caring for Someone Dementia, B '.

7. Helm M. ( 1987 ) Occupationat Therap), "ith the Elderly, Churchill Li\ ingstone.

8. Hro\\n .1. Disea'>e ,odet) Newsletter, ADS (June-October 1988 ).

Glo ary:

Neuron - consi t of a nerve cell with its various proceses and the nerve fibre which it gives origin. Multi-infarct dem enlt3 - dementia caused by more than one blocked artery. Vascular disease - unhealthy blood vessels. Apraxia - los s of power to cary Qui regulated movement. Dysphasia - difficult ) in swallowing.

FOR SOME PEOPLE, CAREER CHOICES ARE A MATTER 0/ LIFE and DEATH.

The National Health Service is the biggest and recovery of our patients. employer in the UK - and the prinCipal provider Career choices are always important: make of health care in Britain sure you know the facts about the opportunities

We offer an immense range of rewarding in the Health Service before you decide For career opportunities, from nursing, physio- some people, it could be a matter of therapy and radiography to catering and life and death finanCial management. For more information, please

Wherever you work, you will be making a write to Health Service Careers, positive contribution to the welfare, treatment S)l90, PO Box 204, London S£5 7£S.

NURSING COURSES

The right course for a • • career In nursing

It's quite natural that member of John should often thinl-.. of nur ing a a career. Whether it a first job choice on leaving school or a econd career move after taking a breal-.. to bring up children there is a wealth of courses available ri g ht acr S5 the country.

At the orth east Esex In titute for Health in Colchesterempha is i being placed on Project 2000 - a which promote the academic ide of nur ing and de a sound knowledge ba e on which tudents can build future nur ing practice.

All the tudent have full student statu s with the University of E sex where they attend lectures and seminars and use th e University' edu ational and leisure re so urce s.

returners, th co ur se covers key c han ges in th e organisation of nursing care and in c lini ca l practice. The course can be studi e\ at an ppro ed Nurse du ca ion en tr e accompanied by tutonal support, c lini ca or practical placement and assessment.

' Return to ursing' ha s been produced in \\Ilh

The Departm ent of H ea lth and th e Royal o ll ege of is spons red by BPI !ealth en ices.

For tho'>e who \\. ish to enter nurs1l1g but do not have th e required en tr y qual fication, there's a chance that the outh \\ est College of Health tudies \.\ ill be offering tra1l1ing ror Ilealth Care sSlstants from thc beginning or 1991.

NURSING COURSES

0'

BASINGSTOKE AND WINCHESTER COLLEGE OF MIDWIFERY AND NURSING KING ALFRED S COLLEGE , WINCHESTER

For tho eeking a return to nur ing the open College have put together the perfect package Thi is d esigned for use b) the HS and

The same college has bcen rorglng strong links with carer and hu s formulated SC\ eral cour-.es and stud) afternoons tailore d to the particular nced,> of a \ anet) of organ i " II ions 111\ ol\cd (as groups or individual-.) in aring.

ector a well a · by the individual

In March 1991 the, outh Wc st ollege or I1 calth tudl e\ hopes t o embark on thc Project 2000 Pre - R egistration urse Education programille. which on succc-.sful complctlon , th e R egis tered urse w ill al-.o ha e a Diploma Inlligher [: ducLllI on ( enabling progrcs'. to a ur\lng Degree our,>e Entr) to this course \.\ ill be Ikxihlc and \ ill catcf for the mature candidate

For the qualified nur,>c, thc collcgc orfers t.1 broad ran ge of E B (Engli<.,h allonal Board) and other courses and \!Ud ) day<." which can bc purcha<;ed by any nur<.,c who i.., cmplo}cd 11\ a caring capacity.

Another olTering hopc to th ose not acadcmlccn ough to enter rormal nursll1g is Basingstokc Di'.trict Il osplLaI. J lealt h are Assi..,tants are now needed to replace the student nUN S who are no\.\ c l assroolll ba..,ed rather than on duty In the Aptitude. motivation and a wi llin gncss to learn are more important attributes for H ea lth are than any acau eml c qualificatiom. There are no 1'0 nll aI en tr y requircment". no written exami nati ons and toward.., gaining a \ ocation al qualification will be at th e J eal th are ssis tant ,> 0\.\ n pa ce10 th eir wor kpl ace.

Although the qualification will be gained wh il e worl-..ing at Basingstoke it will be transferable to o th er hospitals

Again in th e Basingstoke area th erc is a course for tho se with five O - Ievel s who wish to train as mental health nurses. D esc rib ed as a worthwhile career that bot h you ng and mature entran t s from both sexes - mcntal health nursi ng requires exce ll en t inter - personal sl-..ill s and the abilit) to li s en and comm uni ca te.

I f you want to go into nur si ng in whatever field c heck th e nursin g press and t John World regularly. There are so man) superb co ur ses designed to fit all I-..ind s of people, that there r ea ll y must be one that suit s yo u

NOT FURTHER YOUR CAREER IN NURSING ?

(0274) 732832

FELLOWSHIP NEWS

This mon th I am ab l e to announce the formation of t he fift h Fe ll owship Branch in New Zea and, a remarkable achievement as it is only two years since their first branch wal.) formed.

St John Fe llo ws hip , Wes tport , SI , New Z eal a nd Conta ct: Mr M a r ga r e t T odd , 62 Ru . se ll Str ee t, Wes tport

South I. la nd , New Z ea la nd

As the new St John Year opens in eptember, I would remind all what an their local Fellowship branch can be. Do you need casual tie.., for an exercise or an exam? Why spare a member to prepare the refreshmenh at your inspection? What about a timekeeper for your competition training? Above all, do IOU want money? Fund -raising is our speciality.

I fth re i.., no Fellow..,hip Branch nearathand, why not start one'? There nothing to stop active Brigade member" doing ..,0 Let me know if I can help

Sheila Puckle, ational ecretary t John Fellowship

St John's Gate Clerkenwell

London EC1M 4DA

(-+ )

25 01 located i'eer In cami\al (-+ )

26. Pare nt p ro\ de tn\lrument for c ranIal \urger) (6)

2 9. Birthm a rk-. from .1 \ e ln ( - )

30 \lu..,cle enhanctll g .lctlon of an o ther 9

32 Pale ,lid \10 produ c ing parasite c a u Ing malaria ( 9 )

33 \11 t) and blurred 5 DO " , I. \ an 1<. onccrned \\ ith care for the elderly (10 )

2 hl\enng attack. at onet of acute febrile tllne ( 5)

J rgcnt call for ( 1 1 1)

5 qUl11t (10 )

6. Count an l1luc'>lheti<.,t ? 6)

7. Instrument for \ i..,ual e\amination of the oe ophagu 9)

c Characten"t1c feature of beha\ iour (:)

12. Came to the high potnt of the fe\er (-+)

15. Freed from b) idle ..,ISler (10)

17. Ra"h of Infectlou" diseae (9)

19 t-, !u c\c clo..,lng an anatomical onfice (9)

20. sen ict: returnll1g at a great distance H)

23. n upper chamber of the heart (6)

24 Hoist 1 Ilag a _ the "eam<;tre " mal (3-2)

27 The carriage r the bod) (5)

2 Part of Roman name for a girl (-+)

31 r1ak.e fun of a bone (3)

Convolution of brain from groggy Russian (5)

4 MaJ..e free from pathogenic organisms by LIse of chemicals (9) 9. Senior hospital doctor (9) 10. Middle coast of blood vessels for press, radio and T (5) II. A car is reconstructed in an ,,"'colus of

STJOHN

Ride the VAMPIRE - the U.K:s 1 st hanging roller coaster and step aboard Professor Burp 's Bubble Works, a Children's indoor fantasy water ride, both new for 1990! Add this to the existing 100 rides and attractions and you have Britain's top theme park!

One for life

CONTRIBUTIONS

CONTRIBUTOR'S GUIDE I

Following the reader urvey in May, St John World i now in a position to give you what you want. I sincerely hope that in every i ue of the magazine you will find something of intere t and of u e.

It is quite obviou from the responses I had to the questionnnaire that what reader of St John World really want i practical help and guidance 0 that they can carry out their St John role - whatever it may beto the best of their ability. And that's where I have to tum to you. The expertise that reader s want is more likely to be fou nd among the readers them elves than anywhere el e. I reali e that many people have already contributed to St John World and have suffered the disappointment of not having their work published I'm afraid that is the nature of the beast but to make some amends and to try to help those who do feel that they have something to contribute to this magazine I have included on this page a contributor's guide.

I hope you find it of use.

Make St John World a better • magazine

.:. Practical guidance

Without doubt the most popular features in this magazine are those which offer practical guidance. Do you have the key to keeping ambulances on the road , fundraising, recruitment. care in the coimmunity or anything that might help to make the life of a St John volunteer easier?

If yours is a complicated skill that will take a bit of explaining and you re not confident of your writing ability - give me a call and I'll write it for you Or if you don ' want to waste time writing an article which I might not be able to fit in just drop me a short note giving brief details of what it is you propose to write about I'll let you know if St John World can use it and when we need your copy by.

·:·Soapbox

If there is an area of St John which you feel needs some examination step up onto our Soapbox If your point of view won 't stretch to a page, don t forget our letters section

.:. Fellowship

If you are a member of the Fellowship or have an idea for an article whi ch you think will appeal to the older members of our organisation please send them in. Memories of St John life in the past will be particularly welcome

.:. Cadets and Badge rs

Have you got the key to " successful Cadet group or Badg e' Set Are you a teacher who co come up with informative articles Let me know!

.:. Training

Can you offer expertise training or management skills? ArE your weekly sessions the bes' planned in the country? Ifyouwri e about them for St John World VOL won 't be blowing your owr trumpet - you 'll be sharing your skills with others .:. True stories

Real life duty stories are always popular Include photos if you can

.:. Medical articles

Medical articles are alwa ys welcome Any article submitted will be subject to approval by the Medical Board before publication

St John World would also be pleased to receive articles based on service overseas , emergency exercises, lite in the emergency services , hints for first aid instructors - in fact anything you think would be interesting to St John. Send your articles for consideration to Carole Richmond, Editor , St John Worl d, 1 Grosvenor Crescent , london , SW1X 7EF

SOAPBOX

Remember St Johns' basic skills

In this, the first of a new se ries where members can air their views at length, the Deputy Area Commissioner for Dales Area, North Yorkshire, Bob White asks whether St John is neglecting its primary objective - first aid!

There i much talk in t John of "profe..,..,ional ", profes ional appearance, profe ..,ional skill etc . I the Brigade forgetting it.., origin of trained per on ° providing fir t aid - part time?

Much of the new approach by the Brigade lead toward a tandard equal IO ,ore en betterthan thefull [imeCounty Services, encouraging [he recruitment of profes ional doctor, nur e and ambulance tafC With this come the demand for technology; defibrilator, monitor, intubation, drip and other advanced procedure. The new regulations for race-cour e is a typical example, Highly trained, regularly practi ed and well equipped crew are Ideal and profe ional. The t John member is part time (unle we are in anticipation of the privati ation of the ambulance ervice ).

Originally the Brigade fomled to provide fir t aid, with our member being drawn from the mines and POlt rie , fOllowed by member of the public. exforce, police, railwaymen, factory Worker and hou ewive , who wanted to spend their tim e helping the ommunity in which they liv ed, only a very small percentage were medically trained.

I mu t agree that profe ion ally trained person are id al for the Brigade, but i it not time that we slowed down and gave thought to our role - to provide fir t aid, With fir t being the operativ word,

There i a lot more to being a St John memberthan a profe ional qualification. In the pa tfiveyear thedi\-i ion which I regularly a , i t at public dutie ha admini °tered Entono twice, ha never needed a defibrilator or e en oxygen and ha never con idered erring up any type of intravenou medication,

" .... throughout the Brigade there is an obsession with stripes, pips and crowns"

The e ta k have been I ft to the emergenC) ervice or a ualty departm nt , \': ith whom the) have a very good working relation hip, The di i ion attend well over 50 major e ent each year and i one of the few that Ii II co er a national race our ' e without a count vehicl in attendance . Mo , tdivi i n \\-ill agree thatth majorit ofservi e ' required fromStlohnar fracture ,minorcut and plent ofTL (tender 10 ing are), all of which are adequatel overed in the Fir t Aid Manual, with the ambulance vehicle being the ideal ba e to work from. With regard to rank, thr ughout the Brigade, peciall the profe ionall qualified, there i anob e ionwith trip

pip and n ,[he Brigade i top heavy 'With officer Why houldanur e.recentl) recruited, automatically be promoted to officer tatu, a member 10 years experience, who happen to be a hop a i lant. i treated a a lower mortal. ur e and doctor are often the fir t to admit that their knowledge of fir t aid i limited, Let ' tart giving credit to our part timer ho have been the back bone of the Brigade for many year , The e part timer enjoy providing fir t aid at fete, how. cinemas, pony club and al 0 the bigger dutie like football matche and race. their knowledge and kill i ufficient to tabili e and maintain a ca ualty until the emergency ervice arrive. The technology and experti e \\e are nov. forcing upon them i , to be ery blunt. in ome ca e . far too high. due to time available for training and practi e, age or even academic ability. We are a king many member to be higher qualified for their hobby and to accept more re pon ibilit) than they are required to do for their own occupation, I it not time that the Brigade topped and con idered ex-actly what ware and \\'hat 'We can be: we are probabl) the be t fir t aider in the v, orld, ork.ing oluntarily and pan time for the good of the community in \\ hich v. eli e. We are notan '(ten ionofthelocalho ' pitaloran in xperienc d unit of the count) emergenc rvice , 3

Does St John now pLace too much emphasis on the 'professional image'?

LETTERS

Exceptional bravery from fireman member of St John

I wa very plea ed to read in the March 1990 i ue about the West Yorkshire Police Officer who were awarded t John Ambulance Letters of Commendation for their life saving first aid action.

I would like to bring to your attention the equally de erving life saving rescue carried out by a fireman friend of mille. His name i Alex Sinu"s of Bir"enhead and he i a Stjohn member in Merse) '>ide. Mr Sinuk was driving from Binningham to Birkenhead on Chri tmas ight 1989. when, at about 6.30 pm he came across a car which had overturned and cra"hed into the embankment ofthe M6 Motorway just outh of the Sandbach Service c.

Two of the car' four occupants, two ladie had managed to scramble out through the rear window but their husband were trapped inside. Mr SlI1uks made sure the ladies were off the motorway and called for Fire, Ambulance and Police. He then ran over to the car which wa very badly damaged. The roof at the front was squashed down almost level with the da hboard. the electrics were still on and smoke was comll1g from the engine. He managed to open the only one of the two doors not completely smashed, the one on the driver's side, and crawled in ide. He carried out a quick examination of the two men inside. One was virtually unharmed, but unable to get out becau e of hi friend who had suffered a head injury and who was trapped against the roof by the front passenger eat.

Becau se of the danger of fire and the dangerofbeing hit by another vehicle, Mr Sinuk decided to get the men out as soon as possible. Helped by another man on the outside, they tried to move the seat but it was stuck fast. Mr Sinuks had to crawl between the seats to reach the seat adjustment levers at the front of the car. He was then able to slide the seat back and get both the men out through the gap between the seat and the roof. They were laid onto orne picnic matting which was obtained from MrSinuks' carand wrapped in blankets until the Emergency Services arrived. Mr Sinuk also treated the

Views expressed by readers, although

: publi hed, are not

necessarily endorsed by :

the Editor or the Order·

..

of St John and Its

foundations. Writers

must supply their full

name and address to

the Editor. Write your.

letters to Carole

Richmond, St John

World, 1 Grosvenor

Crescent, London

SWIX 7EF.

gentleman ',> head wound Mr inub '>tayed with the ca'>ualtle'>, keeping them cheerful clnd dlcL"lng their condition hefore handing mer respon'>lbJllty to the Ambulance "en Ice. I believe that hiS actions on hnstmi1\ night were speedy and life savlIlg and should be duly rewarded

Mr L. v1orri'i Woherhampton

Use the Minar badge for identification

refer to the letter and for the paramedic'>'?" in the July issue I agree that qualified ambulance personnel ,>hould be readily identifiable, but why else IS the Millar badge displayed? This doe,> not differentiate between different grades of ambulance per<;onnel but does :-,how a certain level of proficiency.

The Area of which I am training Officer covers several large public dutie,> at which nur<.,es, member.., and officer'> from many diVisions work together, '>ometimes with per<;onnel from adjoining Areas, so I am well aware of the posslhle difficulties that can be encountered. It seems to me that perhaps some of thc medical staff need educating to recognise badges, and also need to be better briefed on the day.

Carolyn Williamson ASO Training Walsall-Sandwell Area, We t Mids.

Please don't dismis s the "collection of toys" too easily

The fight that we face to survive?

Over th e past few years, we have seen an increase in the number of private ambulance companies in the UK. Their Dunng the medical conference the selling point i'> that they can provide v. a nll\ed that if St John I'> gOing to 111 0\ professional ambulance crew, including Into the 1990<., and ha\c a lew <.,cl paramedic , and they call into question St flr..,t - <uder,> accredited to u c sem John's ability to meet current demand automatic defihrillator.." when do II "at the prices they charge". em i,>agc any other progre"" heing orne of" these companies have now In a"'piratJon and mechanical alrways et, tarted toencroach on public duties, which The an"v er rrom Dr Bnan Lewl" \\as th upuntil now have been the private domain there I" to he Lin d'occndlng programm e of the voluntary aid cer Ice uch a Illodule" added onto the fir'>t I ourselves.

programme But he 1\ \\orried ahout tr Public dutie are the lifeblood of St "collection ortO),> " phenomena bec. au, John Division", In many ase il i only thc'>e de\ Ice'> are nc\ cr \\ Ith Uo., \\ he the boo!-.mg,> or ambulances at events dl"a"tcr '>tn"c'> etc that keep divisions going.

Ho\\e\ cr I thin'" that the main pOi nt Although we canno l '>top the pri ate that the'>e de\ Ile" are for the good or tn companies selling their services to event ca'>uall), pro\ Ided th\.::) ,Irt: used corre ll organl"er'>, we can by better organisation h) properl) trained per,>onnel. and training, beat them at their own game

Ha\c you hccml of SrvlART ( OUi after all v.e ha e been in the bw.,lne.., Mclnche'>ler \celdenl Reo.,Lue Tean there's a unit to he proud of.

The a'>cending prollrammc of mOllUi should IIlclude (cl,> -;0011 po" Ibl tn.llnlng U'> per"onnel as po,>slbk paramcdlc tJ.llthlrd'> rhe Ie"sono.,ofrec, cal<.htrophle,> "hould he learnt an d colleclJon ot tOy'> should he l'osued partora o.,tal1lJard hr"t AId "Itloradvum per,>onnel.

Don t ta"e u" Into I 99(), ta!-.e u" In thc 21 '>t century lead from the front.

RecrUitment would be eaSlcr,tb pell p would be proud 10 belong to organisation that promoted advancedfil <ud.

t John W<l" formed b} the public thc public and the ,>ad thlllg I'> that wlth Q advanced training and without I 'collection of toy.., we hecomejust wilh helpers instead of hcmg the profess!Of unit we "hould he.

John GUf l

Willing Help

British Coal OHl Registered SJ A Instrucl AIM Hindley Divisi ·

• w nttlhl yo [ vn e w iO'llll : 2urn y ttlhlm g witth

• To II1l Ito §tt IT iOllhl Jr.' \Y/ mM, 1 : Or e sc !'; ;TlJIt, lLon<tllo'

• 7lElF I • ••••••••••••••••• longer than an) of them.

Lel\qart<.,elllllgour..,elves W ha\e no wages to pa), we only make a standing charge lor the vehicle plus mileage - thl'> IS our main "elling point. Our malll '>tumbllng block may be that although \\e hm e First-Alder. ur..,e.., and Do tor'> v. e are short of paramediCS and full) trained ambulance attcndant'>

At the moment ther I.., no national standard I John certificate, each ounty ma!-.es it''> own grades of ambulance allendant tralllll1g. thi need'> Immediate rectilicarion perhap up to M illar,>tandard atlt)J1all) we have a large numher of" hlghl} mOII\ated and highl} ,,"died paramedICS In t John. but unfortunately their qualifications are not recognised. Urgent steps for recognilJon of paramedic qualifications need to he ta"en or we will lOose thc:-,c highly train ed people to private companle'>. where they can practice their skills, with wages as a bonus

Ilow cver I recently heard a rumour that a ity and Guilds erlificarc ma) be Intheplpelineforne tyear,whichiflam 10 und erstand to be conect will s tart at a first-aid level. and proceed up to fully qualified paramedic. Wh e ther or not t John personncl will be allowed to take the various grade" e aminat ion is apparentl) In some dou bt.

LETTERS

need improvement at al l leveh. We all know how lon g it to get a decision from various ranking officers in St John. They are mO'itly busy people who do not have time to hold open forum for the ordinary members, between the lower officer rank<; and county/area staff officer ranks mu t be drawn up and implemented, with the po ibility of staff taking a secondary role a deputy in an appointment. After all, better communications make deci ion making quid,er and more deci ive.

The private ambulance companie have now also begun to threaten the aeromedical branch becau e they too can tran port patients by air. Ob iou Iy St John has by far the reputation in thi<; field but I believe that it won't be long before trade is threatened in this field too. [v.ould like to 'iee more aeromed sen ices at orne of our larger porting a nov. more than e\er helicopterevacuarion is becoming more popular v. ith organiers. espeCially In the motor sports , ector.

Are we going to it back and do nothing. hoping that the private ambulance ompanle'> v.ill go av.ay? They v.on'tthey are out to get allthe bu ine the) can and ma"e a profit.

re we gOIng to be gah amsed into action and go into the fight \\ Ith all gun blatlng? I am for one.

Ambulance member B.G. Fox Thurma ton Diyi on.

From John Hammond, ecretar) to the Medical Board

Paramedic, ad\anced and extended ambulance qualification are, a :\1r Fo\. tate, a different tor}. l'\ot lea t becau e it i rapidl,\ being reali ed b! the Health 'e n ice that there i need for a minimal academic abilit,\ and educational qualification higher than required for tandard of ambulance training. The facilitie for training and a es. ment are e\.pen he and, e the in-ho pital e\.perience, not ea ,\ to obtain. Training i limited to need and the I\\() tier ambulance tructure renect thb. Factor. St John Ambulanc will haH to con ider.

The Millar Certificate ha gone. It has been replaced by eight "eek full time training (including a t\\ 0 week drh ing cour e) ba ed upon the mbulance Service Sa ic Training Manual.

Ad\ anced training, for tho e elected,

is ba ed upon the Extended Training Ambulance Aid Manual. These manuals are obtainable from St John upplie Department, code P80000 £] 0.95 and code F79990 £8.50 respectively.

The difficulties in JA competing "ith such lengthy full time training are obviou , and National Headquarter ee our future lying in clo e association with the !'\ational Health Ambulance en-ice.

For thi rea on counties were told in June 1989 that they should e tabli h an Ambulance Advisor. Committee to plan training and a e ments. Thi committee to con i t of the ounty urgeon, County Nursing Officer, County Training Officer and a member nominated by the hief Ambulance Officer of the Health Authority.

In countie where thi has been done great stride have been taken in training. London Di trict already run Level 111 cour e, and National Headquarter recently ran t"O pilot Advanced Training cour e in Guilder in anticipation of Regional Course in the utumn.

Berkshire, to gh e another example, ha\e negotiated an eight-"eek (o ne night a "eek) cour e with their County Ambulance en ice. National Headquarter expect to i sue :\ational Protocol for certain ad\anced technique before the end ofthi year, and then proge ively more during 1991. Ho\\eyer, before \\e go 0\ erboard on ad\anced training, we mu ensure our ongoing training programme maintain the tandard required our pre ent qualification, e in ba ic life upport kill

The Training i currently \, ork ing to\' ard \' ational \ ocational qualification in ambulance kill. and the Voluntar} id ocietie. are repre en ted on the \-\ orking Partie. It hoped each kill. or group of kill ,\' ill lead to a City &. Guild qualification. The originally propo ed time cale rna) ha\e to be put back to 1992. There i no rea on to belieH that member \,ill not be able to obtain uch qualification and di cu ion ha\ e not progre ed far enough for one to othen, i e. eromedical \'ork: All reputable organi ation follO\, the guideline \\ hereb,\ onl,\ regi tered medical practitioner and regi tered medical practitioner and regi tered nur. e n., a aeromedical e cort o the St John Aeromedical ice i not eriou threatened

Helicopter aeromedical \\ or"- i<; \ e\.pen i\e and unlikel,\ to "ta"-e off" as a \ olunteeror mall firm bu ine .The medic need to be highl,\ killed and mu t ha\ e a high educational bac"-ground before they can be trained. For the e rea on I doubt \\ hether this \\ ill e\er be the pro\ ince of the part time \ olunteer. lcannotcommentonotherpoint rai ed by Mr Fo\.. 5

TRAUMA TREATMENT I

Trautna treattnent in Maryland

Simon Davies, BN, RGN, OCR, Assistant Chief Nursing Officer for Wales used the Sir David Evans-Bevan Bursary Award of the Order of St John, Priory for Wales to help finance a trip to a special trauma unit in the USA. In this article he examines the treatment trauma victims get in these special centres and asks whether the UK could learn from the example .

During a nursing degree cour e at the Univer ity of Wales College of Medicine, I pent ix week at the Maryland In titute for Emergency Medical Service Sy tern , (MIEMSS) in Baltimore, Maryland, SA. I wa the fir t oversea undergraduate nurse to do o.

The State of Maryland covers orne 9838 square mile , with a population of over four million. It lie on the ea tern eaboard of the USA. The tate capital i Annapolis, but much of the population i centred around metropolitan Baltimore, with its revitali ed Inner Harbour.

Originally called The Maryland Shock Trauma Unit, the in titute wa et up in the earl y 1960 by Dr R. Adams Cow ley, a cardiothoracic urgeon. He reali ed that some of the people he saw dying in emergency rooms could have been aved if they had been taken to a well-organised department, taffed around the clock by experienced doctors and nur e

Through Cowley's efforts, a two-bed shock room was established at the University of Maryland Hospital in B altimore. The initia l mortality rate in this unit was of the order of 90%; not surprisingly, it oon became known as 'The Death Lab'. With improved treatment protocols, experience and research, the intervening years saw the mortality rate decrease, unti l today it is und er 10%.

Cowley s howed t hat, with aggres ive o n-site resuscitation, stabilisation and rapid transportation to a definitive care facility, ma ny patients could at least be 6

delivered alive to th shock trauma unit.

In 1974, the Maryland SLate Police introduced helicopters, which were immediately incorporated into the Medevac (medical e acuation by helicopter) sy tem (I). In 1989, the French Dauphin 2 wa introduced This aircraft i capable of carrying a pilot, two paramedic and two patients It is con iderably faster that the Jet Ranger helicopter which was in previous u e

"the American s treat trauma a s a disease , and s o are able to identify many of the causative factors behind it"

In February 1989, MIEMSS moved intoapurpo e-built 138-bedcentre,giving a much needed increase in pace and facilities, which con ist of 11 resu citation/stabili ation bays in the admitting area, five operating rooms, six recovery cubicle, 72 critical carel inte n sive care beds, 57 sub-acute/ intermediate care beds, nine acute rehabilitation bed " X-ray and computerised tomorrow canning equipment, a computer network accessible from 110 bed ide and 50 administrative

work '>tations.

helicopter landing area i'> locate on the roof of the hoc\" Trauma Cent ro Be fore the mO\ c hc IICOpLer., landed the roof of a nearby multi -,>Lore car par'

The patientj ume lime Into the admltl m area WLl'> '>ome fi\(.: to 10 minute s ambulance from the heliport. It 1'-, no two to three minutes and patient' JI taken directl into the admilling area \ one of three lift'>, or from the helt er' ambulance bay at '>treet le\ e l. I Great Britntn ha'> been ,>Iow LO el on the idea of uSIng heltcopter [, tran'>porttng cfltically III civtlians an other countrie,> ha e had ery eni m helicopter tran"port sy'>tems (I) for lI e overa decade . Gradually theIr introduct w i') being een in this countr)- (2)

Through hi observation.., ofnumerou shocked patients owley coined l. phra e 'the golden hour'(3). B maximising resource and intervenin g, soon as possible in the po t-injury perr o the shock proce s can potentiall) rever ed. This may even mean taking l severely injured patient directly into L operating room from the ambulance (. The philo ophy of the 'golden hour ingrained in the American College Surgeons; two day Advanced Trau n Life Support Cour e. The purpo e orlt course i. to provide skilled medical ar nursing care in the first hour after arnl in the emergency department (S ,6). prerequi ite for many posts. The !if cours" in Great Britain wa launched 1988 for doctors. It is hoped that a cou r

ITRAUMA TREATMENT

for nur'>e ,,>, held under the aU'ipice<, of the Royal ollege of ur ing , will be mtroduced in early 1991 (7)

The MfEM trauma team i'> led by a general surgeon who i.., resident in the hospital while on call. He directs the resuscitati n efforts of the team hould they be needed, other specialist can be ummoned, such a orthopaedi maxilliofacial and neuro- urgeon who an b in Ihe admitting area within five minutes 'Jur es are an integral part of the trauma team with a much more extended role than their counterparts in thi county. but still displaying that human touch which i ' vital when dealing with trauma ( ) Maryland ha develop d a model of anefficient emergency medi aL' y tem(9). This incorp rate the 'fir t re ponder' who is first on the c n , through the variou level of emergency medical technicians and paramedics who are trained in advanced life upport technique ' for use in the field

All of the e are linked to the variou , trauma centre by a uperbcommunicarion network throughout the state. It is thi very idea of building a y tem which i the key to ucce in any trauma are

The concept of trauma centr well e tabti hed in the largely becau e of a 1966 report (11), which pro ided the stimulu for agencie ' to organi e sy terns of trauma are. It i intere ting to note that Great Britain had to wait until 19 for a counterpart document to be produced (12) De pite the call for' ction for cid nt Victims' (13), little eem to ha e come about in this country in the I month ince th document wa produced.

The trauma ntredebate i not without con trover y. If one ha all r ouree upfrontandread togoatamom nt' , norice, providing this ' ort of en i ill b e p n i e. Trauma tend to occur out of

officehour (l4),thu onemu tbeableto ju tify ha ing the ere ource available at all time. The number of patient \\ ith mUltiple injurie going through the ervice mu t be ' ufficient to keep the team' kill harpened at all time. Thi \},Iill mean concentrating the e people in orne ort of trauma centre.

The Maryland trauma team at work on a newLy-admitted accident victim. The outcome depend on their skill and efficiency in these first few moment. delivery y tern. The mortalit) and morbidity rate have been ho\\n to improve in area which ha\e de\ eloped a sytem to meet their need ( 10). The ytem allol}." patient to be taken to the mo t appropriate facility. For example, patient with se ere head injurie , go directly to the hoc\" Trauma Centre, a thi hou , es the tate 'neuro-trauma' ervi e, while patient \\ith e ere bum arc ta\..en to the State Bum centre at the Franci cott Key Ho pital 111 ea t Baltimore.

In thi country it would mean e tabli hing larger catchment area, 0 that each trauma centre would perhap ee fi ve or ' i'( uch patient ada). Ho\\ to tran port the e people 0\ er the greater di tance im oh ed i again open to que tion. Thi may require more helicopter ' ervice being ' et up, bur. in the e economically prudent da in the HS, will we ever ee uch e pen i\e 'Wide pread service blanketing the \\ hole countr ?

Fa ilitie for trauma patient are e ' pen ive.Inth ,muchofthehealthcare co t are met b in urance over. However. man of the patient involved in trauma d not have adequate medical in umn Th are till dealt with. but the hospital cannor recoup it 10 e (IS). Man are calling for thi deficit t be made up from federal fund in read of 7

TRAUMA TREATMENT I

being ub idi ed by the general urgical ervice in the ho pital De pite the evidence that many trauma d ea th s are preventable , many tate have yet to e tabli h a ingle trauma centre.

There are difference between trauma experienced in the UK and the USA. In thi country we ee mainly blunt' trauma - cau ed by road traffic accident (RTA ), indu trial and porting accident. In the USA, penetrating trauma i much more in evidence. Thi tern mainly from g un hot wounds and tabbing Many of the e injurie s were related in so me way to drug dealing, a problem which i reaching epidemic proportion in the USA.

The peed limit on mo t road in the USA is SS mph ; de pite thi • victim of RTA were all too evident at MIEMSS Most were young. white and male and had been consuming alcohol before the accident (16). Thi i in contra t to the gunshot and tabbing victim who were mostly black and poor.

It i ironic that, de pite probably the best organised tate-wide trauma ystem, motorcycle helmet are not mandatory in Maryland The wearing of motorcycle helmet wa judged uncon titutional by the state legi s lature , a it infringe s on the individual right not to wear a helmet. A a direct con equence of thi s, everely head-injured people are routine admission s at MIEMSS De pite aggressive treatment, many of the se patients either die , or are so everely injured as to require in s titutional care for the rest of their live s.

The American Trauma socie ty ha adopted the slogan Trauma is no accident'. The society wants to draw attention to the fact that mo s t so-c alled accidents are not accidents at all. The term 'accident' usually implies a random occurence, but anyone looking behind many of the causes of these injuries find alcohol and drug abuse appearing time and time again.

The state of Mary land now serve as a showpiece for the USA as to how trauma facilities can be tailored to the needs of a particular area. The Americans treat trauma as a disease, and so are able to identify many of the causative factors behind it. By appl ying an epidemiological approach to the problem, a better understanding of trauma and its 8

co n equence can be gained.

Once we in the UK have grasped thi concept, we will wake up to the fact that there are many deficiencie on our trauma care network. Some people here are at last lookin g critica lly intoourtrauma and lowly thing here are beginning to change.

REFERENCE

I. We taby, S. Trauma : the problem and some solutions. In: Westaby S. (ed) Trauma Pathogenesis and treatmenl. Oxford Heinemann Medical Boob 1989.

2. Delamothe, T Here comes the helicopters British Medical Journal 19 9 299 : 639

3 Kaplan, B H ., Valenziano, C.V Pre - hospital trauma care. in Cowley, R , onn, A Dunham. C.M. (ed). Trauma Care Vol : SurgIcal managemenl. Phil adelphia: J P LippIncott, 1987

4. Fisher, R P Je lense, S , Perry, Jr. J.F Direct transfer to operating room care of trauma patIents. Journal of the American Medical Ass ocia ti on 1978; 240: 16, 173 I - 732.

5. Committee on tr auma, American College of Surgeons. Advanced Trauma Life Support Course Student Manual. Chicago: American College of Surgeons, 1984

6. Blansfield, 1 Trauma education for nur e . In : Wright , B (ed ). Mana gement and Prac tI ce in Emergency Nursing. London: Chapman and Hall Ltd,1988.

7. Persona communication with Ethel Buckles, sec retary of the RCN A&E Forum, 1990

8. Schere, P Shock trauma American Jo urn a of Nursing 1989 ; 89:1 1,1440-1445.

9 CO\\ Ie), R ystem.., organIsatIon componentl

In Cov.ley , R onn Dunham (edl Trauma Care Vol I SurgIcal PhIladelphIa ; J P LIPPlllcotl. 198 7

10 We\l. J G Trunkey , D D Llln. R C. y"te nl.1 of trauma care rchl\e..,of urger) 1979 114 460

II Accldent<ll Death and Dlsahlllt) The \,egle cted of Modern oClet} NatIonal eadem) Clence\ of the atIonal Re,carch Counc.· ommIttee on Trauma and COI1lI1lI11ee on hoc PublIc Health ervlce publIcatIon.., 107 - A - I J.Sepl 1966

12 ommlsslon on the ProvI\lon of ervlces Repon of the Work1l1g Part} on th management of palIeI1lS wIth major 1l1Juncs. London Royal ollege of urgeons. 1988

13 Yates. D.W Action for accIdental VlctIm\ BnlI,h MedIcal Journal 1988. 297 : 1419 - 1420

14 Trunkey. D D PreSIdentIal address On nature of th1l1g that go bang In the nIght. Surger 1982; 92 2, 123 - 132

15. Shapiro, MJ., Keegan, M. opeland. J TlY Misconception of trauma reImbursement. Archl ( of Surgery 1989; 124 1237 - 1240

16. oderstrom, ,Trifillis, A L.,Shankar, B. ,e a!. Manjuana and alcohol use among 1023 lraum patients Archives of urgery 1988 ; 123:6, 7.1

737 Simon Davie, BN, RGN, DCR, wrote thi, article whi le working in the regional cardi a( surgery unit, University Hospital of Wal e Cardiff. Hi visit wa financia ll y a si the Sir David Evan -Bevan Bur ery of the Order of St Jo h n, Priory for Wal e' and the Briti h A ociation for Immediah Care.

BURN MANAGEMENT

Burn management for • emergency service personnel

In this , the first of a two - part series , loS . Byrne , J.e . Lawrence and A .J. Sutcliffe from the The Major Injuries Unit and The Burns Research Group, Birmingham Accident Hospital examine the best way to treat burns.

Over the years several of thought have evolved concerning the immediate, ie on site, care of a casualty with either bUill ors omeofthe idea involve tniuating relatively complex re uscitative procedures but do not con ider the time taken tad this in relation to the anticipated tran portation time to ho pital which, in the United Kingdom, may often be , horter. There is also an increasing tendency to deploy special 'purpose-de:igned' dre sings which, in practice. may well be unnecesaI-Y: they are al 0 often both bulky andexpen i e. The purpoe of this article i to can ider the problem of the burned victim logically with the aim of not only clarifying which pro edure are mo t appropria te but also making them as simple and cost effecti ea po ible.

Prioritie

In common wi th o th erudden injury or illne the immediate priority with a burned patient i en uring th a t the airway IS clear 0 that the victim can breathe and Ihat the circulation is maintained.

An appreciable proportion of ca ualtie s who h ave s u tain ed bums hav also b en expo ed to mok e and/or noxiou gase whi h may au e re piratory problem. II th e e patient benefit from oxygen which hould be admin i tered a oon a the patient ha been removed from any dang r. If hot moke is inhaled, welling of the upper airway may occur. Patient at r1 k may give a hi tory of breathing mok e, may be Co ughing upcarbon particles ormay , how bli tering in ide.the mouth or burnt na al hairs. Patient may al 0 have car bon

The rem citation oj a seve rely Jzead-injured mot orcyclist Helmet s are 110t mandatory in Maryland and uch admissions are rOlll;1I(

BURN MANAGEMENT

In m a n y area of th e U n ited K ingdom th e tran sp o rt a t io n time to ho p it a l fro m th e ite of acc id e nt i br ief; it i th e refo re prud e nt t o co n id e r ant ic ip a t e d tr a n po rt a ti o n tim e in rel a ti o n to th e tim e to perform intub a ti o n a nd ca nnul a ti o n befor e a tt e mpt i ng th e e.

It i to be re me mb e re d th a t pas age of e lec tri c it y throu g h th e body ca n ca u e cardia c d ys rh ythmi a a nd ca rd iac a rr e t.

Th e refore cl o e moni to ri ng of th e pa ti e nt

pul e is es e nti al and , if nece , a ry, initi a ti o n of ca rd io- pulm o n a r y re usc ita tion

The Burn Injury

Pro v id e d th a t th e prioriti es of ai r way, re piration a nd ci rc ul a ti o n have bee n con id e re d , thou ght can th e n be g ive n to th e lo c al m a n age me nt of th e bum wo und App lica tion of c opi o u co ld wa te r (ie from nou g ht deg ree Ce nti g rade to e nvironm e nt a l te mp e ra tur e) i th e trea tm e nt of c hoi ce for nea rl y all burn e d c a s ualtie s It is not necessa ry to re m ove clothin g fir s t , in f ac t it is be tt e r not to in order to quen c h re s idu a l hea t promptl y Although s te rilit y i de s ir a bl e it is not e ss ential. Wate r from th e main s uppl y can be re g arded as s teril e; if m a in s w a te r is unavailable then oth e r aqu eo us liquid can be use d s uc h as milk , oran ge squ as h or water from the hor se-trou g h. Th e prim e purpo se is to qu e nc h res idu al hea t within the burned ti ss ue and in c ha rr ed or hot liquid- soaked clothin g or oth e r hot material s that may s till be in c ontact with the s kin

In mo s t in s tance s appli c ation need only be for a few minute s; howev e r, lo cal cooling markedly re duce s th e local pain con sequent on bum s he nc e aqueou 10

e appl ied to the wound are usef u l.

Th ere are very few contra - indications to th e u e of water. Clearly, with e lectrical bum , it is th at both ictim and re ' c ue rs a re not in con tac t with, or proxima l to, the power supp ly Metallic

o d ium , potas ium and calci u m are a very ra re ca u e of bum , but these meta ls react

v io le nt ly wi th aq ueous to pro du ce hea t, ca ut ic so l utions and hydrogen - th e hea t liberated can ignite

th e la tt er. o ml a ll y these substance,> are to red in oi l, in co n tact w it h ti ue nuids

th ey wi ll reac t a if in wa te r hence care fu l ph ys ica l re m ova l i req ui red

With o th e r c hemica l burn imm edia te a ppli ca ti o n of wa te r is approp ria te to re move th e bulk of th e c h emica l. However, it is pro bab ly th e n pru de nt to re move clo thin g a nd co ntinu e wi t h wa ter irri ga tio n M a ny c he m ical. in con tac t with kin c ontinu e to reac t fo r ve ry lo ng pe ri od

- thi s i p arti c ul a rl y tru e of m a ny ca us t ic

ub s ta nces a nd th ese a re no t un co m mo n con stitu e nt s of ove n clea ne rs, dra in

cl ea ne r , d eg reas in g age nts a nd pa int stri pp e r Irr iga ti o n may have to be continu e d for se vera l ho ur Orga ni c solv e nts s uc h as pe trol pa raff in a nd w hite s pirit c au se bum s if in co nt ac t w ith skin for prolon ge d pe ri o d th o ug h uc h bum s a re rarel y dee p Be in g in s olubl e in w a te r th ey will not be re mo ved he nce th e bes t ac tion if the se are e ncoume red is to re move a ll c lothin g s u p ec t e d o f b ei n g contami nat e d.

( M od e lle d by K e nn e th J o n es.)

umcrou,> dr c ssin gs for burns arc commercially a\ aIlablc In the first aIQ situation fev. ,i ran} , of thes e are

Large burn d surfaces arc easll covere" with a sterile cotton sheet which can ab0 act as a ehicle for water Cllll g film I bacteriaproof and afrords an excellen l means of Isolatlll g v..ounds from th e en Ironment; if desired water can be applied to Its outer surface. Burns of th e e\treme l ies can be 4ulc1-.l) an d con eniently I,>olatcd fr III the environment b) mcall'i of plastic bag' such as freeLcr bags or dustbin Imers

These item'> arc usually sterile a' s u pplied In the aid situa ti on the s( simple ine pensi e remedies are more t han adequate in nea rly all circumstan m

A far a th receiving hospital I' conce rn ed th ey can be remo ed withou t causing pain. W a ter, bei ng tr anspa ren t, pemli ls immedia te inspecti on or th e wo un d ob iati ng th e tediou s and painful need ror hospi ta l s tarr to rem ole oin tm ent a nd creams.

T he hea t 10 sfromex te n ive lyburn ed pa ti e nt ' ca n be co ns ide rab le, th us u in ga th e rm a l blan ke t to cover th e dress in gs du rin g tr a n ' por t i some tim e ' de i ra bl e.

Fo ll ow in g th ese impl e g uideline' s ho ul d he lp e n ur e th a t b urn e d ca ualtl e ' reac h ho pit a l w ith minimum de lay butl n a co nditi o n th a t permi ts im medi ate d efinitiv e trea tm e nt. (Thi s artlcte firs app eared In F RE l1l11 gU/ llit a journa for h ief Fire O Ticers )

Eastbourne mourns the loss of a friend

Member ofEa tbourne Ambulance and ur ing Divi ion were greatly honoured to be a ked to provide fir t aid cover at the funeral of the town MP, Ian Gow, who wa a a inated by the IR A in Augu t.

Under the charge of Divi ional Superintendent orman Boorman, fir t aid cover wa provided in the church, church hall and urrounding treet

In addition, the Divi ion proy ided one of it four fully equipped ambulance and the equipment on board included a defibrillator. Although the v..eather wa very v.arrn and orne people tood out ide for many hour only a few ca ualtie were treated for the effect of heat.

Both Ian Gow and hi wife Jane, have been very upportive of the ix t John Ambulance Divi ion in hi con ituenC). Mr Gov. wa Pre ident of Hankham Divi ion for many year. That D ivi ion ha ince merged with Ea tbourne and 0 man} member of Hankham were on duty at the funeral.

MrGov.. made many vi it to local divi ion and hi la twa onl) a fev.. month ago, when he vi ited Willingdon and Polegate Di i ion to find out about their fir t aid work and their olvement in welfare v. ork \.\ ithin their community.

Ea tbourne and St John mbulance have lo -t a great friend.

Dorset

All England finalists, Nicholas and Paul Torok , who won the Ambulance Section receive cloth badges commemorating their achievement from Dorset's County Commissioner, Mr Avery. The presentation took place at a barbeque given by the DiVisional Superintendent of the East Howe Quadlilateral Bernard Harvey.

AROUND THE DIVISIONS AROUND THE DIVISIONS

Norfolk

When Paul Brown and Pauline Marsh turned up for dut y at C a tie Rising in West Norfolk the y didn't know they would be meeting a reallife Knight Ho pitaller. Steve Drandsfield, a member of the White Company, was taking part in an historical re-enactment of life in a Medieval C a s tle. Paul and Pauline are s hown admiring a religious book , written in Latin and iIIuminted b y Steve. The y are standing in an exact replica of an Hospitaller's tent and the wall hanging behind them show the iege of Jerusalem in 1099.

Felbridge

Mr. Robert Balehin, wife of the Director-General and Vicepre ident of the Felbridge Divi ion, presented SO first-aiders wit h their ommunity First Aid Certificate and then presented the Division with a framed portrait of The Queen to hang on the \\alls of the recently renovated building.

Wigan

Debbie Coomb y (age d 20 ), a me mb e r of the Sedgl e y , Qu a d Divi s ion ,W es t Midland s, is on e of 400 yo un g peo pl e, from an ori g inal appli cat io n of 90, 000 to win a place on "Oper a tion R a le ig h ".

Debbie , a Gra nd Prior Ca de t , a nd daughtero f th e Supe rinte nd e nt of Sedg ley, s ay s the stron g fi rs t aid co ntributi o n s he wa s able to g iv e to he r tea m durin g the ri gourou s outdoor s ection of th e se lec tion procedure played an importa nt part in he r being cho sen.

Debbie 's group will be g oin g to Zimbabwe to work on a c on se rvation programme for the endan gered Afri can rhino and al so to help build a me di ca l centre in a rural area where health faciliti es are de s perately need e d. 12

afe Driver of the Year Competiti n members of t J hn Ambulance, Kent provided instructIOn In ba ic emergency 'CItation to all competitor. The driver were ent h uslaqie and it was regard d as a valid and worthwhile co nt ribu t ion to the day.

Instructors were Rob Wilkin on, Graham Palmer and John James. Rob and Graham are hown above in true ting profes ional De rek Higgings and Jonathan McGall.

Barnstaple

Thrkish Delight, Ni g Hillyer needed the magi c sponge from Eileen Hare, after taking part in a fun run in Wi gao ,

the result of a Fun Day organised by Bamstaple Rorar} Club, Bamstaple St John Ambulance benefited b £3,200. The picture above shows R.J Braddon, Chaimlan recei ing the cheque from the Pre ident of the Rotary club, John L nch.

London

been amemberofStJohnAmbulance In Ealing for many year taking hi textbook out to the Third World.

John Ber} , 23, of We t Ealing. i a final year tudent at niver it)' College Ho pital in Central London. In ovember John will fly out to airobi to '.'.ork with ick children at the Medical Re earch Centre.

John aid: "The main problem out there i id. In ome tates 0 er 30 percent of the population i kno'.'. n to uffer from the di , ea e. The real figure i probabl) much higher". edi al centre in rural area.." e\ en in relatlvel} affluent eountrie lil--e Kenya, have to ue medical equipment, uch a S} nnge ,more than once. Thi in reae the chance of spreading infectiou , di ' ea e , inc luding the id viru.

"In return for accepting the medical centre' ho pitalit) I will be taking ba i medical upplie .It I con idered \er) bad manners to crub up and put on disposable glove '.'. ithout offering a pair to ever; other peron in theatre. I'm gOIng to have to take a ru k ack '.'. ith me.

" I'm al 0 hoping to take a electi n of medical te\t book, whIch ar in ver) hort uppl) out there. !'\e put up notice reque ring book donation in ho , pital throughout London"he sa) s. Johnjoined I John after hi moth rJomed a fiLl aid cour:e and per uaded him 10 go along

He ha" al\\a) \\anted to \\-ork III de\elopIng natIon, e pe 'ia ll) '.'. ith children. His tnp hi.l been org<lntsed through Ihe resear h department of Great Omlond treet Ho pltLll for Ick Children.

John '.., t'.'.o and a half month trip [0 fnca will co [ about £ 1500. H has been promis d £300 al read) and i hopll1g that busine s span ors'.'. ill , tep fo[\\ ard to help \\ Ith medl 'ul ",upplte 13

Debbie Coomb y Sedgley

a

AROUND THE DIVISIONS

Liverpool

From Irene Robin on, PRO Liverpool and Sefton Area: "Here is a very humourou ver e which was written for me by a friend, specifically

with St John in mind! It ha gi en u uch a laugh here in Liverpool and

I thought it only fair that I hare it with other fellow members.

"It wa written by a Liverpool poet by rhe name of Jad. tocks, and I feel ure your reader will appreciate the alutary humour much as we did."

At every ci ic gathering,

Wherever crowd do meet,

At match or concert garden fete,

Or even in the street.

You'll ee our distincti\'e black and white,

Alert to any call

Quick to re pond to the common need,

Should accident befall.

We've been at it now for quite a time,

A hundred years or so

Our volunteer have panned the year,

As the record proudly show.

But what a tale it would have told,

What changes would we ee

If the Brigade had been born,

In the early dawn ,

Of man's chequered hi tor y.

Would Troy have quit the battle cene

And to Agamemnon kneel

If we had been there to intervene,

And fix Achille's heel.

Would Cleopatra up the Nile,

Have surrendered her last gasp,

If we had applied a comforting smile,

And some antidote of asp.

And Julius Ceasar' gory Ide

Might not have meant di aster,

If we had stemmed the crimson tide,

And been fa ter with the plaster.

And Harold's thanes with wild acclaim,

Would have thrilled to the very marrow

At our ophthalmic skill on Ha s ting' s hill,

When his eye got full of arrow.

We might have raised a grin from Ann Boleyn ,

Held the axeman's work in check

And brought some ease with Victory Vees,

And a tourniquet round her neck.

In Trafalgar's hell when Nelson fell ,

Dismaying each Jolly Jack

Though very far gone, in the care of St John,

He might have kissed Hardy back.

And Napoleon's wiles reduced by his piles ,

Might have found our salves a blessing

You could bet there were few at Waterloo

Who knew how to fix that dressing.

But those days are gone,

We must soldier on , the unknown future calls

Beset by fractures, sprains, contusions,

Dislocations, trips and falls,

But never fear, be of good cheer,

For with splint and sling and stretcher

Should the worst occur we shall need no spur,

14

ST JOHN WILL COME AND GETCHER

Ludlow

Mrs Judy Deak.in. Divi ional uperintendcnt of the large.,t St John adet Divi lon in hrop hlre recentl won one of the Hea n of Britain Award" run by Midland" lectncity Board and BBC local radio.

Mrs Deakin was nominated for her contribution to th e community for her work. with the adct", di"abled group , an d literacy c1ases.The £ I 000 pri/e i bcing handed 0 er to Ludloll ur"ing Cadets to help with equipment and trainIng ,

Framlingham

Pictured above are member of the Framlingham Nursing Cadel Divi ion a nd B adger Set taking part in the town's Gala parade, The theme thi year was song titl e" and they cho e "We allll\ e in a Yellow Submarine". Several nights were given by th e members to decorate the float, which came second in the parade (T he Divi sio nal Superintendent can be een in the gliller wig! )

s AROUND THE DIVISIONS

-

Gibraltar

From Ivor Dalglei'lh, Territory Staff Officer, Gibraltar: We in Gibraltar may be the smallest far as t John Ambulance is concerned, but far from the smallest in outlook.

a little may set the scene. Gibraltar has suffered fourteen seiges, the last of which lasted for three years and seven months, and began on the 11th July 1779. Unfortunately our orp" Superintendent forgot that duty! During this time 120,000 French and panish troops surrounded the rock. The Commander General George Augu . tu'l Elliot held back the enemy and the British presence remaIns to this day. Other great historic events seen in thi<; area have mcluued the naval engagement at the nearb) ape of Trafalgar and dunng the Second World War "",hen the entrance to the Mediterranean was held in check by the troop" In ibraltar.

One of the Items on di play at our head4u<u1er", is a certificate of thanb to St John m mbers "",ho played a major part In the e\acuation of the total civilian population to the UK during the war. Gibraltar'..., future now lie.., in the FInanCial ervices ector a<; well the old faithful: tourism. To v.alk up Main treet in the summer you would be forgiven for think.ing that militar) manoeuvre" of the past were still in e\i'>tence!

Gibraltarians are by nature friendl , nois, and ver) pro -Britl..,h With a popUlation of 28,000 the pre ence of t John is much in e idence.

OUf present were built in 1973 on the site ofa demolished World War 2 concrete pillbox, on one of the old bastions fortif ing the Rock.. This is the first Sf John building to be erected in Gibraltar, where the Order once held Considerable property, for exactly 350 years. The building is at the foot of the Rock below the ancient Moorish a ' tle. At the present time we have: two Badg r Sets; one Combined Cad t Division of 44 Cadets; one Combined Adult Division of 20 members and four closed dult DiVisions within the Gibra lt ar Regiment. POlice Force, Fire Service and Policel SJA Ambulance Service.

A vita l service operated by the

John Ambulance Brigade is the " pecial ervices Group " re pon ible for all cros border ambulance dutie nfortunatel) the hopital in Gibraltar doe not have a 'C T' scanner or an, dialy"i equipment.

During 19R9 we carried out I 17 tran fers between Gibraltar and pain. We are alo involved in numerou public dutie " throughout the ear, e , peciall, 111 the summer period.

We hm e two ambulances at the m ment v...ith a third on order from the K. Clo e relarion hip ha e been establi hed v.ith Air mbulance ervice which are much in u e due t he volume of foreign isitor.

To meet our e er changing ituations we are putting great tress on the training and d elopment of Officers and CO " both dult and Cadet. One e ening a week. is set aside for thi vital area v. ith a aturday once a month for mor concentrated cour es.

Finally, we are con idering inviting the pes to join the Badger"' , a, an e ' ample of good b ha iour.

Best \ i hes to our friend in the UK, we'll b pi a ed t how you round if you vi ' it our i ' land!

Mrs Elsie Sowerby

From Mr D.\'. '" ood ham , Co unt} Director, 1979 -1990. It i my ad duty to report that we in Oxford hire haveju t uffer e d the 10 of Mr E lsie Sowerby (Serv ing iter).

Elsie came to tJohn a A ociation Co unty Secretary in 1979. Her devotion to our aim and her dedication to her work were in trumental in rai ing by o,er 500% the di po able income of the A ociation here.

E I ie pent much of her lei ure time training young p eo pl e in fir t aid and he wa an accompli hed in tructor andexaminer.Shewongreatre pect at Divi ionallevel for the work he did on their behalf. There were repre entative of both branche at EI ie' funeral.

EI ie i a great 10 to t John. It plea e me greatly to recommend El ie for member hip of our Order and it grieve me greatly to write thi dedication to a per on ,\ ho I con ider to be t John' mo t de erYing en ant in thi County.

Judy Deakin

Some Gibraltar Badgers at their first enrolment ceremollY.

ST JOHN WORLD CROSSWORD 9-90

by W A. POTTER.

ACROSS:

I.Type of micro-organi m causing anthrax and typhoid (8)

5.Inflammation of the kin, u ually allergic in origin (6)

1O.Kidney ecretion (S)

Il.Naturally it i the ino-atrial node (9)

12.Metal in haemoglobin (4)

13.Change of air and a song (4)

14.Dyspnoea and stridor due to laryngeal ob truction (S)

17.Case sheet of patient of two down ? (8)

19.5tain for a woven material (5)

21.Increase rear (5 )

22.Carrninative pice from East Indie (8)

24.Laceration is in the true kin (5)

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26.The troubles and misfortunes of life (4)

28.Fa th er in acute physical discomfort (4)

30.Grievance of one with ailment? (9)

32.Complexion indicative of good health (5)

33.0edema produced by operations in dry environment (6 )

34. Select it for gland of reproductory system (8)

DOWN:

I.Slender rigid instrument used to dilate anatomical duct ( 6

2.Footman'? ( I I)

3.Fifty with a strange use for (4)

4.Jaw formed by the maxilla (5)

6. Strip for amusement (5)

7. Deer in Mel\..sham (3)

8.Mydriatic drug given pre-operatively (8)

9.Sure care for , urgical instrument for removal of polypi (8)

IS. urgeon dealing with injuries or the skeletal syst em (II )

16. cute pyogenic infection of hair follicle of eyelid (4)

18.lnllammation of 34 across often complicatlllg mumps (8)

19.Feign illness (4)

20 ln abnomlally large amount in blo d or gouty pal lent (4,4)

23.Biochemical cataly<,t to metabolic proce , sec; (6)

25.Fi h parb of the foot? (5)

27.Supple and flexible in limb (5)

29.Clench teeth for courage and endurance (4 )

31.Doc(or get. round a former hlne<,e leader (3)

Do You know your manual -A WER

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AROUND THE DIVISIONS

B uckinghamshire campers get a right royal treat

Cadets from all over Buckingham hire ha the chance to meet and talk to their Commandant-in-Chief, HRH The Prince s Royal, when he made a pecial vi it to their Annual County Cadet Camp at Charmouth in Dorset in August.

Thi annual camp is now in its 46th year with over 270 young people attending. Morning are pent preparing for proficiency ubject towards the Grand Prior Badge and in the afternoon campers participate in organised port , upervi ed wimming and visit to local place of intere t.

The Camp Commandant, Deputy Commissioner Vincent Smith, and his Deputy Commandant, Neil Carey of Amersham, were up at 5.40 a.m. on the "Great Day". After a wet day before they had prepared an alternative "wet weather" route but the weather had returned to it 1990 beauty again. After breakfast the reality of police and pre together with a dre rehear al kept everybody on their toes.

Although ten minute late The Princess Royal- in woolly pully - was received by Vincent and Neil and then introduced to her two guides, Nursing Cadet Angela Hamilton of Leighton Linslade and Cadet Leader Stewart Hopkin of Princes Ri borough. They conducted thePrince around all aspects of the camp and saw various proficiency cia es e.g. Ambulance Aid and Casualty Simulation in action. During the visit a card made by the Badgers at Camp for Her Majesty The Queen Mother's 90th birthday was handed to the Princess by the Crawley Quads of Aylesbury who are the only Badger Quadruplet in St John. 18 The Com m andant-in-Chieftakes a close look at proficiency subject tuitiol1.

UND TH E DIVISIONS

Relaxing after the Royall'i it.

The 90 minut vi<;it tla<;h d lea\ ing time for the presentation of two Grand Prior cert i to te\\ art (Lord Lieutenant's Cadet) and Peter alan of entral Milton Ke Her Royal H ighncss said that one of the bigadvantagesofa ampofthis kind was that itenables) oung people to learn to gel On wi th one another. I f there were more SlIch opportunities many problems cr ated by lack of communications would be oVercome.

Arter a charming. rela ed chat the

Prine ss I ft for her ne"\t engagement. incenl mithummed up the day by saying ho\\ much the \ is it meant to all those \\ ho work so hard from) ear to ) ear to mak.e thes camps the ucce the) ar . He ha<; since re eiv d a letter of appreciation from Buck.ingham Palace.

With 0 r 270 camp rs Bucks has proven the suc e ' sofsuch a camp. incent \.\ auld ver much li"-e to h ar from other ountie who \.\ ould be '" illing to hare finances. facilitie and LIse the site after Buck.inghamshire

[n the pa t haring arrangemenr ha\ e \\or"-ed \\ell for all - espe iall) to "-eep a . L lm\ - and incent \\ ould be plea ed to di cus ' matter ' \\ ith IIltere<;ted oLlnries. He an be onta ted \ la the Buck. HQ at Croft Road. ) le<;bur) The Ro) 011 isit \\ a ' a great honour for Buckinghamshire and it h01: already been a good year for the Count). It ha: alread) raised LrO.OOO fora ne\\ rraining entre and HQ in ) and \\ ork on that\\ ill begin in 1991 The) hope tharrhe appeal \\ ill rap £500.000.

Preparing the baby' bottle .'

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Injecting ENERGY into Cumbria

by Colin Clark (CSO, Trg)

Cumbria geographically large with a relatively small population We have about 200 adult m mbers. ave for one parttlme typist wIth the '>'>0 iation we have no paId We have two county offices A'>sociation in the north of the county and the Brigade in the south. Our county staff IS small and our finance'> certainly don't corne from a bottomles,> pit. We have tw area,>, Northern rea and Southern rca [n total we ha\e 16 dult DivI,>ion ,20 adet and 13 Badger et'>.

Energy or the lack of it?

Once th e nergy programme wa conceIved it was ob\ iously nece<.;sary for Cumbria to g t invol ed, 'v\-hether th membership lik.ed it or n t - and mostly they did OT! The Count) ommi ' sioner and my e lf had idea of th e concept of Energy from attending conference and hearing presentation ' We set to and decided to tour the coun ty preading th e go pel. This in itself is not ea y, where er we go there is a mountain or lake in the way!

There wa co nsiderab le r 'iistance to change with s uc h commen ts a ' "only eve n hour s training and out loose in OUR unifonn. What if they come aero:s an accid nt on th eir way to th e duty" being heard time and tim again. Well th e Commi sione r trav e ls th e len g th and breadth of our ounty and others, ' everal times a week, and ha done 0 for years. He can count on two finger the incident he ha come a ross.

We could not obtain any furth r information from London as they did not Want to pre -e mpt the "Road how" Thi ' Wa , very frustrating es p cia lly a th

original date for the "Roadshow " in January wa cancelled and put back to the 28 April 1989 (a bank holiday week-end at that)! The launch date of the 24th June was very clo e indeed.

Energy (o r Fatigue) po t Road ho",

Following a ' ucce ful road how ome interest began to emerge and we didn't eem to be 'v\-aving our flag in quite such a barren de.,ert.

"It is our belief that the caring or welfare arm will not fully function until we have a full first aid orientated membership in each Division."

Bad. up literature from London seemed painfully low. Launch date display ' had little r no hard backing from HQ. Eac h adult di ision recei dan infonnation package, but the Count) onl rec ived one cop and th rea , taff none! W had to beg opie frol11 the di i ions. We f It fatigu d not reenergi d.

Off the Launch Pad

Int er pi ked up , more in some quart r than other, and in total w ree i d 53 people via the Induction Cour e. Th re were three noticeable area. The fir t wa the econd large , t town in the count ,the o th er two were mall , elf c ntained communitie on th w t eoa t.

We found that the fnduction Course structure ensible, but two and half hours basic life upport wa not enough in relationship to the care element of three and hal f hours. This was ea , ed 'v\- hen the C-in-C and Jim Bond ga\e the CSO (trg) delegates at the 1989 conference. penni sion to modify Energy to uit local need.

Future hope of Energy in Cumbria

We found ver) earl) on that the \a t majority of members ia the induction cour echo e to continue into the First Aid ann of the Energ programme. The Caring arm 'v\-a not'v\-ell ub cribed. We appointed a County We [fare Officer. \Alho hold an appointment 'v\-ithin Cumbria ocial Service Department, and ha identified man) opening · 'v\-here St John could be u ed. The re i tilllitt[e intere t. Thi lack of mtere t tem from the divi on them elve - they are till hort of active member for public duty. e\\ member have been 'roped in' to learn fir t aid to fill the e gap. It i our belief that the caring / v. elfare ann will not fully function until \\ e ha\e a full fir t aid orientated member hip in each divi ion. On the brighter ide we have een an incredible increa e in the intere t for ambulan e aid co ur e , and we ha e ome difficulty in ' ati fying demand. In urn mary [though we v. ere late to tart Energ). and we found ome re ' j tance. v. e have taken it on and u ed it to our benefit. although we hm e a long v. a to go. We haven't even touched the 'c mmunication' aml ye t! We didn't fe I that the HQ back-up with re ource wa quick enough, or full enough. but \\ carried on. In the word of another famou (o r infamou , ) organi a rion - "We 're ge tting there!"

W d ,ho'v\- ever.f I that En rgy wi II only work if ou belie\' in it. 21

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OVERSEAS CONFERENCE REPORT

An international chance to exchange good ideas

"Few problems are unique - we can all learn from each other, that s definitely the me age from the 1990 over ea eminar" writes Keith Batt, Deputy Director O\erseas relation.

"Our ho t in Kuala Lumpur have to be congratulated on their administrative skill and their ho pitality. Delegate from Au tralia, Hong Kong, Malay ia, ew Zealand, Paki tan, Papua New Guinea , ingapore , olomon I lands, ri Lanka and the United Kingdom had a "er u eful and enjoyable time and much prai e mu t be gi en to tho e who worked 0 hard to make our time in Kuala Lumpur o pecial.

"We didn't only talk in Mala ia - much practical work wa achieved particularl in the exchange of training material and t John primary health care project received a lot of attention.

' pecial mpha i wa placed upon future need and development and delegate "ere a ked to contribute to the over ea department' agenda. Particular area under di cu sion were the ad antage and experience of diver ification into broadl} ba ed community care operation, chool orientated programme and the prmision of "om cia I" ambulance enice A lot ofintere twa ho\\n in programme . de igned to impro e recruiting, retention and public a\\ arene . " number of ' peciali t paper \\ere pre ented including pre entation on 'venom and Victim (Au tralia), Malaria (Malay ia) and the Drug Menace (\Ialaysia).

"There "a al 0 an extremely ucce fut Commonwealth adet amp run by t John Malay ia "'hich ""a held in Malacca to coincide with the conference. Be ide large contingent from the tate of Malay ia, even other countrie al 0 attended. Wale pro"ided adult leader and Wilt hire ent an excellent party of young adets. Together they made a great impre sion - and we ,-.,ere all ,ery proud of them.

"Next year's Regional eminar for t John organi ation in North America and the We t Indie \\ ill be held in Bermuda during March 1991."

Camp ill fHalacca AfondfarewellforMr. Phillips

TEACHING CASUALTY EXAMINATION

A firm but tender toucheffective examination of your casualty

by Caroline Thomas London Training Centre Midland Bank

u pect that many fir t aid in ' tructor glo , 0 er the section on how to examine a casualty becau e of the potential for embarras ment at the amount of phy ical contact needed to do the job thoroughly. Even tho e who demon ·trate it properly may find that their student practi ' e with more giggling than ob ervation!

And yet it is a very important technique. So perhaps instructors and fir t aider hould think carefully about what we are examining our ca ualty for. We will a ume he is

Fir t of all: history. When you a k "What happened'?" don't be ati fied with an incomplete an wer such as "1 fell over".

Keep a king until you get a clear mental picture of the incident. Why did he fall? Becau e he feltdizzy?Tripped oversomething'? Which bit hit the ground fir t'? And then'?

While you are a king and even more important, listening, you can at the arne time note hi general condition. ot only facial colour but expre ion will tell you a lot. Is he alert, far away, pained, di tre ed? E timate his pul e rate: you don't need a watch and it only take a few econds; if it is faster than you count 'one and two and a if doing heart compressions in CPR, then it is over 80. At the same time check the ri'>e and fall of the chest. You can mea ure them more accurately later when time allow .

His respon e to your next question "Where does it hurt" will lead you directly to the most painful of his injuries, but there may be others he is Ie s aware of. And you have to find them all, becau e the most painful one may not be the most urgent for treatment. A fracture can hurt more than a severely bleeding wound, but every first aider knows which has to be treated fir.,t. Beware of referred pain in which the brain gets confused about where the source of the pain message i For example, a fractured neck of thigh can cause pain in the knee I once examined a woman with pain on the inner side of her knee and I assumed it was a displaced cartilage, but I found tenderness only over the knee-cap (which an X-ray showed was fractured). So you must search for tender "pots by pressing carefully but firmly and ask him to tell you where it hurts. As you feel watch his face for sign... of pain.

Examine his head quickly and gently first time round, then repeat your search for lumps, dents and wounds more firmly and 24

SPINE IMMOBILISER

The R . E . D. Spine Immobiliser * heralds a new era of confidence in immobilisation and transportation of patients with suspected spinal injuries.

The emergency services have the responsibility of avoiding further injury whenever possible.

thoroughly, using both hands together Look fordi chargefrom the ear , but don't be misled b clotted blood which ha trid...I ed there from a head wound: wipe thl <1'" a) and 1001-.. for fre sh discharge from the ear canal. Pr ss hiS no.,e, cheel-..bone an d jaw. When did you last practise ob ... ervlng pupil reaction to light?

As you come to each moveable joint, pro\ ided there no tenderne a k him to move the Jointto test for pam Do thl 10 the jaw, neck, fingers, wri.,ts, elbow., and h uldcr.." then to es. anl-..les. knees and hip But only if) u found no tenderne s tleAing an injured joint could cau..,e further damage k him t take a de p breath and e hale full): a fracture d rib", ill cause him to wince vl..,ibly. eellng the '>pine need,> more firmness than mo'>l r'i rst aider thi nk J u t touching each \ ertebra i pointles'i. You need to feel them'" ith Ihe flat of your fingm working all the way down from neck to pclvi .

The abdomen i'> often forgotten In cu,>uuIL) e\aminatlOn The mo'>t likely injury i'> internal bleedlllg to the 11\ er. 'ipleen kidney,> or bladder which are all lair!) ImmobIle orgam an d therefore easily brui ed. unlll-..e the :-.tolllach and which can ft a Iittlc under impa t. e '" arm hunds or )OU v. ill cau e hi., abdominal muscle to tighten v. hen) au touch him!

You are lool-..ing chiefly ror tenderne'>s and unnatural ten'>lOn. so abdominal wall need to be rela\cd; a k him to breath e ,>Iowly and deeply through his mouth and as he eAhale'>, with the flat of your finger , worklllg methodlcall) over hiS rumm) and the kidne) area loot..mg for tender '>POlS. first aid cla'is hould rcall) usc a 'trailled casual I) for demontrating thi'i 'iort of thing. asualtle... nlon are based al I Growenor Crescent, but a k for someone who isn't ticklish !

Modern statistics now show that one in four people / ", " sustain additional '. / spinal injury during rescue and transportation due to { unavoidable move- '\ ment of the patient. "

The R.E.D. is approved for use as an alternative to the short spinal board.

patents pending

Checking the hips

I Formed from a speCially developed grade of polypropylene for maximum resistance to impact in the aggressive emergency environment.

I Easily slides behind even tightly trapped victims, quickly achieving control of head, neck and torso.

I Exceptionally rigid base plate Complete unit weighs only 2 kilos.

I "Variable cushion set" provides correct cervical support.

Designed to be totally X-Ray transparent from the lateral view.

Recommended to be used with universal cervical collar.

Approved by the St. John Medical Board and for use in the N. H .S

I Training video, shoulder harness for extra security, and replacement parts available

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TRAINING IN THE FALKLANDS

A one man training initiative for the Falklands

by Tom Meade

Prior to 1982 not many people knew where the Falkland I land were and for those who may have forgotten let me remind you. The Falkland Islands compri e two large and orne two hundred maIler Islands covering an area almost the ize of Wale. They lie about 400 miles off the coa t of South America. 800 mile from South Georgia. 1000 miles from Antarctica and 8000 mile from United Kingdom, on an equivalenr latitude to Norwich, but the wind which are both harder and much more frequent, and a cold sea surface current instead of the Gulf Stream tend to keep temperature supre ed below normal. The Antarctic continent i also markedly colder than the polar cap of the north.

Climate figure for the capital Port

Stanley are:

Mean annual temperature 5.6 C

Mean annual wind peed 17 Knots

Mean annual rainfall 63.5mm

Annual max temperature 21 9 C

Annual min temperature minu 5C

The land mass contains a variety of terrain. Inland there are rolling moorlands, vast grassy plain and high rocky features on which sheep roam. Sheep farms, some of which are 100,000 acres containing approximately one sheep per three acres form settlements in the Camp. Everywhere are lak es and ponds and mountains up to 2312 ft (712m). There is a magnificent coastline with aide beaches of white quartz sand and dramatic cliffs.

The civilian population lives mainly in Stanley the capital and numbers approximately 1100 while a further 800 people live in the Camp - a local term for the re t of the country outside Stanley. A similarnumberofservice men and women live mainly at RAF Mount Pleasant ju t over 30 miles from Stanley with other smaller group throughout the Islands. The main industries in the lslands are fishing and sheep farming.

The only Hospital in the Islands is the King Edward VII Memorial Hospital which is in Stanley It is a new shared civilian/military hospital opened in August 1987 with a 24 bed acute care wing, two maternity beds, a two bedded intensive care unit, and facilities for

King Edward VII Memorial Ho pital

outpatient'> and community health care

Doctors often conduct their surger) O\ er the radio to outlying settlements \\ ith regu lar visits being made to these farflun g places by Islander aircraft operated by th e Falklands Government.

The military element of the re oponsible for all urgery performed as well as running or as isting in the runnin g of the X-Ray 0 partment, Laborator)

Casualty and Wards, Medical Record s the Kitchen and of course, last but no t least, the supply department where th e author W02 (RQM ) Tom Meade found himselffora six month spell. He, togeth er with a small stafr, were responsible for all supplies entering the hospital as well as the discipline of Military staff and

patients. Responsibtliti s al 0 Included transport, the kitchen and casualty stafr.

Iread) a First id 1nstructor, Tom JOllled t John mbulance sh Vale Diviion in un'ey with his wire Wendy, anurse, in 1979. He wa., later pr moted to Divisi nalOITi er then both went to rea Stafr. In 1984 they both moved to Hong Kong and became members of District Staff. On r tum to cot land they both a sisted with the cots Rail section of t Andrew's mbulance ociation.

On arrival in th e Falklands Tom was approa hed by th e i ilian ide of the hospital and ask.ed to run a Public Fir t Aid Course. Pem1ission was granted b the special centre at Keogh Barrack, the RAM Training entre. hortly after a simi lar request wa ' made by the Falk.land ' [ lands Defence Force, the local equivalent of th e TA. During an eigh t week cour 28 p ople attend d and passed the first aid amination.

Additionally, the n wly forn1ed 1st Stanley Girl uide ompany decided that First Aid would b a good proficiency badge to attain and 0 a cour e was run, at the e nd of which 28 girls pa ed the

TRAINING IN THE FALKLANDS

e amination The Go emor'.., wife, Mr'> W.H. Fullerton a Pre ident of the local Red Cross, which i mainly in 0" d in welfare work. al. 0 asked if a basic fir t aid course could be run and 0 thi ' ""a

andchecking their content..

Tran port to each ettlement \\a b) lander aeroplane. the co t being borne b) the FalJ...land I land Development Corporation and Falkland I land,> Government ir ervice (FIG )

But it wa n't all ""ork and no pia). staying on the \- ariou farm: wa an ideal v. ay of meeting and getting to k.no\\ the local community and to see hov. the) liv

t the arne time the need had been identified for Fir t id to be taught to p ople living out in the Camp mO t of whom were hour 3\\ a from the ho pital in tanley.

one da) emerg ncy first aid cour e as forn1ulated by Tom and the Chief M dical Offi er and a erie of nine cour e \-\ere run all 0 er the I land" Dougla ' settlement in the north east, Port tephen in the outh w I, Ro C e and Hill C e al. 0 on We t Falk.land and Goo c Green on East Falkland.

Fifty p ople attended the cour e which oncentrated on resu citation, bleeding. bum , poisoning and fracture a w II a looking at fir. aid kit.

The opportunity of :eeing the 10 al \\ ildlife v. a tremendou , penguin ' ealion and n arra) of bird life in abundance. Gathering heep v. a a ne\\ e perience a al. 0 was the mending of boundar) fence . t the end of a bu ) i'( month tour orne 116 people were trained and are now hopefully c mpetent in fir t aid emergen y m a ure , \\ hich can be 0 vital in aving a life in a remote 10 ation. pending the arri val of medical staff, or the eva uation of the ca ualt) b) air to the ho pital in tanley.

Each tudent v. as a\\ arded an attendance certifi at Tom returned to Birkenhead to join hi \-\ ife a rea taff Officer in Mer-e) side.

1. This ca ualty i uffering from heat trake. At what temperature would you cea e thi type of treatment?

5. Thi portion of the brain controls body temperature. What is it cal led?

2. When treating a victim of heal exhau tion who i wea ti ng profu ely or ha cramp, diarrhoea or i vomiting - what amount of alt hould be added to each half litre of water?

7. For which case in bums do you app ly a s ter il e dreSSIng over the burn a nd not consider water?

6. For whIch conditions are you advIsed to lightly dre both eyes?

3. For which parL of the body is this the treatment for frost bite.

8. When treating chemIcal bum'> of th e eye, what ..,hould you do to the eyelid..,?

4. In order to le sse n the danger s of hypothennia certain peron'> shou ld not be a ll owed to participate in outdoor expeditions - who are th ey?

9. What cIrcum tances could cause this ..,tyle of treatment')

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10. In the tr ea tm en for chemical burns, what specific instructions are given re the "tap water"?

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EQUIPMENT REVIEW

Pictured above is an early St John Ambulance Association class held at the Guildhall, London in 1890.Times have changed and now St John is widely accepted as the leading training authority for industry and the public. Does the equipment you use reflect our premier position. Remember delegates impressed enough by the facilities on show at even the smallest class might care enough to join the Brigade or introduce others to a first aid course. Throughout this issue companies with first rate goods have advertised - on this page you can learn more about them.

o Designed to be a imple to u e as po sible the A BR E-AA V MA R S (Manual and Automatic Resuscitation Sy tern) leave s the carer able to concentrate on the patient and not worry abouthowtooperatetheequipmenl. AAV offer pecial di ' counts to the voluntary ambu lance service and a specia l conve rsion price for customers w ho have old Sabre Saturn Unit and wish to uprate them to full MARS unit '

o If you want authentic make up for you r casualtie in a public fir t aid COUL e turn to DAU PHI NE ' S which ca n s upply a ll kinds of ca ualty simulation materials and equipment over the counter or by post. Expert advice on make up can be given over the phone and the company a lso offers the c hance to attend teaching weeke nds,

o Adam Rouill y's unique range of p last ic ske le to ns, ana tomica l mode l , simu lators a nd charts are used wide ly in hosp ita ls and medica l schoo ls througout the co untr y a nd have proved to be idea l trai nin g aid

ANOTHER NEW PRODUCT PAREvAC MEDICAL BAGS

These most popular size bags have a main section which fully opens out with an all-round zip to reveal six assorted detachable pockets with hi-vis labels and a medical equipment roll.

The gussetted pocket on the front face of the bag is an ideal storage area for Survival Blankets or documents.

IDEAL FOR:

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For further information of these and other sizes available contact:

o The R .E. D , pin e lmm o bili erfrom NA PI E R Q IL L now foml an Integral part or equipment carned on many frontline vehicles in ngland, Wale and Northern Ireland according to the company.

The R .E. D has gained approval b) the Department of Health and the t John Medical Board Durin g Ambex thi s year apier Quill also pre ented Hartw ell Medical\ vacuum p linting y tern - the Evac-u-Splint and Evac- -Splint Mattres s.

o There is now available a new range of Paramedic product to complement the well known EVACU M AT Relea ed b) Paraid, P AR EVAC includes medical bags, spinal tre tcher ,ex trication device. protective c lothing, splint and cervical co ll ars.

o Improve your p upil" intere and rete nt ion by the use of one of the moS I powerful teaching mediums available. For \ furt her de tails plea e ontact John Dodd s a U .0. Safet y Ser vices, 3 Cleve land Road. Hinck ley, Leics LEIO OAJ.

MARS

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MARS is very simple to operate , leaving the operator to concentrate on pat ent care , not try ing to remember how to use the equ ipment.

MARS provides resuscitat ion for patients who are not breathing

MARS detects spontaneous breathing and automatically switches to breathing on demand mode

MARS will detect spontaneous breathing failure and automatically return to cycled resuscitation mode

MARS warns of an airway blockage .

MARS also provides Oxygen Therapy - can be used at the same time as resuscitation mode.

MARS is supplied in a compact , robust lightweight case with all masks , airways and therapy outlets requ ired

Sabre-AAV also manufacture a comprehensive range of Domiciliary and Portable Oxygen Therapy equipment.

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PARAID

RESUSCITATION TRAINING

Teaching resuscitation lay people remember it? - do

In this article which first appeared in BASICS Dr. P. McAteer, Senior Registrar in Anaesthesia and Dr. P.J .F. Baskett , Consultant

Anaesthetist at Frencha y Hospital Bristol , examine whether lay people can retain the knowledge needed for successful resuscitation and also give guidelines for effective teaching.

Introduction

Durin

IOlff of tha t number to attend one of four evenlll g ..,c"slon.., to mee t with doctor.., Involved with re ..,U,>CtlallOn practice and trall111l g The invltee<., w e re not inlorm ed lhat the y would be on whatthcy had learned in tralnll1g A <.,tamped addre..,..,ed envc l ope Wll'> cnc o"ed and li g ht rerreshments were promi..,ed Invitations wcre '>ent to c v ery tenth name on the co - ordinator 's regl..,tcr of participant'> , the fir..,t hd v lng been ,>elected on the 'throw of a cI ice' in an attempt to achieve a representa t l ve ,>ample of t he group

Participants in the Assessment

lIlety Ietter<., were sent and 60 replle'> received (66.6 Ck re'>pon<.,e rate) 0 1 thmc who repllcd, 33 did not ""i<.,h to attend and 27 accepted thc 111\ tlalton.

Reflecting the c x 01 the total number<., trained In A von, 21 \\omen and 6 men attended n s 1) Their age ranged from 970 year<." ""Ith a mean or 46 6.

I RESUSCITATION TRAINING

T a bl e 2.

'Sa e a Life' campaignA

appre c at ed in man y co untri es, p arti c ul arl y Sca n d in aV a (2) and th e U nit ed St at es, (3,4 ,5 ) Brit a in h as bee n r el ati ve y sl ow to r e pond t o the nee d f o r edu ca ti o n o f th e l ay publi c in C PR

The Save A Life Campaign

How e ver , in Nov emb er 198 6 th e fir s nati o n a l ca mp a g n to addre ss the nee d o r suc h an edu ca ti o na l prog r amm e was es tabli hed as a o int ve nture betw ee n th e R oya l Soc i e t y of M edi c in e, th e Briti '> h H ea rt Found ati o n , Th e Res u sc it ati o n Council (UK ), th e BBC and Indu str y. E ntitl ed " Th e ave a Lil e Campai g n' , th e pro g ramm e c on s s ted o f a numbe r o f sh o rt 10minute t e evi sion bro adcas t s d epi c tin g sce na ri os in vo v in g r es u sc it ation b y l ay peopl e. Th e o bj ec t o f th e Ca mp a i g n was to stimul ate a war eness of th e p o te nti a l life-s avin g rol e of th e ay individu a in a v ari e ty of c omm o n life- threa tenin g situation s.

Vi e w e r s w er e enc ourage d to o llow up th e ir int er es t b y att endin g spe c ially c on struct ed two - ho ur tr ainin g c our ses h e ld in va ri o us lo c ation s throu g hout th e UK Th e trainin g sess o n s w er e without 32

e ca

aig

t i mul ated

people to att e n d tr aInin g sess on" and th e co-o r d na t or<., h a \ e bee r info rm ed of 24 Ill'>tan ces "", he re It\ e'> h a e been '>a \ ed a,> a direci co n se qu en ce o f th e ump al g n (Table I ).

Experience in the County of Avo n

Th e ca mp a g n in A o n wa ,> 'i upp o rt ed by t ra inin g c l a'>se \\ lIh d i<.,tr i butl o n o promo ti o na l and c d uca tl on tI ma tenal In di f f erent In th e o unt ) ou nt ) o-o r dllla tor ma d, arran ge m l o r to be he ld and direc ted enq UIrer. tl, th e ir m o "t co n e n e nt l oca ll o n t o a o f 2.232 peo pl e ""ere t rallled 111357 t ra ning e<.,..,lOnl Th e mtru cto r " ""e r e dr a"",n l rom vo unt eer from ambulan ce pa r am edi caL <" p o rt i ng a nd rl r st -a d orga n l..,a tl oll'>, notably th e Red S t Jo hn A mbul a nce and A o n mb li lance enl ee (T abl e 2).

Assessment of trainees

To a" ses , th e re tent io n o f k.n ow l ed ge and ,> k.t1I " we d eCided 10 r eca ll a pro p o rti o n o f th ose w ho h ad bee n t rai ned in A von r es ult or th e ca mp a g n B y M ar c h 19'8.7 90 i n di \ Idu a'" had und ert ak. en PR tr a inin g i n A vo n an d tl wa<., d eC ded to In\lte

Table l.

trained aero the UK (January 1988 )

Area Number of people trained

En g a nd 9 5J 0 5

Sco tl and 12,8 15 o rth e rn Ire and 2,932

W a les 13,9g0 T o tal 125, 0 32

In March 1989 a total of 24 live were reported to ha, e been saved as a direct result of the campaign.

Each v>a" u"k.ed to complete d simple quc<.,tlonnaire V> hich Inrormalton about the IdUor(S ) which ,>llmulated their mtere'it in the '>ublecL details oj' an y pre\ IOUS trainin g and suhjecti vt: vie\".., on the or ganl..,allon and tt:achll1g quail ty of the training <"c""lon th e y had att e nckd They \\ere al<.,o i hk.ed hOI,\ confident the) kit <.,hould the) ha\ e to appl) their re<.,u<.,cllation ledge ,lilt! <.,k.t1I<., In a real cmergenc)

Aller completloll of the qlle tlonnalre. each indi\ idual \\<1 .., lestell In hoth theoretical kno\\ ledge and practlcal k.IlI<., of Ba'>lc Lite Upp0rl hy an experienced ande tht:lI t \\ ith d '>pecI,1l intcrc<.,t III rC'iu<.,citation training and practice Thl<" pertornlancc recortkd \Iter lhc te,,!. a ·Refre her Cour c· \\<\.., given highlightin g the Indl\ Iclual' ';I partlculdr area of Imperfection

Results

I. Pre-tt:<"[ Que tlonnalrc

(a) tllllulallon 01 Intere<.,t. The tcle\ I ion ..,erIe" triggert:d IIltcre<.,tln the maJont) or the 27 (22 ), concern to help ,110\ ed one III se\en, po,>ter publIctl) In four and nature of their occupa t ion III fi\e Fi\l? pt:ople under\\ent training becau<.,e the) \\ere per"uaded to acCOmp,Ul) ,I friend or relatl\t: \\110 had been tlmulated to attend.

(b) Pre IOU<., Training Eight member" or the group had h,ld prevlou.., trallllllg In PR but. In all hut olle per<.,on, thl<., had heen man) year<., hefore. Ithough t\\O of thl'> group ,Ichle\ed high scores I n te lIng their perfOnllanCe, thi<" matched b) t\\O IIldlvidua <., "" ho had no pre\. 10U<" training The a\ eragt: "core In the prevIOLhly traint:d !!IOUP \\as the <",l1ne as rhtbe v, ho had onl) had alll: tnllnlllg '>e<., lOn lI,>"ociated \Iv Ith the campaign. (c) ,1111 p 11 gn our<.,c Appral'>al. There \\ a<., genu al sa tl,>factlon (t)SC'j( ) \\ tlh the manner In \\ hich t he cour<.,e,> \.\ ere organised and the tui t ion conducted. \ 11 but one of the Lralllce could rccalllheir Instructor relating the pracllce of re<"U"Cltatlon 10 at le h t one of a group or <.,peclfic emergenclc,", <.,uch <-1" a Prt m ary car d iac aITe"t (2(:,/27 = 96 (,() and a near dnm nlllg IIlci dent ( 1(:,/27 = 60 o/t ) but less t ha n ha r the group could recall speC ifi c in o t her emergenCies <.,uc h as electrocu ion, chokin g and tr aum a after a road ;ccldcn l. Pri o r to cs lIn g, 2 1of th e Sli bjec h ,"ta Led th at hc) \\erc fair!) co nfid e nt' i n p Ullin g th e ir sk.ill s n t o prac t ice in a ge nu n e

emergenc): one V\ a<., 'completely confident' but fi\ e tated that they \."ere not confident.

2. Theoretical KnO\.\ ledge. Tv,erlt) of the ubject" (7-t '!c ) v,ere a"",are at the t) pe of '>ltuation \\ hlch could lead to cardiore plrator) faIlure requtrtng immediatere u"cltatlOnandabout.:-0 0i: hadaclearunder tanding of rhe dim and obJectl\ e of the re,>u,>citatlon proce 3. Practical Perfomunce.

'\, ot one of the 27 ubJech perfornled PR complete I) '>all factoril) on the mannik.in, including thme \\ ith good tht:orellcal knov, ledge. The mo 1 common faull \\ as an Il1carreCl technique 111 aprl) Ing che t compre '>lon , \\ hleh oecured In 22 of the ubjt:Ch In L , the rate \\ a too ,,10\\ (Ie <., lhan 60 per minute ,\l1d In one. too fa t (more than 110 per minute). e\en trainee adopted a d,lllgerou ly 10\\ applIcation pomt to rhe ....ternum

i\teen of the participant... lllade no attemp t to a ..,e,> the condillon of the pallent priorro tartll1g re u citation and eemed una\\ ,Ire of "k.in colour change a oeiated \\ Ith cardiore piralory clrre"t. e\en of the ubJeeh \\ alted for a I1lmute or more ponllficallng before ta l.. lIlg an) c l Cllan \"hat oner.

Discussion

PublIc Intere h In Re<.,u'>citarion O 2( ( of (he popula t ion of the L 111 ted K Illgdom ( 12 - ,n0060 million) ,Ind an equal proportion or the populatIOn of \on (2.232 , 11 millIon) re ponded ro the Ll\e a Life Campaign' b) underta k. ll1g a practic,li tra nIng cour"e On th face or it. thl I.,eem ro Intiteate ,1 ub (antlal degree or Llpath) III the n,ltion, a man) of rhe tele\ 1<"lon broadca"('> \\ ere "creencd at pca k. \ le\\ Ing hour.

\ !though the 66( '( respon e rate to our in \ ItLltlOn \\ a (hought lO be e ncouraglllg. Ie" than one third of t he tota l chose to ,Il tend. Tim Llccep ring group m,l) , rherefore, be a " C I I - elected eohort of rh e mo" t Inrere<.,ted, \\ hlCh \\Quld ma k. e the re ult" rLlther disLiPPolllling Ithough some of tho<.,e \ ho did nor re pond or art en d may h a\ e included a fe\ \ \\ ho \\ ere en n rel) confiden t in 33

RESUSCITATION TRAINING

continued from pre, iou pag e their ability, it is lik ely that the e number were mall and it i improbable that their elf-confidence wa ju , tified Retention of Skill

Theratherdi appointingre ult mu t,however,b compared with the equally di appointing re ult in UK doctor reported relatively recently (6,7). It i al 0 heartening to know that even Ie than perfect re u citation attempt do enhance urvival rate (8).

Ourre ult howthatin tructor mu tplace pecialempha i on the following a pect :-

1. An appreciation of the aim and object of citation attempt and their relevance and application in a variety of dayto-day emergency ituation

2. In itial patient a e ment, including kin colour.

3. Pul e check after airway control and initial ventilation.

It is al 0 intere ting to compare thi group of mo tly adult . with a group of chool children aged II - 15 year who were imilarlyas e ed after a re u citation cour e conducted by the authors three month earlier.

B y and large, the chool children produced better re ult than the adult, but they al 0 fell down on a e ment of pule and rate of che t com pre ions (Table 4 ).

It was, however, clear to u that the performance of both group improved radically after re-training and the opportunity to practice was much appreciated and led to greater confidence amongst the participant It would , therefore, eem wi e to recommendaRefre herCour ethreemonth afterinitial training After that, it may be po sible to delay a further Refre her Cour e for a year, but no longer.

References

1. Eisenberg M., Bergner L., Hallstrom A. Paramedic program and out-of-hospital cardiac arrest: Factors associated with uccessful resuscitation. Am J Public Health 1979; 69; 30-38

2. Lund I. Skulberg A. Cardiopulmonary re u citation b y la o peop le. The Lancet 1976; 2; 702-704

3. Cobb L.A , Hallstrom A.P., Thompson R.G et al. ommunity cardiopulmonary resuscitation Ann Rev Med 1980 ; 31: 453-462

4. Eisenberg M.S. , Bergner L., Hall trom A. Ca rdiac re s u citation

A dam, Rouill y's medical n. training aids range from human anatomy charts to full size, full weight rescue manikin s, and everything you can think of in between. Their osteological, functional and anatom ical models, as well as the most lifelike electronically operated simulators, have been proven time and time again as ideal in training

Table 3.

Retention of knowledge and s kill s over 3 month amongst 15 choolchildren - 10-15 year o ld

General A e ' ment

Airway Mana ge mcnt

A ss e sment of Bre athin g

E pired Air Ve ntilation

A se sme nt or E xternal Compress io ns Full CPR in the community. JAM A 1979; 241: 190 5-1907.

5. Thomp on R.G., Hall trom A.P., obb L.A. Bystander-initiated cardiopulmonary re u citation in the management of ventricula r fibrillation. Ann Internal Medicine. 90: 737-740

6. a W.F. re u ci t ation: A SUrH) of tandard among junior ho pital doctor .J Ro)al oc Med, 77: 921-924

7. kinner D.V., amm .J., :vtile Cardiopulmon an re u citation kill amo n g tHou e Officers Brit Vled .J 1985; 290: 1549-1550

8. obb L.A., Hall trom A.P. ommun it ) ba ed Cardiopulmona n re u citation - \\ hal have we learned'? Annal NY Acad ci 19 2: 382; 330-342.

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CONTRIBUTIONS

Contributions

tOrial address below. If possible supply a phone number for the writer Material can vary from a paragraph to a 5,000 word article but It should all have some connection With St John and ItS work Photographs should be glossy black and white prints or good quality colour prints, or transparencies. If photographs are

SUBSCRIPTIONS

•

•

Applications are invited from uitably qualified holding ither RN/RGN with Di trict or llealth Vi iting qualifications or ocial Work to pioneer the development of a package for ommunity are within the Brigade's new Energy Programme Visionary and organisational skills are required to establi s h a programme suitable for the volunteer to function in aring in the ommunity

Good communication and inter-per. onal 'ikills are e sential and some lnowlcdgc of marketing would be an ad anta ge.

This e ' citing but hallenging post will be ba<.,cd at t John Ambulan e I IQ at I Gro<., enor rc<.,cenl, London W I X 7EF. but will e ntail .,ome tra e l in the development ..,tage of the programme. alar) n g otlable

For information and job description ..,end v- ntlen applications to : M. Latham E s q. Bn g ade ecretary t John mbulance I Grow e n r Cre.., ce nt London W I X 7EF.

Your St John Ambulance Membership entitles

take advantage of one of the best, low-cost car insurance policies you can get and, because you are a member of St John Ambulance, and considered to be an exceptionally careful and responsible driver, you will al 0 get the

LETTERS

With heartfelt thanks for your dedication

[was in France with a friend when "he had a

A doctor and nurse arrived at the \1ontpellier Il o:pital and as I speak French Iluently 1 wa able to liaise between the English and the French During the flight the nur..,econstantly attended to my friend.

At tanstead a t John ambulance \\ltl1 driver (Roger, aged 21), navigator and nurse was waiting to take us up to Hammersmith Ho..,pital. The nur e commented that she had taught Roger a a Cadet - v"onderful!

ner e actly two week'> my friend died, but I would lik.e to sa) that she was attended b} acharming nur.,ecalled Peter When 1 as led him hov" it wu.., that he had come into nursing he "aid that he had been With t John mbulance as a adet in Comv"all and had come to London to train

[ thinl mo t people thin1-- of you in connecti n with concert.., and football matches They do not lnow the e tent of your worl

At my friend " funeral I asked the Vicar t empha i ' e all you do - I hope it will help you in a small way. Name withheld b Editor

Could you help to find a cure for Alzheimer's disease?

I am writing about the article Alzheimer' Oi ea e by Belinda Harding. It hows very clearly the need for organi ation such a the St John Ambulance which can provide nur ing member to it with patient to allow their carers to have orne time to them elve in a 24 hour -a-day, even

If you wish to contribute to St John World's letters page write to The Editor, St John World, 1 Grosvenor Crescent, London, SWIX 7EF

( Reader's views although expressed In St John World , are not necessarily endorsed by the Order of St John or its Foundations ). day -a-week job.

It al 0 mention that a lot of vital re earch i being carried out into Alzheimer' di ea e. I work at the Re earch In titute for the are of the Elderly, a charity ba ed at t Martin' Ho pital, Bath.

A large part of our work i involved with looking into the u e of drug in Alzheimer' di ea e and related dementia. We are currentl. looking for patient to take part in tudie of potential treatment.

The tudie are conducted under the upervi ion of Dr Roy Jone. Invoh ement in a tudy would mean taking tablet dail and attending the In titute on regular occa ion for a number of week.

It i important that each patient ha omeonelookingafterthemto upervi e the taking of medications.

Tran port can be arranged for anyone who would have difficulty travelling to the In titute.

Belinda Harding mention at the end of her article that " hopefully a cure or treatment will be found". tudie like the e take u a little nearer that goal. If anyone would like to find out more, plea e contact Jack. Prior on Bath 835866 or write to: The Re earch Institute for the are of the Elderly,St Martin' Ho pital, Midford Road, Bath, BA2 5RP.

Mr J M Prior

Re earch taff Nur e Oi i ional Nur ing Officer

We tbur. QuadrilateralOivi ion

Duke of Edinburgh success story

Although there have been previou participant in the Duke of Edinburgh A ward Scheme, Lancashire wa not promoting it atisfactorily.

Tony Birkett, who i not a member of the Brigade but i very intere ted in the Scheme, wa a ked by my elf to try to give the Scheme a boo t within the Brigade. By vi s iting Divi ions at In pection time during 1989, and talking to young people betv.een the age of 1S and 24, he compiled a Ii tofyoung people who were aguely intere ted

A meeting wa then arranged in February 1990 and intere ted young people per onally invited to attend. At thi meeting, Katherine Pre ton from London HQ and tv-o officer from the Regional Duke of Edinburgh department talked about the cherne

From thi ' meeting young people enrolled on the Scheme We now ha e 24 participant and more application are coming in dail). e are eagerly awaiting our fir t av"ard

Lione l Harri ommi ioner Lanca hire

Casualty!

Like mo t Divi ion \,\ ithin t John v- e like to 1--eep up to date \ ith modem technique In Bangor we ve found aver) intere ting \\ a) of doing thi t lea t once a v- eek. m elf and ome memb r of the Divi ion help out in the local ca ualty unit at the Di trict General Ho pital in Bangor. We ee more in one night than we ee in three or four ear of public dut). We have had e er thing from nake bite to jelly fi h ring to an ' iet attack

Of coure. we are not allo\',ed to treat an one but ju t ob en ing doe gi\ e u add d kn wledge and al 0 help u to recogni e illne e etc a lotquickerwhen w ar n dut

Andre Pepper Officer in harge Bangor Divi ion 3

TREATING BURNS

Forget the rest, water is best!

A for the use of water as a fir s t aid mea s ure for thermal injurie s by J.C. Lawrence , The Burns Research Group, Birmingham Accident Hospital.

StaffattheWe tMidland RegionalBum Unit are often a ked what is the best fir t aid for bum. On being told that cold water i the imple t and be t remedy thi answer is often queried even by person in the emergency ervice on the ground thatit is only uitable for mall bum, that it is un uitable for electrical bums and 0 on.

Many are tempted to resort to complicated and ex pen ive dre ing forgetting that the receiving ho pital may only be less than ten minutes drive away where any dre ing applied will be immediately remov ed. Member of the public also find the advice difficult to accept, they are inclined to think that grea essucha butterorvaselinearebe t, alternatively they want to use anti eptic materials , usually as cream, and often apply dressing.

Surveys made here in recent years suggest that sca rcely half of the burned ca ualtie s attending the out patient department used co ld water (1), some of the alternative therapie s were hazardou s. The findings of our recent s urvey are shown in Table 1.

Cold water, that is water at a temperature between 0 degree centigrade and normal environmental temperatures (whic h may reach approximately 20 degree s in thi s country), ha s been recommended by various authorities (2,3) for a long time.

Reputable Victorian medical herbal s give the same information (4). Laboratory studies concerned with the time4

TREATING BURNS

(curve B, Fig 2). Thus the quenching of residual heat is dramatic. of 100 degrees centigrade were for much of this work as half of the burned patients admitted to the bums unit here had sLlstained ')calds (5,6) and were ther fore exposed to temperatures up to but not exceeding 100 degree: centigrade. election of the d lay b tween injury and applying water was based on the assumption that tap water would be reasonably clo'>e at hand - many scalds occur in the kitchen thus tap water is Ilonnally readily available - and that a little time would b needed to react and move to the water supply. It follow,> that cooling is more efficient if the water can be appli d in a ..,horter time and les efficient if there i.., a delay.

Th experiments described relate to bum.., made with a bra')'> blOCh heated to 100 degrees centigrade applied to the sklll..,urfacc: ",ere mea'>ur d b) mean) of..,mall inserted sub-cLitane usl . Howe er. in man) a cldent ..,ituations there are other heat reservoirs in close pro imlty to the skin. Such re')crvOlr'> are pro\ ided by clothing soaked in hot Iiquid, hot material ueh as bitumen or ,>mouldering clothing. In connection with the latlercircumstances It is pertinent to reali.., thaI e tinguishing clothing on fire by means of a blank.et i the appropriate immediate action but thi depri cs the fabric of oxygen thu " although fire may be e ' tingui hed, the re idual heat is often considerable.

water(which can be regarded as terile) i not available, alternative hould be con idered. Tho , e frequently at hand could well include liquids uch as milk or fruit cordials . neither of the e normally contain bacteria that are likely to colonise a bum. I n the absence of such al temati ve recour e may have to be made to other sources of water ",hich may be emiClearly uch source cannot be regarded a free from halard but is preferable to u e the e rather than do nothing.

"It is evident that burns can occur at lower temperatures than is commonly supposed"

Fig. I how ' the time-temperature relation:hip of heated metal (bra ' ) to cau e thermal burn For mo t practi al purposes water can b regarded a beha ing imilarl .Thecurvei:modified with insulating materials - ome information on th is i a ailable 0).

bum form bli tel' nor doe bli ter formation nece arily occur immediately after burning: on et of bli tering ometime take hour rather than minute .However,thepre enceofabli ter following expo ure of kin to a heat ource indicate that burning has occurred. Once re idual heat in the vicinity of a bum ha been removed the que tion ari e "what nextT. Ithoughome bum are more con eniently treated by expo ure, for in tance bum of the face and neck are a", kv. ard to dre it make en e to i olate wound from the em ironment until the casual t) ha arri ed at an accident and emergenc department. bewildering array of dre ing i available ome of which purport to be uitable for fir t aid and tran portation purpo e. 1any of the e dre ing are both e\pen ive and bulk thu" unle the anti ipated time 10 tran port the ca ualty to ho pilal i likely to be very long, imple mea ure are omm nded.

Stick to water when you treat a burn - bleach or tootilpa te WOTl't help ! temperature relation hip to cause burns (F ig. 1) (5) how that on et of burning occur at co mparativ e ly low temp erat ure and thatthe re s idual heat in skin following a bum i appreciable such that th e s ubc utaneou temp erat ure contin ues to rise for a time after the heat so ur ce has been removed. The time taken for ti ue exposed to 100 degrees centigrade for ten

E periment were also made in a simi lar manner to the heated bra s blo k but u ing molt n ugar at a temperature of I 0 degre Thi adh re t the kin and, if Icrt untreated, takes a very I ng time to cool- a comparatively mall ma s retain temperatures above 37 degree for man minutes. Quenching this mas with cold Water also reduces the temperature dramatically, body temperature being regained within forty econds.

econds to return to body temperature was three minute (curve A, Fig. 2) (5 ), This time cale wa lon ger if the origina l bum wa at hi g her temperatur s. Appl ication of tap water at 14 degrees centigrade ten econds after making a burn o n skin at 100 degrees cen ti grade reduced the time for the tis ues to return to body temperature to thirty econds

CI arly it i pr r rubl to u e terile water a burns by nature contain dead tissue bath d in erum, an excellent bacterial cu lture medium, tend to r adily become co loni sed by a variety of micro organisms. How ever, in an em rgen y si tuation it icon idered that e limination of heat ha a high r priority thus, if tap

It i e ident that burn .' can oc ur at 10> er t mperatur than i common I supp s d u h that length expo ures to temp rature abo e -1-3 degr v. ill damag skin but necro is rna take tim to de elop. T pical coagulati e butTI ar not [ol1n d until ti ue temperatures reach abo 56 d grces.; prot in . do not oag ul a t blow thi t mp rature.

It is important to r ali that not all

Practi al e\perien e ha shov. n that cold ater ompre e applied to a bum relieve pain ' uch that the impl m a ure of appl. ing a damp di po able tov. I to the wound ha a r markable oothing effect. Thi ' Ie hniqu is u ed by ca ' ualty taff until the chni ian arri e: and i a ver helpful aid in r a _uring a burnt child.

Thu a imilar te hnique i sugge ' ted f r u e b th on it fir ' t aider once the initial \ ound quenching ha been compl t.. , teril cotton h t. nonnall) carried on m rg nc) ervi 'e vehi is uilable though there i no rea on \\ h)

5

TREATING BURNS

Table One

Fir Aid Accorded to Burn and cald Patient (Three urve y during 1986, 1987 and 1988 )

Number s ( Percentage )

Fir t

Dairy produce (1 ) Sprays

Other material (2)

(Percentage values ma y not add up to

( 1) Butter wa the mo t common but two patient had applied) oghurt.

(2) The e were diver e but included dry alt, bicarbonat e of oda, sodium hypchlorite (bleach ), Sugar olution, toothpa te , talcum po" d e r and proprietary antiseptics (eg TCP and Dettol ).

Fi2ure Two

e ffec t of lo ca l coo lin g on th e ubdermat temperature of ')k in in ,i, 0 following burning.

this should not present u problem. l rthcrc is to be any considerable dela then the \.\ oUlld '>it should be inspected and the film replaced if necessary. Other readily available hou:ehold items an be into ser ice as temporary dres . ings. Polythene rrec/cr bags and dustbin lincr are al'io sterile <1!'l supplied and afrord an e\cellent meam of i..,olating wounds of the extremitie rromlhe environment. bag!'l are routinely in many unit.... to manage burncd h:.lild

Thi brier utline or thc underlying rationale ror burn II r t aid III a..,urc!'l,>hould h lp tho e il1\, olved III dealing with burned and ,>caldcd ca ualtie.., at the '>cenc or the accident that the mea'iures that are uggc..,tcd are ba'icd both upon .... ystematic .... tudic .... amI c\pcrience . Referencc'i

I, Ll\.\ rence. J and Phlpp"', R (19 6) fir t aid ror burn'>. Lancet. ii. 757

2. Flr t id Manual (19 ) London. t John. ndrc\.\ and the Brlti h Red rm

3 La\.\rence. J (197) Bntl h Bum ",,,,oclation Recolllmended Flr t Id for Burn and cald Burn 13. 153 ...j.. Robin on. M (mid-nineteenth centur) ) the e\\. Famll) Ilcrbal. London. 'fr, ichol .... on and on..,.

5. La\-\rencc.J andWIlI-.II1,>.M (19(6 )

The Epidemiolog of Burn In Burncare. Britsh Bum 'i!'loclation/ mith c' ephe\\ Ltd. Hull. pp 13-26

6. Lawrence. J (1987) Inr ction ontral in Bum In Burns and Pla!'ltic urger), linical nacthc'ilolog). I. .3 London. Bailliere Tindal. pp67 1-692

50 100 I 50 7/

Time in seconds absorbent ga uze or paper shou ld not be used.

7. Medical Information on Human Reaction to I-.in ontact "" ith Hot urfaces. PD 650...j.: 1983 London. Bntish tandards Institution

CARE IN THE COMMUNITY

Caring for the carer

Mary Greaves, SRN, is a Nursing Officer with Mumbles Division in wan sea. She has recently reached the finals of the Outlook Pathfinder Award, a major national nursing competition. Here she explains how she uses her semi-retirement to run a course for carers.

\11)' general training ""a" at The London Ho pltal. Whitechapcl, in thc East End 111 the 1950.." The l11o<.,tlmportulllthree word,> \carnt were 'Patlent'> arc people' and no\\. year later. I ""ould amend it lightl} to Pallent and their n;latl\ e.., are people'. bec:.lu e fnend) and relallve arc 'iO Important.

Following 111) mldVvI fery training and a \anet y of Job 111 and out of the nur'>lng world. I \\ ent to u tralia for two }ear.., and gi.llned \ aluable experience in nlllh\ fer} and cOlllmUnll} nur ing in the Cll) and the utbacl-.. When 111) children were old enough. I returned to llur ing:.l a practice nur e and rem,lIneu one for the past 16 )ears 111 our \'illage of Mumble near \\ amca.

In order to i olate the wound from the e nvironm ent cling film offer a cheap readily available dressing It has been used here for many year to provide temporary cover for bums attending the out patient cli ni c (8) and i a l 0 u ed elsewhere (9). Laboratory studie here hav e hown that it i terile as upplied but it is probably prud e nt to remove and discard the first turn on the roll. In this connection it houJd be noted thatsterility 6 i ade irable but notab olute requirement such that if terile item are not available fre hly laundered heet. and towel are usually clean enough bacteriologically for this purpose.

8. Lawrence J (1977) the Treatment of mall Burns with a Chlorexidinemedicated Tulle gras. Burns. 3. 239-..!-..).

Cling film can be applied direct to the wound urfaceanda wetcompressapplied or it can be u ed to sec ur e we t compre , e Concern has been expres ed concerning the po ible tourniquet effect or cling film shou ld oedema occur. The oedema consequent on burns u ually takes time to develop, often everal hours, thus for a

9. Wilson • and French. G. (J987) Plasticised polyvinylchloride as n Temporary Dressing ror Bums. British Medical Journal 294.556-7

10 later. RM and Hughs. (1971) A simplified meth d oftretlting bums of the hand. Briti h Journal of Plastic urger ) 24.296-300

This article appeared in FIRE - a magaLine for Chief and Assistant Chief Officers.

It \\ a.., dunng thl lime that I becume a\\ are or the need to teach people ho"" to carcfonhelrloved ne underdifficultor trying clrcum tance but time. a u ual. wa at a premium hance remarl-. b) a fncnd opened up. unl-.noVv Ingl) then. the eed or an luea. Would I be intere'ited in teaching her member .... in the t J hn Ambulance Brigade rheir home nursing cour!'le? nd'i I became their unifornled nursingolTicer. ftera)earorsoI reali:ed that all tho'ie loncly carer in the community could perhaps benefit from thi'i t pe of learning and haring their ideas with us. and th cia se

ow I ha e almost hung up In stethescopc and entered seml-retirem nl. that precious ommodity. time. is now availabl . With the pas!'lage of the H and Community are t so much orthe emphasi!'l or caring in the communit is laid at the feet of the primary health care team and voluntary s rvices, w in the Mumbles division of the Brigade realised that we !'lhould channel even more or our

energy in that direction. tati tic are onl) a rough guide. but it may be helpful to reali e that there are 379.000 disabled people in ale and at a \ery r ugh erimate. between 17 ,000 and 190.000 careL' in ale ,' . Le than 2 % recei\ e an) laturory more than Soc'c- d pend on famil) upp rt. ...j.oc'cof car rs are 0 er 60 years old and 65 C7c of carers are \\ omen. Onl ...j.% of carers b nefit from respite care. There arc man) different I-.inds of carers. There are those \\ hO!'le children ha e been handicapp d from bil1hmentall or physicall) - and \\ho ha\e learnt to li\ e \"ith their hard hips o\erth ears.

nother group is those \\ hose relati \ es have been rendered b) ac ident such as road traffic injur). sp rring injury or criminal injury. Th se ha e to

learn to adjust ver) much more rapidly. The need for help i urgent the time of realisation of the implication of the injur) andofongoing ·upporl. but. \-\ hate\erthe reason for the di ablement. the trauma to the family is deva tating. The group ,' ofearer v.ith whom I am more involved are tho e \\ ith ageing relative, \ ictim of troke or enile dem ntia. the ,' hort-term are of patient ' \.vho ha\ e had earl) di harge from h pita!. the carer of the relati\ e \\ ith long-ternl progre " i\ e illne , ,,, or ternlinal care and the neighb ur \.\ ho pops in n \t door \\ hi Ie the arer goe shopping. Whate\ er th group. and bearing in mind that ever) person is an indi\ idual and it is impos ible to gen rali.e, each person r quire , "-nO\., ledge of th help a\ ailabl and the right to choo , e what help mO:1 suit.., their particular need , 7

SUPPORTING WITH CARE

Good communication between a many caring discipline a , po sible i s. entia\.

The aim of the cour e is to teach carers, and other who are keen to learn, b tteror easier way to improve the life- tyle of the one for whom they care.

The local GP are kept well infonned with detail of the forthcoming cour e, as are the health visitor, di trict nur e and local people. We adverti e in the public library, hop, churche and the local media but word of mouth i mo t effective.

Our community i centred around a thriving ea ide village with a wide election of council and privately owned property. Many of the re ident have lived here all their lives, while other have come home to retire. Many have relative living far afield. Social ervice finance home helps, but not enough. There ha a1. 0 been a huge growth in re idential nur ing homes, but there are still people who do not, or cannot, qualify for thi kind of care, 0 it i the carer of the , e people whom we hope to help. Care as istant al 0 come to cla e to gain confidence in coping with their patient.

The cour e i held in the village hall at a co t of £5, which goe toward the rent of the hall. The practical kills are often taught in my home, which i where we learn much aboutthedifficultie ofnur ing in the home and adapting technique to uit the situation.

The course followed i that et out by the St John Ambulance Brigade's Caring for the Sick manual and take roughly 12 weeks, meeting for one and a half hour weekly. We follow Maslow's hierarchythat is, physical needs, safety needs, social needs, esteem needs andself-actualisation This sounds very grand, but it cover the everyday needs of basic living translated into nursing and tender loving care. I encourage group discu sion throughout the course, because by thi we all learn from each other' experiences.

Each week my hopping tro lley changes its role and becomes filled with an amazing assortment of equipment borrowed from home - inhalation jugs, mouth-cleaning tray, bedpan, a carafe that make a very useful urinal in emergency, feeding aids, walking aids and all the articles that help make a Ie son more interesting.

Mo t of the course i good common sense, butthat is not all that common! An 8

under. tanding of hygiene in to learning about wound care and simple dreing bandaging, stoma care - all duties that can be carried out by a competentcarerat a time which suits the patient rather than ha ing to wait I'or a bu y di trict nurse to fit it in with her already 0 erl aded schedule. Admini tration of drugs and the associated danger are all carefully outlined and di cus ed.

The one subject that seems to be most helpful is care of the dying. When the inevitable doe happen, our carer.., are equipped mentally and physically and know where and when to find suppon. Macmillan have been invaluable with their friendly practical discussion In the relaxed atmo phere. We all benefit from specialist teaching. The continence officer, the dietitian, ocial ervices, the diabetic si ·ter - all are willing to come and talk to the group.

Bathing, bed-making and lifting are taught in the now-empty granny nat in my home. Looking after two grannie ' has been an enonnous help in under tanding what being a carer can mean. A cup of tea or coffee and a bi cuit, a Ii tening ear, a laugh about ome funny mistake or a shoulder to cry on are very much part of our evening activitie and give me an opportunity to pick up any stress signs and act on them, if necessary

By teaching the lay person to care correctly, I believe we are helping to reduce the workload of the profe sionals and offering the carer a background of support and the knowledge that they are not forgotten. It al 0 offers a chance to meet the people with similar problems .

From feedback I know that these cla ses have been found to be really helpful

to our participants and especially to the men, whom we n ourage to attend. This group arc orten totally unrrcpared for nursing, but, with guidance, they dis cover that the tasks that have , for so lon g, been left to the women are now th eir responsibility and they learn to cope.

When therc is a need our Bri gade mcmbers, both young and old, can become a rriend to the ramily or carer by popping in and giving breathing srace, a c han geo f race, a difrercnt li..,tenin g ear.

These classes ha\ e opened up an important a enue for lonel) carers after they are no lon ger required to care. Ill sa difficult time for some to readjust after bereavcment, but it I.., eased by the faci that the y knev. how to cope and v.ere able 10 give their loved ont.:'" the be..,t pos..,ible care and help them to a dignified death . o what ha\ e the course.., achlc\cd ') The patients receive bl;tter care \vhlCh "hould mean the) arc happier, more content. They Illay ha\ e learnt more skill throu gh rehab ilitation , better or mort suitable nutrition, better III billl), ar impro cd r"'ychologl<.:al outlook. Pcr..,on al and financial problem ma) ha\e come to li g ht and thl; arrrorriate obtained. ommunicallon may have been a barner which the carer nov. better.

One man looking ahead to caring for a daughter with motor neurone di<;ea\e wanted to build a reall) practical bathroom for her. Where should he ..,eek speCialist help in respect or design and grant ? couple with a ne Iy acquired foster· daughter needed reassurance that their general practitioner in the new area to which they were moving would not reje ci then because the severely handicapped girl would Cosl his practice 100 much money I do nOI know all the answer to many questions but at least. like the adverti ement, I can say, "T don't knov. · but I know a man who does."

My own satisfaction is LO see peopl e grow in confidence and companion hlP and to hear ' omeone say: "How grateful I was to have cared for my mother or father to the very end and to know that I had done my best." It is salisfying to know Lhat one's acquired knowledge is being used in a worthwhile manner.

Which type of muscles arc displayed here ?

Identify this type of hernia.

3. What are the signs and s mptoms of cramp?

S. When treating cramp in the foot muscles, having straightened out the casualty'., toes, whathould you do?

8. Which procedure i being di sp Jayed and which word is used to abbreviate the treatment?

4 For cramp in the calf muscles in which direction should you move the foot?

6. What type of joint i di played here?

9.When treating a di location what are IOU advied OT TO DO?

10. When treating a recent train for how long hould you apply the ice bag or cold

II. Hov. would thi ca ualt) de ribe the pain that v. a. experienced at or near the joint cau ' ed by this di location?

DUKE OF EDINBURGH AWARD

Going for Gold

Katherine Preston , Duke of E dinbur g h Aw ard

Development Officer, e x plain s ho w St John m e mb ers are continuing a long histor y of participation in on e of th e countr y 's best kno w n y outh aw ard s.

I hope that by now everyone i fu ll y aware that our M e mber s can gain the Duke of Edinburg h ' A ward thr o ug h St John Ambulance. In fact we became one of the fir t operating Authoritie when the cheme wa launched in 1956. As HRH Prince Philip pointed out in th e preface he wrote for our new leafle t , a group of StJohn Cadet from Birmin g ham was among the first g roup of yo un g peo pl e to gain their Gold A wa rd

St John memb e r hav e alway acted as in s tructor to participant doin g first aid for the ervice ection of the cheme but now increasing numb e r of St John members are participatin g in the sc he m e. There have been over 150 new e ntr a nt s ince la s t October.

Many people a re joining as th ey reali e thatthe DoE Award cherne can not only run parallel to the Grand Prior Award, but can be a natural continuation of activity if the Grand Prior is achieved at 14 or IS The late s t age for entry in the DoE cheme is 23 so many members in Adult Divi s ion s are finding it a way of expanding their activitie s.

When we held our fir t General Conference in April las t year, over] 00 members attended. As a re s ult the Counties in the South We s t Region se t up their own Regional Committee and have pooled resource . A s imilar Committee is being formed in the Midland , and will be followed by the otherregion In March this year the South We s t Committee held an Adventure Training weekend and the Dartmoor Panel of the A ward Scheme generou Iy offered to help to in s truct and assess the candidates. A further training weekend is taking place thi s month and a Gold Week training course is bein g discu ssed.

10

In M ay thi , yea r we held o ur first ational Award c heme Training wee kend Th e Midl a nd s R eg ion a l Officer of the Award Scheme, Jim Par kes, who ha s been re pon si bl e for mu c h of th e Award Sch e me ' tr aining ma teria l,jo in ed u on th e Friday evening, a nd o n the Saturday the Derby hir e Award Offi ce r led an observation/map reading week, followed by a pre entation. It was clea r that thi fulfilled a nee d , a nd it w ill now be an annual event.

W e are also holdin g a n Annual Conference of County Li ai on Offi ce rsthe fir s t will be he ld in Bri s tol this month In th e meantime we look forward to welcomin g a t Gro sve nor Crescent thr ee member s from Cornwall who will be coming to Buckin g ham Pal ace to receive their Gold Award s from th e Duk e of Edinburg h.

The So uth W es t r eg ion trail1ill g weekend.

In Jun e ounty Counct! organised an ward scheme day in Pool e Park, which was attended by IIRH Prince Edwa rd a nd two of o ur (w ho had been c hos n by ba ll o t ) were presen ted to th e Prince and had tea wi th him Th e) were Melissa W eeke ' w ho play" th e trump e t in th e t J o hn Band a nd Louis e Whit e, w ho coincide nt a ll y, is the Lord Lieutenant's Cad t thi s year.

The new lea n e t is now being c ircuinted to ft gives full details of th e link s between th e Cadet Trainin g Progra mm e and th e Prof i iency Scheme o ne of th e eve nt s out lin ed abo\e cou ld have take n place without th e advise and s upport o f eve ryo ne involved in the Award Scheme, a t a ll leve ls. All of use in vo lved in the c he rn e thr o ugh St John find th a tth ci r cn thu siasm is both inspirin g a nd infec ti o us.

r County and D ivision READING

Tony Best. Divi sional Superintendent, Reading Southern Divi sio n, lived up to hi · name when he became the first person in Berk hire to receive one of the ambulance service' top award.

Ambulanceman Tony wa preented with the As ociation of Chief Ambulance Officer ational Award at a ceremony in Bracknell (pictured left).

He received hi award from chairman of We t Berk hire Health AuthOrIty Dr Peter Philip s for hi " devotlon to dut), caring for the public and o\erall qualities shov,n a a profc ional arnbulanceman".

Peter Taylor, a spoke man for Berkshire mbulance ervice, deSCrIbed Ton} as a totall) devoted member of taff.

NORTH UMBRIA

The official opening of t h e new Co u nty Hea d quarter (Hu mberside) wa conducted by HRH Duc h e ofG louce ter. She i pictured above with Mr L. Barker, the ou n ty Commiss ioner, Mr R Bet h e ll , the Lo rd Lieute n ant and the Ea rl of Ha li fax, who i C h a i rma n of t h e St Jo h n Co u ncil.

Thank.s to substantial fundraising efforts and donations t John i Northumbria were recently able to tak.e deli ery offourne'v\ ambulances.

The ambulan e ' \\ ere , upplicd b} the Prior} Garage group '. Renault dealership in e\\castle in a on tract worth o\ er £ 0,000.

Thi 'v\ as the first time that orthumbria had e\ er tak.en dell\ ery of n w applianc s. service of dedication took. place al orthumbria County HQ following the handover of the ley Both BBC tele\ i ion and radio arrived to CO \ er the e\ ent.

Pictured abo e are Count) of orthumbria Commander Len Con , tab lewith re\\ and three of the ne\\ ambulance . nd Count) ommi " ionerGordon rowtherbeing interviewed b) Radio ew a tie . 11

•

AROUND THE DIVISIONS

LONDONDERRY

Pictured above are all [he Cadet from Londonderry Area who won trophies at Area Competition. The gir l seated from Li nagelvin Quad D ivis ion went on to win the orthem Ireland District Competition and took econd p lace at the Fir t Aid and ur ing Competition at the ationa l Final in Croydon. The Cadet tanding are from orthland Cadet Divi ion.

COLCHESTER

Winner of the second prrLc in the olchester carnival , Colchester Cadets are pictured above on their " Ye Olde First Ide Po'>te " nOllL adets up as of t John With \ arrous InJurre,> and a version of medieval nurses Pictured from left to rrght are : Danrell e Williams, KellyTaylor.Jamcs ylOll. Martin Dc ' th, Michael haplin , Laura Johnson and Icola Gambling

TAUNTON

PRIVATE MOBILE UDIO FOR THE BUSINESS USER

ICOM

P JJ OTO by On St John Day a ervice of Rededication was hcld in t Mar) Magdalene Church, Taunton, attended by 300 adets. families and friends.

After the Service, presentations of a Wedgewood tea service and a bouquet were made to Mrs Jean Hodge on her retirement as Count) am missioner. The presentations 100h. place at Ihe nearby Taunton Divi.,ional HQ Teas were served by Members orthe Taunton Division. Mrs Hodge jOined St John as a adet In Minchead In 1943 and after training as a State Registcred urse rejoined and served in scyera l nursing appointments in the ounty For thc past two years she h;rs served as Commi sioner

A few daY1> earl icr, Mrs Hodgc was given a pearl necklace subscribed for by members of the St John ouncil In olllerset at an evening function allhe home of Mr and Mrs Jul ian Luttrell Pictured above, Mrs Hodge is shown with John Sunderland (Commissioncr - in- hien , Julian Luttrell (Commander) and Cadct Leader Tracy Hudson of the Glastonbury & Street ursing adet Division.

AROUND THE DIVISIONS

FOLKESTONE

Pictured above are members of Fol!..cstonc ursrng adct DIVision, rour of v. hom too!.. second place rn thc First id and Caring forthe Ick QUIl at thc allonal Finals The seven trophies shown are tho,>c won dUrIng thc last year.

The team leader Asmara Goodwrn v. as unfortunatcl) absent v.hen the photograph was tah.en but the rest or the team are Danralle Ross. Katrina Gale Joy Richardson and Gemma Bishop. Fol!..eslone ursrng Cadets have also had team at the allonal Finals In the praclical compeltlons three times in the pa.,t rew )ears

SALTASH

DUrIng ur'>lng adets \\ ere bu'» cleaning \\Imbcreens al Granada cr ice tat ion the picture belo\\ show,> thc adcts In aCllon. watched b) the Forecourt 1anager. Alan Guest. The ,>creen -cleanlng sen Ice \\a<, free but cu '0 10 Ille rs could mah.e donation,> If the) wI..,hed Most people were ery generous and the) enJoycd talh.rng to the adcts \\ hrle the) \Vor!..ed The Cadet'> found It Interesll11g meeting people from man) dlflerent place'>. both rn thl COUIllI') and abroad.

As \\ell as clean1l1g v.lndscrecn.., the) at\o ga\e direction.., to hal Ida) mah.er.., and lorr) trIed to translatc and rnterpret for roreign vI<;itor.., and ",hen they \,cre not too bu<.,) helped the scr\lce station ..,tafT One adet \\as on hand to give aid to a pasenger \\ ho \\ as sufferIng from shoch. after bClng IIno"ed In an accluelll on a nearb) slip road

The '>crcen v.a"hrng not onl) benefited the altash 01\ ISlon flllanciall) but aho made It po"..,ible for the general publIc 10 learn about the worh. and alms of the t John mbulance BrIgadc and lIS adets.

For ten years retired member of Buch.lngham hire ha\e mct for an annual reunion tea at the ount) Training Centre. To celebrate thl'" anni\ cr'>ar), 5 members and helper \\ ere entertained to a "alad lunch follo\\ed b) gateau. ' offee and mint'> all pr pared b) the ecretanc" - Pat Cheo.,terton and Joan Piper ee picture abo\c) The function \\ as onglnated \Ir.., Jeanne \lercer. Chlef\\ elfare Officer \\ ho attendcu Ihl\ ycar'.., funclIon. "'pectal \\ elcome \\ a.., giwn to Margaret Boothman, a fOnllCr ount) upenntcndent. \\ ho no\\' li\ es in Jerse) he has ne\ er missed an) of the reunions and travcls thc furthest distance to attend Colonel Bob Pa) ne. Count) Commandcr. brIefed e\ ery bod) on latet dc\elopments 111 Bue!..s t John and reponed that the Count) ppeal had rcached (350.000 en route to the target of £500,000

a

AROUND THE DIVISIONS

FELLOWSHIP

We welcome the fOlll1ation of the ig hth Ch a pt e r (Branch ) of the Fellow hip in Canad a , at th e Provincial Headquarter of St John Ambulan ce in Briti h Columbia:-

Vancouver Chapter , Briti h Columbi a, C a n a d a Cont a ct: Mr s Co ve n ey- Bo y d

Provinci a l S ec re ta ry

St John Ambulan ce Briti h Columbia

St John Hou Le 6111 , Cambi e Str ee t ,

Van c ouver , BC. VS Z 3 B 2 C a n a d a

Recently I heard from on e of our m o t ac tiv e member , Ronald Gri s tock , Ch a irm a n of Runn y m e d e Branch, Surrey, who ha ju t ce le br a te d hi 9 0th birthday. Mr Gri tock ha b ee n e lec te d Co unt y Repre ent a tive for th e F e llo w hip in Surrey . H e attribute hi g ood health to th e fac t th a t he k ee p 0 bu s y, " When you retire y ou hould not ju t s it a b o ut and watch televi ion ; y ou mu t ge t o ut , do om e thin g and help people. "

For more information about e ttin g up a F e ll ow hip branch contact Sheila Pu c kl e, N a tion a l S ec r e ta r y, St John Fellow hip , St John 's G a te, Cl e rk e n w e II , L o nd o n ECIM 4DA.

WHITEFIELD

AROUN D THE DIVISIONS

THE DRONFIELD BAND

R Ba tes, ounty ommis!-.ioner for Derbyshire writes about the Dro n ficld Band.

"I'm surprised tha t the editor needed to ask for information as the band is vcry well known nationally The freckly faced lad is still charnling and serving with the band. He has been a drum major for the pN six years, and is now a sergeant In the DiviSion He hold., an FA W certificate and a nur.,ing certfificate.

SEDGLEY

'" ell as", ork.lOg hard at allthelr proliclenc) .,k.III the badger\ from cdglcy Quad (Woherhampton Arca) DIVI\lon. aho find time to have ome fun The'" ork. the had put In dunng their ' arlng Badger' course reminded thcm that o.;Ol11c elderl) people can be \Cf) lonel) 0 th e\ decided to adopt a randm<.l. Mro.; Malic auden aged 76 year agreed to join them The children plan to tak.e her to the pantolllime im Ite her to all theIr Bngadc CCrCl110nle\ and ask. her to thclr partie,. The badger of edgley are pIctured above'" lIh theIr llC\\ Grallll)

LIPHOOK

"The band is in good heart and ..,till going strong. having fir"t been fomlcd In 1937 - it has been in continuous exi"tence ever sice. It has played tWIce at Royal Tournaments, three times at Paul's athedral. It has also enjoyed the distlllction of leadlllg Her Majesty the Queen around Hyde Park. for the t John entcnary Parade

IMPORTANT NOTICE

All corre pondence for St John : World hould now be sent to 1 : Gro yenor Crescent, London, SWIX 7EF

x PHORAID is a general purpose disinfectant x PHO RAID is a safe alternative to hypochlorite and other hazardous disinfectants and cleansers.

x PHO RAI D was d evelope d to d es troy bacteria vi ruses a nd fungi, including H IV, hepatitis and herpes.

x PHO RA ID is harmless to the public and the environment.

NORTH YORKSHIRE

Mid evening our control officer received a call from ambulance control asking for a vehicle to answer a red call, the details given were or a woman with back pains at Brighton police )lation. On arriving at the poli e )lation we were informed that the patlcnt wa.., in one of the interview rooms and had come into the police station complaining of back pain.." it wa.., her ..,econd \. i..,it of the day for the ..,amc reason.

The woman turned ut to be a 16-year- Id girl who I '>hall call uc. he wa<., In a sorry "tate generallycomplaining or a dull ache across the small of her bad, and '>eemcd very agitated. The Intervie'W room v. a,> not an ideal place to exam1l1e u and my colleague, a Red ro..,s voluntccr, brought in the carry chair. ue 'Wa.., a poorhi..,torian but I managed to get out of her that she was pregnant and that "he thought she 'Wa.., at about 32 'Wee,," Her pregnancy 'Wa<., not obviou,>.

We transferred ue onto the carry chair and too\.. her into th back of the ambulance. We had just got her into the vehicle when sh became e tremely distres"ed. All sh would ' ay was "There's something down there!"

Look.ing under h r skirt the pr blem was very ob ious - bulging from around her knick.er leg wer the m mbranes that surround the baby. Sue was rapidly m ved onto the trolle and her underw ar remo ed, no sooner than that had be n done was there a gu h of fluid onto the trolle bet ween ue' s legs and a sac was expelled from her.

I real ised that th is sac was th e baby with its' membranes comp lete around it. Whilstmy colleague dealt with ue 1 started to work on the baby

SPECIAL DELIVERY

Tony Kemp, SRN. IFNA, is an Area Staff Officer in Sussex.

During the ambulance dispute he was called to attend to a woman suffering back pain.

Little did he think that a few minutes later he would have a tiny baby in his hands.

that 'Wa.., e\tremel) '>malL virtually fitting into the palm of my hand.

I removed the baby bo) from the membrane : it \1,. as naccid, blue and making occasi nal ga ping breath lie knev. that '>he had given birth and a sense of elation filled me as [ told her that it \J a: a little bo), fortunately she as,,"ed no more que tions a she \Va ' unsurpri ingly in a tate f shoc,," from th whole thing. It \ as plainl obvious that the little fello,\ \, a in e ere re piratory di tre , and hi ' bra hial pul ' e \\as only 30 bats a minute and weak. Fortunatel I carr) a mucous extractor in 111) personal kit and was able to clear the infant's upp rairwa) of mucus but with little improvement to his breathing.

M colleague pas ' d a radio message 10 our control

informing them ofthe ituation and requettng that the) contact the ho pital to reque t the neonatal ra h team to be tand ing by, ou rET one-t\.\. 0 minute, the ho pital being one mile up the road.

I had ommenced CPR on the infant ' eemingl) \\ ith little effect. he remained tlaccid and blue. ue \\,a a\\ are that something \\ a wrong and \\ a getting very di tre " ed. he had notet delivered the placenta and 1 had not yet cut the cord. 1 had no clamp and no tim [continued CPR \\ ith the baby hroud din blan,,"ets and try ing to l-.eep my balance and not get kick ed b) ue. On arriving at the casualt) 1 continued m)' effort , ,\ hile Ill) colleague \\ ent in to get help, asualty taff put out a cra ' h call for the neon team as the) had not ) et arri \ ed fr m the 14th tlo rwith thcirequipment

and incubator. The ca,>ualty unit was not equipped to resuscitate a neonate of this sil.e.

By now the baby' '> heart rate was increa ing and I di<,continued the che'>t but ..,till hi.., breathing wa<, ..,pasmodic. After what seemed like a lifetime the first midwifery staff arrived and after a rapid a sessment of my dilemma they cut and tied the cord freeing baby from mum and giving me more range of movemenr.

The mid'Wive concentrated on Sue and I continued ventilating the bab). paediatrician arri\.ed and after en uring baby 'Wa afe in my hand Y> ent into ca ualt) to arrange a 'Warm room and to prepare to receive the baby Minute later I \.\a given the okay to ta\..e the baby into a prepared a room, gingerly holding the liLLIe bundle and '>till perfomling mouth to mouth \ entilation . I v. al,,"ed into ca ualt) to the prepared room. On handing the baby over to the paediatrician it \Va noted thar hi colour '.\a now a nice health) pink and he wa making ome de ent attempt to breath, the paediatrician 'bagged' him for a ouple of minute and at the grand old age of twenty minute ue baby v.. a rying \\ecll.l) and all hi ' limb were mo\. ing. ue named her baby R yan Bobby, he \\ a \.tremel) mall for hi date, hm ing the appearance of a:2 week ne nate \\ hen in fa t he \.\ a 3-l \\eek He \.\a b m i\. week , earl). Fortunately Ryan did welL much to e\eryone' surpri e he did not need ventilating and v\. ith a balanced feeding regime on gained \\eight. Hi might not ha\ be n the 1110 t au . pictou :tan - but at least Ryan 17

FREEWAY

• Operate s from ; Own int er n a l batte r y Mains supply Car c igarett e I ig ht e r soc k et • Rechargeable battery from m a in s o r ca r c i ga rette socket

• Portable , c ompa c t a nd li g h t w e i g ht (2.5kg)

At least 6 ten-minute treatm

PARAMEDIC MOTORBIKES

But where do you put the patient?

by Steve Evans

Public

Relations Manager

West Midlands Ambulance

For man) people mention of the Ambulance er ice conjure'> up image of fla..,hing light'> a.., a vehicle hurrie to tran"'pon a .,id. or injured patient to ho",plta!.

Today, howe er, the reality of .Imbulance fundam ntally differ nl. revolution in training brought about a highly group of ambulance staff trained in life ing \kills and primary role in the stabilisation of In thi way a patient '., condition can be sed. reuscitation techniques applied if necessary and appropriate trea tment commenced befor the patien t is moved to ho pita!.

Thus, introdu ti n of the Paramedic has meant that certain treatment traditionally giv n in the ca ualty department can now be taken to th sene of the accident or t he patient' home in the case of eriou il lne .s su h as heart alta k., or diabetic ondi t ion.

The need to rea h injured or ick patients as quickl a po ' ible. and the difficul ties encountered through ever Incr asing traffic cong , t ion in bui lt -up areas, ha led to new thought on ho \ best to meet needs in these ircumscances.

Ear ly in 1989 West Midland Ambu lance Service began to look at th ro le which cou ld be filled by a Paramedi U ing th flexibi l ity of the motorcycl to re pondtoincid n tsd mandingthchig her level of skil l

Leading Ambulanceman Brian Fanthom. an experienced Paramedic and motorcyclist. was given the ta.,k of re earching the true need for the ervice which could be provided and to look in detail at 'Ways of making its introduction po sible. One of hi fir t ta ks v. a to identif) the most uitable machine for the role. With the in aluable upport of orton Motor Ltd. the hen tone ba ed company IA ho alread) uppl) high performance motorcycle to many K police force.,. Brian began by identifying the range of equipment whi h 'Would need to be carried.

In order to pro\ ide irtuall) all the features of an emergency am bu lance other than the mean of carrying patient .it wa es entiaJ to examine e er po ibJe opportunity to maximi e the amount of towage space.

Equally it \ a vital for thi to be a compli h d in a \ ay \ hich would allo\>, in tant a ce to the life av ingequipment on board Clo e collaboration \\ ith d :igner ' and engin er at orton led to a serie ' of modification to the ba i po lic spe ifi ation f the cho en motorcycle. the 5 :lcc orton ommander.

While still retaining the benefit prov n in er ice ith the poli . the Paramedic ver ion m del develop d for the <lmbulanc us nOlA gi \ es additional s cure st rage pace behind the rid rand a lso arri , a radio communicators st m.

Equipped with integrated front and rear trob lighting system compl men ted by Ip/\: ail audible \ aming supplied b) Y MA of pain, the overall colouring

and markings e tabli hed the motorcycle a an 'a mbulance while the rider i di tinctly identified a a Paramedic. Before a pi lot cheme could become operational it wa agreed that rider mut be trained to police dri\ ing tandard. Potential candidate 'W ith uitable motorcycling experience and paramedic kill were invited to apply from \\ ithin the We t Midland mbulance er ice. Careful election inconjunction 'With We t Midland Police led to three ambulance paramedic completing an inten , ive three v. eek motorcy Ie training cour e in March 1990. The rider are nov. read) to take their place in prov iding an emergency re pon e .

On 9th priJ a pilot ervice commenced with tv\ 0 motorc cle in u e . The , e are ba ed in the Solihull and Black Country area re pectivel) , from \vhere a rapid re pon e to much of rhe We t Midland an be achie\ed. Initially the pilot cheme \v ill be for ix month operating fi\ e day a week alternating between th hour of 7.00 am to 10.00 pm. Barry John. Chief mbulance Officer, We t Midland. i highly optimisti to\\ ard the benefit which an be gained from thi new re ource. He a '. of the ne\\ en ice thi ' ithe fir t time that motorcycle ha\e been u ed forthi purpo e b) any ambulance in thi countr) and demon trate the ommitm nt of an innovati \ e. caring and professional ervice to pro\ ide th be t po ible standard of mobile mergenc) are to the communit). 1. in particular. loo k. fo[\\ ard to mot rcy Ie becoming an establi hed f alure of our operations."

HISTORICAL SOCIETY I

Skulls, torture and soap powder

A trip to Malta with the Hi s torical Society b y Robert and Lesbia Percival of Kent

The St John Hi s torical Soci e ty already organise vi it to places of St John intere t in th e U K and earlier thi s year it und e rtook. a trip to M a lta

Julia Findlaterand Amanda Devon s hir e, from the t John Mu cum, had reconnoitred earlier in the year, a nd a rran ged for th e part y to be. hown many of the place where th e Kn ight · of t Jo hn had been ac tiv e.

On our fir. t d ay we vi ited St John Cathedral. and we re hown round by Dominic Cutajar, the learned Curator of th e Malta Fine rts Mu eu m

There were later visit to th e forts of St Angelo and St Elmo. which were rebuilt in great s trength after th e bloody ballle of th e Great eigc.

There a littl e balcony on the top of a. hee r wall of ton e a t St Angelo , whence in colonial tim e a Ro ya l Marin e trump e te r o undin g un'iet could be heard floatin g acro th e ha rbour.

Memb er were a bl e to see rh e ha t and word of Grand master La Valerte , which he had plac ed on th e altar on the raising of the Seige , prior to g ivin g th anks in the Church 1n facl. many of th e places we vis ited were nor ge nerally open to th e publiC

Among s t the se were the c lo se d Convent in whose keeping in th e

-

so

s k.ull of the blcs'ied Gerard , regarded as the founder of our Order. It 1\ likely th at we were the fir"t vl'iitor'i In modern tllnes to be allowed to sec this anclcn t relIc , which stood in a gillS" case In the room. with a gar land round It'> brow The nun,> '>cell1cd delighted to have th e chance to gi\e u.., coffec and cake.

The omlun Il ou,>e In Mdlna ( the onglllal capllal). had been the temporary home of Grand Ma'>ter de L' ble dam \\ hen the Order fir\t took. po'>se,>,>ion of Malta In 1536 Dating from 12th century. It v.u, probably the o ld e'>t place we sav,. apart from the prehlqoric remain, <;uch as GgantiJa on GOIO

ot all th e Knl ghh had a noble history : th e ummer Palace 01 Grand Master de Verdal1e had a gue'>t room With a '>Inl'iter passage leading to a <;ecret torture chamber. He 1m Itcd ui1<,u pectlng guests to s tay - but it was a one-way tn p: they v,ere never een again.

On a lighter note. women on GOIO '>tlil u'>e the v, ashhouscs prOVided by the mcdlcval Knl ghts;pnng \\ater runs Into large stone basin'>

The Brigade HQ In trait treet contained l11uch of Intere<,t : not least a photograph of Freddie Wit ch, Doyer of Bngade duties on Ro yal occasions.

Having ,>ca led th e heights around Valella, we ultimately went on a boat tour of th e two harbours with their many crce k. <; and ..,hipyards -tim combined interests both o ld and new

The Hi s to ri cal Society is not alway<; able to offer such dramati c vi its, but th ere i<; much in the UK wor th y of note cw member, are a lw ays welcome; no kn ow ledge is needed - on y 1l1teresl.

ST JOHN HOUSE CLUB

Situated in the heart of Belgravia and just minutes from Harrods , this superbly appointed club offers excellent accommoda ion at very good rates

Trea yourself to an overnigh stay and make Christmas shopping a treat not a

For S chore ! further details contact the Warden , John House Club , 50 Eaton PLace , London , SWl BAP Tel : 071 235 2732

FUNDRAISING AND PUBLICITY

New posters and leaflets

A new series of colourful and a tt ractive leanets and po<;ters are now available from supplics. Onc complimentary et has already found its way to your ounty Office and tillS should be available for Divisions to borrow . If you wan t your own set herc are the product codes and prices.

15400Cadet Recruitmcnt Lcanct 1540 I Badger Rccruitmcnt Lcan c t 15402 arc Lcanct 15403 Awarenes'> Leallet (X page) 154040phthalmlc Ho'>p. General poster 154050phthalmic Ho'>p. Outreach po'>ter 15406 Brigade Recruitment Po<.,tcr 15407 adct Recruitment Po'>ter 1540X Badger recruitment po'>tcr SI5409Generai warene'>'> poster S1541 0 are po<,ter 15411MIlliPoster et

£2.50 per

Roadshow Trailer

CASUALTIES UNION

CASUALTIES UNION

Giving a death defying performance every time

What sort of union is il that proudly boasts in its promotional literature that it i "the only union allo\.Ving its member to lie down and be trodden on",?

The nion of course!

It' s the SO [1 of jo ial statem nt v. hich suits th members orthi<., curiou<., " union" o well, for de pite the very serious purpo e of their voluntary work.. a great deal of fun and laughter is inevitably involved in theirprimary function as casualties for the rescue and vo lunta ry ervice to practise on during training for real-life

and anger. To be as real[sltc as poss[bl e. you must take account of how r al people b have We find that women often tend to be quiet after receivin g an injury. whereal men do tend to whine on!"

Training, v.hich i<., approved b) the medical profe<.,sions, <.,ome of the top members of which are represented on the uni n'<.,go emingboard,i based on re al· life injuries and em tional or ment al conditions. fterqualifying as a member. it' possible to go on to two higher - those of" demonstrator and instructor ·

emergencIes "Women tend to be and there are a fc \\ speciali<"l <.,uch as make-u p e\perts and

We all know how invaluable the Casualtie Union i<., to St John but it i<., also used by the medical and nursing professions and busine ses

quiet after receiving an injury, whereas men do tend to ..,pecia li sing staging planning In and Demonstratin g just how succes srul whine on!"

throughout the UK. Reali m is at the heart of their work, for all would - be casual tie must be able to act the part of an injured per on as well as looking the part by using make - up and artificial material to imulate real-life injuries.

Honorary Treasurer Joyce Park er, an active member of the Union for over 30 years, explain : "To become a member, you must be bale to act and to use makeup to simulate injuries. Special props aren't needed: most ordinary rooms are full of things which can ca use injury - for examp le , a kettle which can burn, or windows which can trap fingers, "The most important thing is the ability to relax and overcome your inhibition s. You must a lso be able to portray the emotions which overcome injured peopl e, which can include hysteria

union members are at simulating real - life emergenC)

<.,ituations, Joyce recalled:

"A group of our ca ualtie were enac tin g a rescue operation whi ch involved having to jump fr m a wall to a dangerous si tuation One of our member wa playing a pregnant woman and had equipped herself with th e inevitabl e cushions to look th e part. She s tood on the wall and another membe r playing a rescuer s hout ed repeatedly fOf her to jump he acted out the terror ofa pregnant woman afraid to jump in case her baby was harn1ed, but after mu ch coaxing and en ouragemcnt s he finall) jumped.

"I s udd en ly reali ed that the people s tandin g next to me were ordinaf) members of the public who had come 10 see what was happenin g and were ralhef

alarmed. J heard one woman say to another: 'Fancy making a woman in that condition jump from a wall!'

"Children can also enter into the humourou sideoflhings with great gusto. Our junior members (aged) 1- 17) take great delight in running home to Mum complete with gruc ome injuries after taking part in our co mpetitions ."

A retired civil 'iervanl, Joyce has long "ll1ce qualified a'i a demonstrator and mstructor, but <.,till plays the part of ca<.,ualtles on a regular basis. Much ofher lime is also taken up with lecturing and demon'>trating to classes, administrative work at the nion'5 I-IQ at Gro venor Crescent, London and acting a advi<.,or for film-mak.er'> and televi ion directors \\ho want their actors to portra) injurie.., as convincingly a.., possible.

Her colleagues at I-IQ. a small but devoted team who arc equally committed to the union are al 0 all retired people. am are fom1er civil servants, some ha\e a nur..,lI1g background, one i. a nun '" ho wa<., also a nursing sister before retiring, and one is a retired woman bank.er. In addItion to their professional career the) have nearl) all spent a large part of their Ii es engaged in voluntnr work. Ca:ualtles nion has around 1.200 member<., in and branche all 0 er the countr) ( to attain branch ,>tatu'i. a group mu .' t have a member who ha reached intructor le\el) and over ea in Holland, Malay ia, Yugo . lavia, South Africa and Au tralia.

The value of the nion ' work can be Judged by the efficiency of the ervice who e job it i to pre erve live in the 'normal cour. e of! ife. uch a in accident fire and road cra he. II the emergency ervice drawheavilyonCa ualtie nion a a con i tent ource of reali tic ea ualtie But a well a training for the "everyday" accident ituation the Union al 0 train it member to act the part of Victim of large- caledi a ter .Herethey are invaluable to th emergency ervice for theirexperience and e pertise. In the e exerci e . reali m i cru ia!.

" omeone may have to act the part of a ea ualty who ha been lying in a ditch waiting to be found. So they d literally lie down in a ditch and wait. And a in real life, rhey are ometime nor found for a very long time!' aid Joyce.

nstinring de otion to duty is obviou ly a mu t for acceptance in to the nion, and Jo)ce and her colleague find that tho e with an unreali tic idea of the job are oon v.eeded out.

"Peopleometimes ee u during our major competition and are attracted b) the drama and excitement on the day. But those who v.ant to join for an ego-trip oon di cover that much of the time our v.ork.is\eryrunofthemillandi u uaU) not at all glamourou !" In recent rime , the -K ha had it fair hare of disa ter invol ing large- cale lo<.,s of life.

How do Union member. feel and react v. hen uch a di a rer occur? Do they judge the emergency per onnel v. ith a detached. almo t "profe ional" eye? Do they re ' 01 e to ena t a di a ter iruation which ha not 0 curred before in order to be prepared for the event of it recurring?

"I can only peak for my elf aid Joyce, "but I imagine mo t nion member feel the ame a I do When you ee a di a ter in real life, or on the tele i ion, your 0 en>,. helming rea tion i of horror and deep adne at the wa te of life You feel exactl the arne a an other human eing - ver ad and orr

"But 1 uppo e if true to ay that once the fir t emotional impa t ha left ou, you begin to think about the re ue operation and what an be learned from it. If it ha gone well and life ha been a ed where it might othen i e ha e been 10 t you feel very glad. There i · no egoti m involved, but there is a thankfulne that, perhap, ome of the e erci in \ hich

A member of the Casualties Union at work. the nion ha been invohed rna) ha e helped the ervice to cope a well a they did ."

When the Union wa fir t foundedduring World War II - the countf) \.Va in the grip of daily terror and 10 of life. It main aim then wa to a i t on the re cue of people from bomb blitzed building v. ith the rna imum pre e[\ ation of life and minimum injury.

It \'vas Eric Claxton. a head of the heav) re er\le quad in Leatherhead. Surrey during the \>,.ar. v.ho identified an urgent need for an organi ation to provide reali tinolunteer forthe re cue e[\ ice to practi e with. Teaching volunteer hov. to re cue people from the top of burning building he reali ed hov. inadequate their e perience wa ba ed in tho e da) on ' implefir raidte hnique and practice e ion v. ith \ olunteer v. ho were not trained in looking and acting like real ca ualtie

nd 0, thank to Eric Cia ton' work and in ight. the Ca ualtie nion v. a founded in 194_, taking re cue and fir (aid operation out of earlier amateuri h effort and into the high I -peciali ed. ophi ticated and ucce ful field it i today.

The nion ha expanded and developed beyond all expe tation Mo t peopl ha\ e probably een nion" membeL many time. v. ithout being a ware of their \\ ork. nd there are man) who have a great deal to thank them forwithout alv,, ay knov. ing it.

II ifh fhollks /'(1 emf Dcji'lICcfor PCI'I1I1SSIOII fO lise fhe qllOfCS,

H o n o rary

Trea s urer J oyce Parker at this yea r 's Brigade Finals

Clues to Crossword No. by

W.A.Pouer

ACROSS:

1. Not in love having had no cardiac surgery? (S-5)

6. Home of vcry early man. (4)

9. Not vcry well and locking variety (3-2-5)

10. Waste product of protein metabolism (4)

12. Speechless (4)

13. Ultrasonic examination (4)

14. Intuitive feeling to asswne a bent posurre (5)

16. Nut with inert parts provides nourishment (8)

S&S MOTORS LTD

18 Bla:khcad changes end of comedy (6)

19. One change in a very long time in the USA (3)

21. Exhibiting the mental detericrat.ion of old age (6)

23. Sensory nerve-ending in the tongue (5-3)

26. Element important in control of noclear reactors (5)

27. Additionally in lethal soporifics (4)

28 Accommodating eye structure (4)

31. Always feverish when locking fish (4)

32. Death of tissue due to inteffilption of blood flow (10)

33. Light periods (4)

34. Laughing uproariously aftcr repair of laceration (2-8)

DOWN:

1. Bone at the root of the tongue (S)

2. Make an effon (7)

3. In ill humour for a slight quarrel (4)

4. Atropine-like alkaloid from the nightshade (8)

5. Disease not {l"Oducing signs ex- symptoms (6)

7. Ran in unusual gear to put in order (7)

8. Middle layer of the meninges (9)

11. How one feels when suffering from pharyn gitis (7)

IS . Station where one can satisfy th e (7)

16. Epistaxis (4.S)

17. A small amount of spirit for a young child (3)

20 Sane aunt produces sub tance making one feel sick (8)

22. Where young children have bloomers? (7)

24. Marie on skin or defect of charocter (7)

25 Girl goes in tin for stringent and stypti c (6)

29. Passage from abscess cavity to skin (S)

30 Badly cuts tail (4)

* All Ex National H ea lth Vehicle

* All Make Rebuilt to Hi g h Standard

*

REFURBISHED AMBULANCES & SPECIALISED VEHICLES

A handy way to remember what to do about a gas leak.

LETTERS

Call for sensible culottes

In

i LETTERS

Ad v ancing to meet the challenge s of the future

Bob Whit (October i'><.,ue) ,>uggest<., that the role of the Brigade should be solely to provide fir<;t aid He gives the impres'>ion that ambulance aid and the tran portation of to hospital be left to the ,>tatutory ambulance <;ervicc'>.

The ol' the Brigade are to provide first aid, nur..,ing care and training in these area Over the la..,t century, fir'>t aid technique,> have change rtificial re'>piration has progres _ ed from the yl cster method to the Holger eil'>en to mouth to 111 uth expIred air re)uscitation.

is

und

a nd o ut of a mbu la nce ea ier.

It ho uld be u p to th e D ivi ional

rm f or new Cade t w ho join. I agree mini kirt s and t il e tt o hee ls ar e definit e ly o ut , pl a in kn ee le ng th s kirt ho uld be accep tab le wit h plain w hite hirts. Bl ackc ul o Lte areanexce ll ent idea to wea r, they ave embarra ment w he n k nee li ng on th e gro un d dea ling w ith cas ua lti es, T hey make climbing in

A moving tribute to a man from another time, Joseph Galea of Malta

In S epte mb e r my wife and I v i ited Ma lta. It wa a d iffic ult vis it fo ru to m ake, beca use sin ce our la s t trip ther e we had lo s t our dear fri e nd Jo e ph Galea.

A s I s tood at hi s tomb lo o k i ng at hi s ph o to gra ph o n th e me m orial to ne, fo r it i the Maltes e cu s tom to pl ac e a photo g r a ph of th ose w ho have di ed o n th e g rave, I th o ugh t of th e word s, " I s a proph e t without honour ave in hi s o wn co untry."

Jo seph Gal ea, a member of th e Sov e re ig n Military Ord e r a nd of th e V e ne ra bl e Or de r of St John , pa sse d away on O c tob e r 25 , 19 89, th e da y aft e r hi 77 th birthd ay.

My wife and I vi ite d th e Cath edr al , and foll owe d th e pa th of J o e ph 's co rt ege through the s treets ofMdina , to the tin y ce me te ry outs id e th e w a ll e d Cit y of Mdin a, th e city he lived in and lov e d so much

The p e opl e of Malta paid th e ir tribute to thi s qui e t, littl e ma n, w ho m I a lway fe lt wa s born in the wron g era.

He wou ld have been at home with th e Kni g hts of Malta , for in hi co mp a n y, o ne could feel that the clock had been turn ed bac k a nd I a m s ure th a t he wo uld have pl aye d h is part in the G reat Si e ge of Malta as he did in th e iege of M a lt a durin g WWII

T here were many fa cets of m y de ar fri e nd I ne ve r kn e w , beca use to me he was as hy, retiring man

Maybe there is someo ne w ho c an be tte r p a y tribute to Ch e va li e r J o eph G a lea th a n I , or is he to pa ss in the hi s tory ofthe Order without a ny me ntion of hi s effo rt s to furth e r the wo r k of St John T h os H H o llin gwo r t h S B.St. J 3

uperin tendent di eret ion to ensure the unifonl1 as to regulatio n.' a po

L. Law on EN

Area up e rintendent (N orth ) t John, G e rm a n y

Communicatin g

w ith the deaf

M y nam is Gary Orriss and I am a membe r of W a ndsworth D i i ' ion. I am partia ll y hearing w it h a ligh t speech impediment, but I lip read well. It i with thi parti c ul a r prob lem in mind th at I wri te to d ay.

Communicating w i th ca ua lt ies i e e nti a l to prov id in g ef fi cien t fi r t aid t rea tm ent. But w he n co n fro nt ed with a d eaf cas ua lt y, how do th e f ir t aider m a ke co nt ac t?

I am co n ve r a nt w ith ign la nguage a nd wo uldb cw illin g tovi it yo urdi vi ion t o give a n i llu t ra ted t a l k on "Co mmuni ca t i n g w ith th e D eaf", N a tur a ll y you wo ul d no t be expec ted to lea m all of th es ig n u ed to d ay. Butl can po int o ut a nd de mo ns tr a te so m e useful ha nd s ig n a nd g i ve o rn e ge ne ra l tip s and hint s th a t may be useful w he n o ut o n dut y.

H yo u a re inte re te d w rit e to me ca reofSt

J o hn Wo rld

Gary Orri ss Wa nd swo r t h Divi ion

II change,> in first aid occur a'> new mformatl n from research to more effccti\e technique.., and improved technolog . Hence the change,> JJ1 the ralio of vcntilation to comprcssion" in CPR fi\e years ago .

t John ha ... mo\ t:d ith the in ba"ic fir..,1 aid and we are faced with challengc,> in ambulance aid. in e the Taylor report published earlier this year, the role of the Brigade al major public dulles ha'> not altered dramaticall , We still pro\ Ide pcr"onnel ror fir t aid co er but our ambulance,> lllu"t be of a \tandard acceptable 10 the '>taLutor) ambulance ser ice in that area. There are er certain v here the nature or Slle or the dut) demand ambulance" and per" nnel capable of prOVIding an ad anced le\ el or car.

Wh n on a pub lic duty we are 'iupported by one of our own ehiele'i to a palient 10 ho:pital. In the event of a per'>on sufferi ng a cardiac arrest, the) would be initial I Iremed b) personnel performing PR and then transported quid,l) and safel) to h spital. the continui ng using ambu lance equipment such as an Ambubag and oxygen.

But sl-.ilb such defibrillation and the munagem nl of intravcnous infusion have been -hown to sav lives. Research shows that irdefibrillation isadmini ' Lcred wit h six minutes, providing P R has been effec t ive, t he patient Sllr ivai rat s are much h ig her t han those who arriv at hospital having on ly had P RoSur Iy t John ha: an ob li gati n to the patient, and to th eir r I Hives. to provid t he best

available care and le\ el of treatment '? I-IQ ha<., made il quire clear thaI advanced training "viII onl) be a\ ailable to those who \.\ i"h to undertak.e it and \\ ho hene n their ability in ba ic ambulance and first aid. Bob Whire implies that b cau e t John p rsonnel ar 'part - time' the) can nor be "highl) trained. regularly practised and well equipped". Thi impl) nor true, as the Brigade demonstrated during the recent ambulance dispute.

Would he that the Ro) al ational Lifeboat InstitutIon (R Ll) which i abo composed of part-time oluntt: r: i unable to pr vide a highl) train d and II quipped pr res ional service?

I n ugu ., t this y ar. th sociation of hier mbulan e OtTicer publi hed mbulance 2000" n document \\ hi h outline: th sen ice's philo oph)'_ aim and objecti s ror th coming d cade. This paper recommends that all emerg ncy ambu lances a nd cre\\s should b of param di standard whi h \\ ill I ad to impro ed patient 'are and increa ed surv iva i ra tes. I t a lso suggesrs tha t co unt)

ambulance ervices , hould find \\ a) to generate in ome. for e\ample by prO\. iding aid at major e\ ent and u..,ing their teaching _ k.ill to in truct in fir aid. The) al 0 em i age that the ambulance ..,en ice of the fUlure \\ ill re ei\epartofit ' finan ialsupportfrom public donation and ommer ial sponsorship.

With thi., il i clear that if r John to continue to fulfil it: present roles, the Brigade mu t be capable of prO\. iding a le\ el ofservi e and care equal to that ofrhe statutor) ambulance ef\ i es. Ir\\ed n Lthen\\ema)\\ell eeatime hen r John i ' lilllit d to pro\ iding per onnel for mall public dULie , \\ ith th ount) ambu lance sef\ ices and pri\ ate being the onl) people capable of meeting rhe required randard in ambulance car to tran port the criticall) ill or injured to John S io n H a mpt o n Co urt a nd M o le ) Divi ion

l a tt Bark e r T wick e nh a m Divi ion tud e nt N ur e -+

LETTERS

Handkerchiefs and omnibuses

memories of a time when St John got it right?

With reference to Bob Whit e' que tion "I St John neglecting it' primary object, fir t aid?" I think the an wer i a resounding ye With the hind ig ht of 53 year ervice, I feel that St John is doin g just that.

I can r e member two of u go in g to a duty by omnibu and walking two mil e carrying a tretcher, two blank et a nd a haver ack. Paramedic are u eful a t public function, but like mo t me mber ,I treated mo t of my ca ualtie when I had nothin g more than a handkerchief with me A recently as three month ago, I kept a neighbour , uffering from a heart attack, alive until the ambulance arrive d a nd to me that is what St John hould be a ll about.

I wi h Bob White every ucce in hi effort to keep St John on an even ke e l. Eric Bowd 5t John Fellow hip Kent

Call to care for the needy in our communit

y

Reading St John World we ge t the impre ion that St John is not very intere s ted in caring and the welfare of the elderly and infirm While it i tru e that we are primarily a first aid organisation, public dutie s at sports events s hould not be our only priority.

There is a va t number of elderly and infirm people , living at home and cared for by relatives. These carers need help. Our Division ha s established a depot from which nur s ing equipment (wheelchairs, bedpans, bedrest etc.) may be borrowed. Someoftheequipment was paid for by a local chari ty. A carers group has been formed to offer upport.

Subsidised by the District Council, a car scheme ha s been started to take people to surgery, ho s pital etc (we are in a 5

re la tiv e ly L olat d areas). W e have provid e d member. o f th e ca rers gr Lip with fir aid and nurs in g tr a inin g.

On e problem is that mo s t of th e "care r " are th e m se lves e ld e rl y ancl so cannot be member of o ur St J o hn Divi ion. This i · a pity, perhaps some thou g ht ould be given to th e retirement age. Certainly he lp given by St J o hn to carers i app r c ia ted a nd provides a s rvice at lea t a u efu l as public fir aid duties.

Jim Booty D i visional Superintendent orthwold Di ision

.... from Queen Elizabeth , the Queen Mother

Qu ee n Elizabeth th e Queen Mother has bidden me write to thank you very much for yo ur le tt er of I st August and for the e nc lo ur e which her Maje t was so plea ed to rec iv

Qu ee n Elizabeth greatly apprecia ted yo ur me sage of g ree tin gs and good wi he on th e occa ion of her 90th birthday, and I am to convey to you and to a ll ur ing Members of t John Ambulance Brigade the Patron s warmest gratitude for yo ur kind thought.

Martin Gilliat Private Secretary to Queen E lizabeth The Queen Mo t her

As we come to the end of another year and are hopefully ab le to gather with our familie s to ce lebra te hristmas, it may be that amidsl al\ the festivities we might find time to pause and rcllect upon our work In the entice 01 Mankind.

During th pa"t year many of you hav e given hours of your timc to hclplng tho'>e In their hour of nced. eithcr by admlf1lslerin g first aid or being th ere to care Olkntlmc you must have wondercd whcthcr the public care about you or do they Just ta"'e you for granted You neithcr ..,cc'" nor rcceive any reward and yct you pers ist in you r erv ice to \I) an kmel It is. or course , that \-cry lact lhat mark.s you down as someone very special. Perhaps you do not appreciate Ihat thc presence in th e crowd of the black and whltc L1nllonn brin gs \\ Ilh It a ccrtain dcgrce of comfort to thos e \\ ho watch. In you they see someone "'ho IS \lcadfao..t, reliable and. abo call c\<'e SOllleon e

\\ ho carcs - care'> about them

To all of you who ha\ e glven o much thi pao"t year - ollr thank..... ay you too ha ve every comfort and jO) th", hrio.,lmao., and your Scnicc to Man"lnd bnng you lllUL h happine 111 thc comlllg ycar

IStjohn World records with greatest regret the death of the Lord Caccia, GCMG, GCVO, the Lord Prior of th e Order 1969 - 1980.

We also express deep regret at the untimely death of Alec Rabarts, ACA, K St J, R eceiver-General SInce 198 6.

John , und erland Commi s ioner-in- Chi ef Ph)llida uperintendent-in- hi ef

IOnce again the end of a year has arrived. and we can 100" back on our achlcvcments The Fellowship has grown, not only with the inauguration of thirte n new Branches, but with a "tart being madc In two ounties. until now without a Branch. Our to both Foundations of the fder has been gi vcn In an increasing variety of ways, and I hope that our new organisation With the appointment of ounty Representatives will enable Countie s to poin t to further ways in whic h we an help. In the several meetings I have attended this year have ..,cen th e other sidc of our Fellow ' hip at work; the help being given to each oth er. and the joy being experienced III continuingthemany friendships r ml ddunng th e year when we were active Brigade or Association

send you and a ll your my best wishes for a very happy hr is tm as, and the hope th at our Fellowship will co ntinu e to expand both in it work and its mcmbcrshiplll 199 1 Major Genera l Peter Leucha rs Chairman, St John Fellowship

Back in 1988, we were al l delighted when th e Director'i of <lfeway c hose t John Ambulance th eir main beneficiary charity for the rollowing two and half year<; through to the end of 1990. They were aUra ted by our nationwide member<;hip of all age!' and couldee thaL we had a lo t of idea we wanted to develop in order to expand lllember<;hip , but were frustrated by lad. of ca<;h.

The afcway propo!'al wa to inject the huge 'ium of [250,000 imo national project!-. to benefit the Brigade a'i a \\ hole, but a lso to encourage fundraising on a local level through their taff and to c"tabli<;h "trong contact with Brigade m mber.., Ba.., d on pa'>t experience, they e'>ltmated that further £250.000 might be raised by the <;torcs.

5AFEWAY AND 5T JOHN

Safeway - raising our spirits and rasing funds

December 1990 - the official c1o,>ing date of the partnership - ha<; now come round. and the following is ju t a ... ample of what has been achieved thanl-..s to the un . tinting support and encouragemem of afe'v\ay per<;onnel. both at national and 10 al level.

The £250.000 corpora te donation to national headquarter htl'> funded the last fi e i!,sues of Badger BUI7 which previously could on ly be produced once a sponsor had been found for ach indiVIdual issue.

Badgers have also enjoyed the aret) Badger leanet. '"Badger goes hopping' and a Badger ideo a are ult of the afe'v\a) commitment to our youngest member.

1990 ha seen the launch or" tart!'"maga/ine for Cadetagain. funded by areway, and thi s provides a mu h needed forum I' r ad t · to air th eir iew ' and opini n ab ut t John and topica l is 11 •

The new Challenge award for young people ag d 15 - 25, which al lows participants to t th eir own goals and monitor their own progres " ha been part-funded b arcv, a .

A considerab le part of th Energy Programme material have been produ ed wi th help from Safewa . Th ir . upport ha meant that th e Brigade" recruitment drive cou ld ge t off the gro und much fa ter th a n w uld oth rwise hav been the case.

Since th e partnership with afeway began, th er ha ve been tw o par ti c ul ar wee k set apart by aeeway sp ificall) for insto re ta fT fundr aising. numb r of Ie on were learnt both by St John me mb e rs a nd af way personnel during the 19 9 eek, and th e t J o hn W e I-.. in ptemb f thi year showed a distinct improvement, espec iall y in omm uni a ti on.

The organi<;ation thi year wa "Link" to each tore. higherrarget wa etthi year - £ I 00.000 nationally-andatthetimeof'v\ritingitlook a ifthi v"illhme been e ceeded.

national coupon promotion '"Give Take' ran oncurrently v, ilh rhe fundraising eek. upported by afev,.a) upplier Thi raised an additional £ 100.000

ucce ful fundrai ing cheme included - shoe hine. carryto-car. bed pu ' he \\ ith a trolle) -da h a a prize. gu " the v,eight of rhe cake and lot more. ufe\\ a) announced thar they are \ ery generou ly going to continue their upport for t John mbulance - for another two car. We can all continu to build on our pa t experience , of wor kin g together v,. ith them both nationall) and I cally. Who kn W ho'v\ much a afe\\ ay/ t J hn fundrai ing v, ee l-.. in 1991 might rai ' e. if we an continue to refine urcommunicati nand de\ elop u e ' ful idea ' ?

, ou may b a\\ are. lJ hn mbulan \\ ill be launching a major fundrai ingcampaign in Februar), \\ hich \\ ill run through to July 1992 It \\il\ be a high-profile campaign which, it i hoped. will apture the imagination of the general public. It ma ome as no urpri , that afeway \\ ill be the main ponsor fthe campaig n and the ompany i makingasub:tantial financial commitment to \ ards it. In rd r to nchie\ e ll1a\imum publi it at the launch in February. full d wil ' ha\ nor been released ' et: plea addre:s an) enquiries to Ro ,' Bidmead. Marl-..eting and ppeal Oir c tOf, 1 Gros\ enor ere"C nt ,071 _35 523 I xt. 23 ). 6

JOHANNITER-UNFALL- HILFE

The wall comes down and St John • moves In

by Wilhelm Graf v . Schwer in

Founded in 1952 to provide general fir t aid training in Germany, the JohanniterUnfall-Hilfe (JUH) i amedical and social relief organisation run mainly by unpaid volunteer.

Since its creation, the sphere of activities has been greatly expanded and mod i fied. ow, in add i tion to comprehen ive fir t aid training, the organi at ion offer ambulance and re cue ervice , training and further education for medical a istants, catastrophe relief services and ocial programmes for youth. In social welfare work, a broad pectrum of support now includes services such a meals on wheel ; per onal/private alarm systems and home help a i tance.

Thus the JUH attempt to meet orne of the challenge. pre ent in modern ociety. Concentrating mainly on charity work, it is upported in its aims by subscriptions from more than 500,000 members.

From its limited beginnings, the Johanniter-Unfall - Hilfe has developed into a many faceted and vital organisation but we recogni e that as our responsibilities increase, the work that lies ahead, especially in the social welfare sector, will demand even more energy and dedication. Volunteer and permanent staff must be ready and willing to accept changes and added re pon ibilities to keep pace with development -and they will be helped in this by comprehensive training and further education programmes.

7

Our training institution ' and our in tructor are th backbone of our education systems and currently a new concept i ' being developed to further increae the s"-ill and qualifications of our people. Letmc relate just some of the more important activities of th J H during the past twO) ear.,.

With the opening of borders from the Baltic to the Black ea, thousands of Gennans from th GDR and other eastern European countries decided to leave for We t Gennany We in the J H feel it our duty to accept and welcome the..,e peopl e, to offer them a homeland and to ea.., their tart in a new future.

FortheJ H,thismeant theprovi.,ion of accommodation, welfare service, the organising and distribution of furniture and clothes, trying to find employment opportunities and otherwisc supporting the newcomers in every way.

Later in December 1989 Ru ss ian detente led to the fall of the 'Wall' - and hundreds of thousands streamed out of East Germany into the west, many of them tra veil ing freel y across borders for the first time in their lives.

Here too, theJUH was active. In Berlin and many othercitie bordering the GDR hundreds of Johanniter helpers offered food, beverages, road maps, car fuel and much other material assi tance. These operation featured deeply moving moments which will never be forgotten by the Johanniter taking part.

Romania was the next scene of operation: On December 23, the JUH members were asked to run the Diakonische Werk of the German

hurch 's rir"t con oy in to the countr). arious unit!"> helped tran!">pOrl 15 tonne of medicine. food, blan\..et" and a waterpurification unit.

Despite the 'vCI hard wor"-, di"comfort and dan ger. the J II "taITderi'vcd pleasure In h Ipln g thc Romanian,> in their desp rate"ituati n Truly, the) were livin g the organi.,ation·" motto of " Oem chwachen hiW' - "Ileip thc weal('.

Up to F brucu 1990, around 40 relier convo s left for Rumania co-ordination office had been e:-.tabli.,hed in Budapest. Hungary with the suppe rlofthe ountr) 's Lutheran hurch, and from there aid i!-' being Thi" help will be vital and will continue in the future. uch aid is also very important to Poland and for some years now the critical situation there has seen the J II providin g aid continuously to parishes In th pre iousl y German prm ince of Poland

The Johannit r's relief wor\.. our ide Germany is not limited to Europe. In amibia, a first aid group was established by the organisation in 1974, and now th e project and stations in that country include a handicraft school, tudent hostels, a first aid training crvice and out-patient care and cial welfare pr gram me

Forsome time, we hav been preparing a project to , upply orthopeadic appliance to the Third World.

This project i expected to be launched soon and will feature a special workshop built into a container for the manufacture of orthopeadic appliance There, local Johanniter will be taught to manufacture simple equipment by JUll in truClOr s.

JOHANNITER-UNFALL-HILFE

We are participating in a peace obser ing group in Middle merica by providing medical d ctors and nur , es. And in EI alvador. J H member s are presently on duty helping during th repatriation of fugiti es from refugee camps in Guatemala.

The population developments in our own ountry will present one of the future challenges for the Johannitcr- nfallHilfe. There, the ratio of pensioner. and the aged will double. W consider the extension of our ocial services as paramount. In Gemlany, aboul90 percent of care in the home is carried out by members of the patients family - ften under difficult domestic and financial circumstance

ocial welfare help stations of the JUH - and e pe ially th organisation's mobile social aid , ervice - can play an important role nabling those in need of care to remain within their familiar domestic surroundings. ot only direct

care for the patient i. offered. but important physical, psychology and financial aid is offered for the relati e ' wh provide home care. nother J H role in the futur will be intensification of youth a tivit) programm : helping rhi ector of the communit to int grate int ociet). to accept, enhance. and contribute to 0 it' value ' and re ' ponsibiliti e , \\ ill be th main focu , We \\ ill b work.ing with our outh group to in pir a ' ense of communit and r pon ibilit) and to re ruit n w m mber ' for the furure \\ ork of the Johanniter- nfall-Hilfe We in the e inten ' ified activities within the youllgersectorofourpopulation theJ H making a major contribution in the prevention of drug con umption.

With the planned European Mar"-et in 199_ will com political hanges uniting the ontinent of Europe and tiP aid organi tuion fth ariou countri will have t co- perate much more clo el in

as

the new European future. We \\ elcome this move! For man) year the JUH ha \\ orked in Italy and Au ' rria and this e-xperience of international co-operation ha been a fruitful ne for u, all. endeavour to "pread the Chritian ideal ofourorgani ation in Ea tGernlan) too, b d ed and b) in piration 0 that we, one day, will be able to found an orc-ani ationtherea \ ell.Th allleholds true for other Ea tern European countrie \ here privat 0 ial help organi ation are still unkno\', n. \Jerel) on the ready o-operation f our i rer aid organi arion throughout Europe in th future - a situation we \..no\\ \ ell through our relation hip ' " ith the r John mbulance, an organi ation with \ hi h we'v k.cpt in clo ' ont:! r ince our funding. Th coming ears pre-;ent lI with man) n \\ ra:\.. ' and onl) b) cl !">e o-operation throughour Eur pe can \\ e b r ally lie essful.

Celebrations

the Berlin Wall comes down

HELP FOR ROMANIA

A nightmare holiday in Romania prompted Anne KnighL. rea PRO, We st orfolk., [0 tart a orfolk

Cadet and Bad ge r Crusade which ha re ulted in £25.000 good being hipped to an orphanage where " tin crap. of humanity lie helple s., waiting to die, their innocent year wa ting a\ ay with a cruel certainty" according to a journalist who i ited it.

Anne tell her tor y:

" On Saturday. 9th Jun e.

we et off at 5.30 a.m. For Romania having no idea that t he fir st week of our holida y had been cancelled by the Official ational Touri t Board of Romania ( 0 T ) at I pm the da y before! Somewhere along the lin e from 0 Ttoourtourcompan y to the local travel agent, th e me age had not co m e through)

" After delays, we arrived at Buchare t Airport at about 7.30 pm and wai ted for our rep andbaggageuntillOpm.After one hour we went to th e 0 T to a k about our rep only to be told that there was no rep in Buchare st. At the des k we met

a Romanian lady who had bee n ent tomeet an English woman

A Romanian holida y in s pir e d N orfolk

Inember A nne Kni g ht s to ta rt a campaign for orphan s in ROln a nia w hi c h tran s formed the li ve of C ad e t a nd

Bad ge rs a s we ll a th e c hildr e n s hut up in a Romanian orph a na ge.

Norfolk

Cadets and Badgers act

to help the children of

Romania

who h ad come to collect her ado pt ed R o m ani an baby. Thi., l ady rang 0 T and th en she told us that we were booked in at the Hotel Mod em and we could share a ta x wi th her.

" The airport was badl y lit, th ere were bull et ho es in th e windows and the only drink available was water or bitter Turkish coffee and we were g lad to accept th e lift.

On arrival at the Hotel , the ta x i driv er demand ed £ 15 although the ta x i had already been paid for. Th e hot e th en inform ed us we were not booked in th er e and we mu st pa y 76 do llars before we could have a room Havin g no dollars we tri ed to pay on Acce.,., but thi s was refu se d. We were ex hau 'i ted Eventually we go t a room on the condition we paid for it in th e morning.

"An En g li shman in th e loun ge heard th e co nver sa tion and offered to help. He gave us th e address of the Briti sh Embassy and told us about the Brit club at the Embassy where we could get a lunch on Sunda ys and make co nta c ts

" Sunday 10th June we walked throu g h the prot es tor s in University Square , seeing th e Hun ge r Striker s' and m edical tents , the wooden crosses where revolutionarie s had been kill ed in the upri sin g and all the candles burnin g in memory of th e dead 9

en route to th ONT office.

The rep th ere was most helpfu and ensur ed that th e hotel wou ld accept o ur Access card after 0 T had provided the ccess slip rorprocessing. We visited th e Brit Club and there an olTic i al made notes about our case.

"On th e way back. to the hote I we passed by eaucescu',> Palace where the .,urrounding buildlng\. includIng the librar}. hdd been gu !led b ' fi re and strared by machll1e gun bullets. Back. at our hotcl v'.e met another Engll\hman w ho had come to

o ll ec t hi\ Romanian adopted daughter. At th e la..,t moment he had nearl y lo\t her :.\\ an mencan couple had offered the mother lo.noo dollar\ Fortunatel) .,he had refused the money.

"Monda) 11th Jun e: Our tou r I'> on and \\ e arc allocated Flonn - a computer engineer \\ 110 ac ., <1\ a touri..,t guide to \upplemcnt hl\ monthl) '>alar) of -£ I 00 per month.

"The re t or the tour W<I ranta\tlc and we took. In the man eIlou,> Roman Ian \cener) and hi\tor) - dining in the medIeval house once li ved In

by Count Dracula.

" Whil e we were in ibui we 'law IOITic\ marked" enmlnia - Romania" and WIth the logo of th e erman order or t John. They 'v\ere carrying rood \upplie,> and although J couldn't find anyone connected with th e orrie.., t o talk. to it did mak.e me wha t St John mbulancc might be doing 1'01' the people 01 R oma ni a.

" W e met up with Brian Mansfield of th e Pro tek.ton Tru\t (a medical c harit y) and he told us or th e enormous gaps in medical provision in Rom an ia The eq uipm en in hospitals is about ]0 years o ld and in o nc ho'>p ital wi th over loon patients he had rou nd on Iy one def bri II ator.

" hildren with Aids whom he had visi ted had originall) been malnouri shed and in stea d of being g ven an improv ed diet, th ey had bee n inj ec ted with import ed , un screc ned blood.

" li e was also co nce rned thatambulanc e perso nnel in R omani a had ab!->olutely no trainin g in fir st aid and he wondered whe th er any St John perso nn e would be able to go over to Romania to g iv e basic trainin g. Ho spi tal s alld doctors in Romania are d c!-> perat e for any kind or m edical equipment - particularly c rut ches, walki ng frame s, sy ri ngcs, dres!->i ng"', un forms, sheets,

blanket'i - A YTIII G AT LL.

"Ano th er British ady who had visited the Negru Voda Ilo spila l in the on.,tan t a (pronouned Constan/a) area said there were 220 mentally and physically handicapped children there wi th only one doctor and 50 starr to cover thn.::e shifts. he had 'ie n chi l dren lying in beds sa tu rated in their own urine with their legs permanently up in the air becau\e of dl placed hip'> (cau\cd by being restrained In cot\ too small for them).

"When .,he held the hand or one chIld. it didn't wan t her to let go and "he had to pri/e It\ finger.., awa). t the ol-phanage in on..,tanli.l whIch we \ i\ited. there were 157 children bet\\een 3 and 7 years old. <;ome of whom were handIcapped. There \-\erc two teacher<; and 20 <;tarf 'v\or k.in g on \hi I"t.,. They were in th e middle or a mea"lc epidemic and hal r th e starr 'v\ ere on holiday 0 the remainder were tryIng to run a non-'>top programme. e were not allowcd to see the handicapped children. W ashed blank.ets on th e lin es ut ide were o ld ." nne came back. rrom Roman ia de termined to help. rmed "" ith a list or goods that were needed at the orphanage for the handicapped in egru Voda .., he an'unged wi th ount) personnel that orfol k. adeL ad Badgers cou ld start a crusade ror R omania. They have be n very succe'>sful and hav e collected detergent, disinfectant. soap. 100thbrushe\, toothpast e, combs. baby c lea nsin g produ ts. race c l o th s, tow eb, toilet ro ll s, nappi s. plastic pants, rubb er sheets. blankets. toys. dried bab milk.. vitamin pills, medicines. plasters, ed uca ti ona to s, walk.ing rrames. rutch s, ho spi ta equipmen t and a m;.\'>si\ e donation of baby food rrom R ec k.ill and 0 1 man of orwic h

" I 'm very proud of our adets and B adgers. Their respon e ha s been tr em end ous - th ey ha e stood up in sc hoo l assemblies. in th eir Browni e Pa cb. at uides and in C hurc h gro up s. to talk about th pi ight of th e Romani an orphans and have proved that they rea ll y do car - th Y hav e tak. en the " aring" aspect or St John and r ea lly put it into practic "say nn e.

" W e co uld no have carried lit thL mi ssio n \\ ithollt th e cooperation orBrian Man sfie ld , who i s ananging the tran spor t for us Hi s tru st r eno va tes obsolete H -ray equipment for

HELP FOR ROMANIA

Romanian hospitals".

The orphanage where the goods collected by orfolk'<, Cadets and Badgers will go i., egru Voda. It is just a mile from Romania's Bulgarian border, in its Black ea regIOn of Con':itanta, and i':i home to 232 young':iters. More than I SO died last year, a further 16 this year. It i" estimated that a further 100 could die thi winter if condition do not improve.

The home ha no heati ng. ater run only three time a day. Medici ne and diinfectant are in pitiful ':iupply and brok.en V\ indo'v\ pane are et to let in the e\ ere Romanian \\ inter.

The orphanage ha a po tCeauce eu appointed doctor and one nur e. The ret of the taff are untrained helper. gi\ ing a ratio of one adult to e\ er) thirty youngster. Butperhap wortofalli the degree to \\ h ich past ruelt) and di regard coupled \\ ith pre ent ignoran e to produce uffering.

Young rer aged bem een e\en and 12 look. lik.e di toned two-year-old their limbs bent double a a re ult wearing Iloppi es. ofmaln utrition and being k.ept ina con fi ned pa e \\ hen the) \\ ere bable

Di\eaeSllCh a cuny and rick.et., go \\ ithollt trea tm ent. \\hilehuge,>toma h, arethere lIltofchroni dige ti\edl order. They can be rreared but there i neither [he ;,\pertie nor [he medicines to treat them.

orfo lk \ goods are being tranported b) a POl1 ' mouth cha rity ca ll ed Ra) of H ope' and its leader is D r D avid Ford. H e tf\' ina to hire a boat in nlanta H arbour on \\ hich urgeon fromcou ntry can carr) out p ra ti ons in m ore terile onditi ns than the operating th eatr _ in R omanian hospitals.

Th ope rari on \\ill be on children \\ho are badlv d formed (some \\ ith back-to-front k.n es and :ome \\ ho thrOUg!l hip defollllalitie ' \\hich were not picked up at birth ha\e th;ir feet eac h side of th eir ears).

He s s ar hin g for an ambulance for about a month t o relT) th e childr n from th e boar ba k. to th e orp h anag

The o rr) full of good collected b) y ung t Joh n memb r in orfolk.left th e countr) on ov mb r _ ) and nne \\ auld lik.e to thank. again all those people \\'h ga \ e a rime. mone) and energ) to th e Romanian appeal.

ISlonal Olll er

tebbing.s. Oi\ ISlonal Officer Gordon Park.er. mbulance\\ oman Ket Mollo). rea talT OITicer Bnan Timms and mbulanccman Phillip BCI1lIc) and rea COl11l11i..,..,ioner John Hard) The oventr) team came rourth 0\ crall and Phillip lebbings \\on the dm II1g te..,t oLl tri ght.

Rye

Pictured abo\e are Emele) and Chn"topher Manion from R ) e Badger"at the !lower re'>lI\ al held at the Pan"h Church of St ar) the Irgin\ II the local you

Devon

De c ember 1990

Abingdon

Abl\1gdon

Chessington World of Adventures wishes to thank St John officers for all their invaluable assistance in the park during our very successful 1990 season. We wish them a very merry Christmas and a happy New Year.

ALLIED PRESENTATIONS LTD

Reading Speedway

Warrington

St John Ambulance members for their work on Monday evenings during the 1990 Speedway Season and I

1 1 t .I

\ olullteers

" For/our hours. three tllnes a Barbara Ro\\ bothLl1ll and Phd Genmlln arc Y\.lred up to their dial) SIS machine to ekLl1l their blood "The \olullteers arc there to help them connect thems!c\ e to the machilles and deal \\ Ith all) hiCCUps and so l1lal-.e their 11\ es more comfortable. T\\.o more of our Brigade member arc JOining the team once the)" e been trained ami then \\e ll be abk to rut a t John badge on the door."

Isle of Man

A troph to honour past 01\ Isional we look forward uperintcndenl.) ril ( nu)') nder"on, \\ ho (lied earlier thiS year. was Included In the Newton Abbo t Open eompelltion.

Hampton Court

£3.500

The trophy wa a'''arded to the be t perl'orll1anccb all1emberofa tJohllteaml1l thc individual section thus nd)" pride in t J ohn and his on indi idual test pCrf0rl11ance. The fine siller salver was enhanced by a polished hard. ood presentation

Pict ured abo\ cis the

Th e winner was mire,", Tal'l,cy (pictured abovc)of th e Northville (Bri tol) Di ision who was presented wi th th tr op h y by Dr Mar k Anderson (Andy\ grandson).

The Bristol Hippodrome would like to thank St John for their support throughout the year. to seeing them again in 1991 . 1 1 t 1 t 1 1 \ , case made by tw o members or th e Newton Abbot DiVision

ion ofcer! i and potter) badgers by Dcrel-.. Bridson to to three member,; of "Douglas Badger e t "at th eir headquarters -the thr ee. oirre Keggin, Ri chard Karrran and Jame or l-..hill arc the first Badger!\ on the island to

screen and tal-..e part in "e\ eral rarne".

OrganiseI' of the e\ enl. 01\ ional Pr ident tllr John Lelliot S:lld: "We are delighted to h,1\'e 'ouch an c\ccllent amount \\hich \\dl go tt\\:.m.ls bU)lng a Landro\'er ambulance." tllrs Lelliot to hold a similar c\ent ne\t ) ear.

DINNER THEATRE

The Mill at Sonning Theatre would like to thank the local division of St John Ambulance Brigad e for their continuing dedicated s upport and constant reassuring presence.

The Promotions Team wish to thank the St John Ambulance Volunteers for their help and upport at all the events we organised for the people of Readin g during 1990.

PRESTON NORTH END F.C.

LTD

Preston North End Football Club wish to thank the St John Ambulance Brigade volunteers for their kind assistance throughout

and take this opportunity to extend to them al/ Christmas greetings and best wishes for a happy and prosperous

LUTON TOWN

FOOTBALL CLUB

AROUND THE DIVISIONS

In 2-+

from Bmtol to Wlnd<,or. non-stop

Paddling along canal,> and nver, carryll1g a loaded canoe round loc!"'s and obstructions. months of tnunlng and hour'> or planning paid off and Sedgley cro .,ed the finishing line, ral'img £700 In spon,>or,>hip for the DiVISion The cight - man team were led by Tony Wilson ( Captain) and John Kclly (Vice). pic ured abovc. were ,>upported on ,hore by Superintendent Margaret (lomb) and her team. who used the 01\ ision's mll1i - bus to proy Ide re'>t food and fir'>t aid for the hard pres'>cd crew,> throughout the 2-+ hours The marathon canoe e\ent ""as organised b) the Ro) al Bcr\..'>l1ire Fire and Rc,>cue crVlce. \.\ ho did a superb Job mar hailing the route and mar\..lng hU/anj." 'ouch a 10"" bndges. ,ubmerged rod and debri and dangerous weirs. Entf) to the race I, b) In\ Itallon onl) but If other Di i\lons \\ ould like to rule mone) b) II1vl t ll1g people to "'ponsor edgle) John K ell) \.\ould be pleased to hear from )OU on 03 .f 63H936

Buckfastleigh

LEICESTER CITY F.C.

Saltash

Leicester

The St John AmbulanceIBP ;';atJonal Po ter competition \\ inner EI izabeth Crac!...nell proudl) pre ented her prize. a R e ' cu i-Anne. to her chool in Melton M o\\ bra) he I

=

AROUND THE DIVISIONS

AROUND THE DIVISIONS

's very special cake

Hayle

Pictured together with the Mayor and Mayore of he terfield IIr. and Mrs Webber and Area Commissioner M.J. Newell are ix member of T.T. he terfield Quad \\ ho rece ived their Grand Prior Awards at their nnual Pre entation. The) are Jamie Flaxman, Emma Ty ler, Steven Lever, Graham Walton, Oa\\ n Yate and C laire Horton

lemma Smith is pictured with confeclloner Stephen Haude pUlling t he touche < o the ca\..e she deSigned for the Queen Mother\ bmhda) to \.\. in a compe t ition in Badger Buzz The competition \.\. a ponsored by Searcy's and the prc'>entallon of Gemma' cake took place at the compan) 's sump tuou\ headquarters in London.

Merseyside

ls H a) Ie the onl) D ivi ion to name their ambulances? Pictured abo\e are G\.\.ereer and Co\.\. eth The name mean Helper and Friend.

Hayle recentl) joined force'> \.\.jth the Count) Ambulance Sen Ice and the ir Ambulance to transport a badly injured racing c)cli to ho pita!.

F rench rIder P lerrick olent collided \\ irh a car dUring the three-daJ Redruth racing e\ent. St John per onnel who took part In the airlift operation \.\.ere R Da\)-Thoma \1 H ) nard and E. In the Ambulance One. and P Oa\)- T homa G Phillip.., B urge ' in Ambulance T\\o

ngela and Philip "atkin "ere voted Prince and Prince , at Polegate arni, al. Both are member of St John ombined adet Oi, i -ion Willingdon and Polegate.

The Oi, i ion were al 0 runner up in the decorated float contest at the same carnival.

WESTERN AUSTRALIA

Executive Director of St John A mbul a n ce A u s tr a li a, Ian Ka ye E ddi e, brin gs us anecdotes from We s tern Au s tralia - a s tat e t e n tim es lar ge r than th e U K

A land where the trees are called widowDlakers and the doctors fly

The tyranny of distance ha real meaning in thi partofthe world. We tern ustralia cover an area of two and hal f million quare kilometre, which mean that the United Kingdom would fit into thi , State at lea t ten times. The population i only 1.6 million with just one million living in the capital city of Perth.

To meet the need of the community scattered throughout the State , the Order of St John provide an ambulance ervice, fir t aid training and the provi ion of first aid services at public gatherings.

In Perth and all the larger country towns, the ambulance service i admini tered by paid taff, whilst in the smaller town , the Service is provided by volunteer. In this article we hope to illustrate how we serve the community in thi part of the world

The first story tell of the hardships faced in thc Pilbara region , which has the largest iron ore mines and gas proce ing plant in the world. The climate in this area is hot and sub tropical, with regular cyclones at certain times of the year. From a little town called Roeboume, just near the Burrup Peninsular Gas Fields, the volunteer related this story:

"One of our most trying experience was in January 1987. We were on duty one afternoon when a motorist came in to report a road accident he had passed near Python Pool, about 83 kilometres down the road towards Wittenoom. A panel van had ro ll ed about seven metres down an embankment and there was a girl trapped inside with a suspected broken back.

"The day was atrociously hot - about 50 degrees in the open sunlight. Taking a policeman with us we set off, and were only about 25 ki lometres out of town when we came to another car that had just overturned. It was on its side, 'parked' on its doors,

with the oc c upant.., ..,till in it and unable to g e t ou!. We helped them .., c ramble frecand right theircar. The drme off. limping alon g and we le arnt later that the had eventuall y been forced to abandon the car.

"In thl: meantime. we got going again, but the air temperature wa.., so high. our ruel started e up rating. The only way to keep It cool wa.., to spurt mouthfuls of water over it e\ er fc'v\ kIlometre:-.; and we had to k.eep thi.., up all the way to the accident site It took us an hour and a half to

The allthor, I an Kaye Eddie get there, and by the time we alTived, the girl had been trapped in the van for rivc hour. The other three occupants, who were unhurt, had clambered out, but had been unable to do anything for h r other than ask the pa sing motorist to call us out when he had reached Roebourne

"Getting her out was our fir t problem. The van was pitched over on it left back wheel on a 30 degree lope. The only way to extricate her was to manoeuvre the stretcher in and out through the front door window. The van was so hot you could have fried eggs on the panel work. The patient was badly dehydrated and in pain, so while we were moving h r we had to swab her down, administer oxygcn and give her painkilling shot. of penthrane.

"The trip back to Roebourne wa even war e than the drive out. The petrol continued vaporising. J became car sick, and had to admini ter oxygen to myself. We tried calling the Wickham ambulance to come to ur a istance, but we couldn't getthecall through. Then about 30 ki lometr s out of Roebourne one of the tyres b lew out. The wheels were so hot we couldn 'ttouch them, and so we had to limp home on a hredded tyre.

"We eventually reached Roebourne after a five-hour round

trip, but on getting there discovered that the local doctor wa s unavailable. We therefore had to take our patient a further 12 kilometres onto Wickham, where the Flying Doctors picked her up to fly her on to Port Hedland By thi , stage our patient, a ew Zealand tourist who had only arrived in Australia the day before, must have been wondering why she had ever wanted to see the Pilbara. "

ot all stories are as dramatic as that one!

"We get many ocld cac.,es. Once we picked up an Aboriginal woman who had a pet goanna (large lizard) she took everywhere. I r he went to the pub the goanna had to go along too, and would sit on the bar One day she got badly smashed up in a car accident. The goanna was unhurt but th e woman wouldn't get into the ambulance without the goanna. In the end we had to let it come along , sitting up on the front eat. When we got her to the hospital. we handed it over to the police, who kept it in a box for her until she wa.., well enough to take it away."

Further orth , there is the tropical town of Broome, which is a famous holiday resort pre'lently being extensively de eloped by a well known British entrepeneur - li.,tair cAlpine.

unburn is the cause of mo..,t of ourcalb. Tourists and people who have arrived to li\e here from further outh often don't appreciate how inten:-.e the sunlight is up here It is particularly distres ing to see little children often only babies, who've been badly bli tered because their parents have been taking them around without any pr tection from the'lun. ome cases are so bad that we feel th parents ought to be charged with neglect.

"Broome get a lot of dri fters who need attention as they pa through the town. One we attended wa a 'bikie' \ ho had fallen from hi motorbike and broken an ankle while toned on gra The br ak wa 0 bad hi foot wa . ju t dangling by tissue: and , 0 we ga him the painkiller penthrane.

"He wanted to know what it wa and wher he could get ' ome b cau e h thought it wa better [han marijuana. He couldn't have cared les about hi foot: getting hold of a uppl of thi e citing new drug was hi main con m!"

Pember10n i a mall fore milling town in the outh

We tern part of the tat where the limate is cool and t mperate. Some unique torie about timber worker and th problem that occur in thi area provide intere ting reading:

"Many ca e handled by the all-volunteer, ambulan er ice are injurie suffered by timb rworkers, who p nd th irworking day in the fore ts of giant Kan-i tree, many over 60 metre tall, which urround the town. Apart from accident. with hain aw and timberloading machinery, there i ' the danger from falling

WESTERN AUSTRALIA

branches ,Even a twig can inflict fatal injurie as it nears terminal velocity after dropping 60 metres orso. Timber workers call these sailer or widow -makers

"The Glouce s ter Tree is one of the talle s t trees in the fore near Pemberton. In ] 984 a man from a tour bu collapsed in the lookouttower at the topofthi tree. Oneof our volunteer hauled the heavy oxygen revival equipment up the ladder, only to di cover that the man wa already dead

"Getting the corp e to the ground pre ented technical difficultie : carrying it down the spiral ladder was too dangerous, nor could it be imply lowered on a rope becau e ofrhe branche and ladder in the way. Someone then ugge ted a flying-fox cable and pulley arrangement between the tower and ground, which the volunteer obtained from one of the timber mill and oon put in place. (It i till there, in case of future imilar emergencie ).

"Securing the body to the hook beneath the pulley wa the next problem. Thi wa overcome when omeone got the idea of borrowing a hang - gliding harne from a local hangglider pilot.·'

InAlbany, which i a mall port at the very Southern end of We tern Au tralia. Sub Centre member told man) tale about their experience a ambulance volunteer accompanying the port doctor. who i periodicall) required to put out in a mall boar to attend hipboard ca e at ea. imilarl . there are numerou torie about retrieving patient from along the coa t. "A number of torie are abour The Gap. a \ a t blo\\ hole in the granite eacliff ' ourhwe t of the town On the ea\\ ard ide of the blowhole i a huge natural arch. which i one of the area' popular touri tight. t 10\" water it tand about 20 metre ' above the sea. but during high ea ' oc a ional giant break over it. It ha fa cination fortouri t and . ome adventurou one attempt to clamber acro it.

"0 er the ear a number ha e been \\ ept into rhe ' ea from it. In ome in rance the bodie have never been re overed: in other there ha e been miraculou , ur i\ al During the 1970 the kipp r of a whaling boat tandingju t off hore. n\\ a youth ashed into the ea at The Gap. He div do erboard and r ' ued the lad. On another occa ion. a pair of Eng Ii h touri b in a hired ar from P rth were doing the ight f the outhwe t. huge wa wept th m from the arch int the blo\\ hole wher it mu t ha e e m d th y had no hope f urvival. The next \\ aye. howe er. wept them high up on the blowhole' land\\ ard ide. and they were able to ramble free. Both uffered crutches and abrasion and on had a brok n arnl The) found their \\:1) to the local hospital unaided and \Vh nth ir injurie had been rr ated,

WESTERN AUSTRALIA

Continued from pre , iou page. they got bad. in th ir car and drov e back to Perth

"The be st known local ca e of a sea r eocue i s that of uptain

Che ney Studd s, the kipper of a whale c haser who lo st a le g in a freak hipboard accident in the 1970s. He was standin g ne t to a coi of rope attached to a harpoon as th e harpoon was bein g f ir d the coil unravell edoneofhi le gs b ca m ee ntan g l din it and was torn otT. Crew memb er s gave him first aid and contacted their whale spott er plane by radio. They then laid a trail of oi Ion th e ' ea around the boat 0 th at th e pl ane which was equipped with noat ,co uld land and co m e alon g id e. The pilot landed afely and Studd was tran sf erred from th e boat to th e plane without mishap.

"The pilot radioed ahead to th e whaling tation at he ne's Beach, to arrange for an ambulance to wait at th e harbour. The ambulance wa: tandin g by h e land ed th e plane at Emu Point. Studd urviv ed and l ater returned t o seafari n g.

"Albany is one of th e co unt ry towm where the Bri ga de i till fair!) ac tive Memb er have th ei r own characteri tic ally 'Brigade' tori e . On e th ey te ll again t them elves i about the tim e a group of women from th e Bri ga de' l oca ur ing Divi sio n were doing vo lunt ary work at th e ho pita!.

" The y were give n the job of cleanin g all th e elderly patient' false tee th Th ey did th e job mo t th oro ugh l y, and were tandin g back admiring their h a ndiwork when orne one voiced ado ubt , " how do we know who belon g to which teeth ?". The only thin gto do wa spend an anxious afternoon fi tti ng denture to likely mouth by tri al and "

The ullabor Plain , which has th e of )t r aig ht railway line in the world, a so ha s a bu sy hi g hw ay which crea tes enormous probl em in the event of vehicle accidents. It is a hot dry , de se rt re g ion

Fortunately the Royal Flyin g Doctor ervice ha s l andin g strip s along the Hi g hway but St John i s r e pon sibl e for trainin g volunteers who work at th e half do ze n road hou ses ( mot els) along the Eyre Hi g hway. Th er e s a very hi g h staff turnov er at th e road hou ses, and no ooner have we trained a batc h than they leave and go elsewhere. At Balladonia th ey went throu g h 700 staff in one year! Thi s illu trat es one of the probl em s we hav e to contend with in , ome of the outlying area of our Stat e Kalgoorlie i a rough, tou g h go ld minin g town in the dry Eastern part of the State. Over the years many tale ' hav e co m e out of thi s area.

One volunteer who ha s worked for St John for over 50 years relate s the story that he recalled from 1936.

"My work in St John help ed me to beco me a mine safe ty 21

officer at th e Lal-.. e View and t ar Min e. I u, ed to ook after the min ers in any way I co uld , for exa mpl e, in hl;lpin g th em with claim for co mp ensa ti o n W e were mat es, 0 recko necJ 1ought to help th em

"A lot o r min rs used to fal-..e injurieil to ge 'compo' (wor k er 's ompe nsa ti on One chap 1 helped neecJed money so badly he deliberat Iy put his fa t on th e tramlin down the min e so a tru ck. would run over it. I li s big toe and seco nd toe were cut ofT. The onl problem was he'd tak.en orrhis boot berore he put his foot on th e rail. as t mal-..e sure the toe , were cut ofT. I realised w hat he'd been up to as soon as I got to him because boot was n 't mark d.

" e.;uid noth in g, but tool-.. awa hie.; boot and thr ew it n the rire SO no one wo uld ever I-..now w hat he 'cJ done. 1 r ck.oned he de'>erved his compo ifh was brave enough to cut his toes orr!"

Thes few help to ,>ome of the worl-.. that hu<; been carried out by t John o\er thc in the community in Western Au'>tralia.

t John in thi " tate i" one or on l y two ommanderies that st II functions in the \>,orld The Organisation believes that it I.., responding effectivel) to the communities' nceds.lt isa uni(,.juc organi..,ation that lIses both paid and volunteer "talT and con"tantl re sits rgani"ati nal structure to en"ure that it '>ltly s relevant to the dcmand" pia ed on it b) the communlt

t John in We tern u..,tra ia IS str ong l y supported by the ustralian Priory, the tate overnmen t and the communi t y at large, in carryi ng ou t its mision of

erving Hum anity'.

I. Indirect force is divided into three separate 'iub h adings, which one causes thi s type of rracture?

2. Both of the e fracture,> may be 'comp li cated ' how'?

s tions on the 5th edition First Aid Manual Series 3 , Number 6

BRUC COLTMAN, rea ommi ioner Northumbria

5. A ca ualty with a fractured col l ar bone may upport the arm in thi way what el e may you ee happen?

8. Which type of force i'i the caU'ie of thi , type of fracture?

3. Whi h condi ti on must be dealt with b for treating a rra tur ?

9. Your ca ualty ha a fractured elb ow which cannot be bent. What mean of tranport required?

4. Y o u are trea tin g th is ca, unit y, wh n an yo u r el ease yo ur g rip after steady in g and upponin g?

7. Wh n tr ea tin g an open fracture of the for aml. ha\ ing dr d and padded the \V und, what should happen next?

10. Fracrure of the hand are u uall) due to \\ hich t) pe of force?

1. \ h n trearing a compli ared rib fracture, ",hi h o nditi n hould b treated immediatel)?

A Potter

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con erned with hi own feeling (9)

9. eriou compli ati n of wound ending in terminal part of alimentary canal (7)

10. Take too many cour e , maybe (7)

II. Applau -e(4)

12. ctworkpartof<;ame hape(4)

13. Part of dre ' to prepar for ath letic event (5)

16 . Word-blindnes shown b boy with I t cia , return (6)

17. Doe he ha e a in hi drawing room? (7)

19. ickne of oyager ' (3)

21. Seal the lip for 9 a ro (7)

22. n improvement in the patienr condition (6)

2S. What th myocardium doe in dia , tole (5)

27. The occlu ion of the teeth (4)

28. Epidermal appendage (4)

30. Almo t having high hope for an analge , ic (7)

32. Di turbing ibration f oft palate and vo al rd during leep (7)

33. Ca e hi tor y gi en by th e patient (9)

34. Daily -inapi m produc di olution of cell (5)

to Do You Know your Manual. : I. Twisting or \\ renchmg force 2 By mjury to blood vessels. nerves or adjacent organs b the fractured bone ends or fragments 3 Difficulty in breathmg , severe bleeding and unconscIOusness 4 When the limb is effetivel) immobilised 5 The may II1cllI1e the head towards the injured side 6 To fill the hollow between the aml and the trunh. 7. Immobtll e and elevate the injured pan If posl-iblc Direct force 9 stretcher 10 Direct force I I Any such.lIlg wound OLUTIO TO OVEMBER' RO WORD Across : I Heart-who e 6 Java 9 Out -of-sorts 10 Urea 12 Dumb 13 can 14 Hunch 16. utrient 18 omedo 19 Eon 21 enile 23 Taste bud 26 Boron 27 Also 28 Lens 31 Ever 32 lnfarclion .:n Days 34 In sti tches Down: 1. Hyoid 2 Attempt 3 Tifr 4 Hyo -cine

DOW N:

J. Person concerned with how one looks (8)

2. Infu sion going directly into the blood stream (II)

3. umber of vertebrae forming sacrum and cocyx (4)

4. Keeping together part of the foot (6)

S. Hot, clear mixture in part of humerus articulating with the ulna (8)

6. Disease in which the diagno is is obviou (S)

7. Palindromic sense organ (3)

8. Mu cle spasms due to hypocalcaemia or hyperventilation (6)

14. A usual spice for god of healing (11)

15. Correct mark for a para ite (4)

17. Moi ture precipitated by cooling of air at night (3)

I. Drink exces ively having direction from ummit (4)

19. Orthopaedic urgeon looked at X - ray? (8)

20. End-organ producing male hormone (8) 23. The mi takes amended at rear (6)

24. Drooping of upper eyelid i following breakage of pol. (6)

26. Dangerou woman give a ound warning (5) 29. Staphylococcal

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