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NEWSLINE<br />
AMBULANCE <strong>UK</strong> - OCTOBER<br />
Research shows<br />
the valuable role of<br />
Helicopter Emergency<br />
Medical Services<br />
(HEMS) in responding<br />
to incidents of<br />
penetrating torso<br />
trauma in semi-rural<br />
areas<br />
Research by Air <strong>Ambulance</strong><br />
Kent Surrey Sussex (KSS)<br />
and the University of Surrey<br />
also highlights a prevalence of<br />
incidents along known County<br />
Lines.<br />
Research from life-saving charity<br />
Air <strong>Ambulance</strong> Kent Surrey<br />
Sussex (KSS) in partnership<br />
with the University of Surrey has<br />
shown the significant benefits<br />
of HEMS in responding to<br />
penetrating torso injuries suffered<br />
by patients in rural or semi-rural<br />
areas. Penetrating trauma is<br />
most commonly associated with<br />
stabbing or shooting.<br />
The retrospective study, which<br />
analysed data over a sixyear<br />
period, also highlights a<br />
prevalence of these incidents<br />
along known County Lines,<br />
networks established by citybased<br />
drug dealers to supply and<br />
sell drugs to users in towns and<br />
rural areas.<br />
The findings demonstrate the<br />
value of HEMS in expediting<br />
critical treatment for this group<br />
of penetrating trauma patients in<br />
rural and semi-rural areas and will<br />
inform multi-agency knife crime<br />
prevention strategy in these areas.<br />
The study identified that between<br />
1st January 2014 and 31st<br />
December 2019:<br />
• KSS attended 363 patients who<br />
had sustained a penetrating<br />
torso injury;<br />
• 88% of these patients were<br />
male with a median age of 30<br />
years;<br />
• 62% of these incidents<br />
occurred during the night;<br />
• 121 HEMS-specific<br />
interventions were performed<br />
in 14% of patients, with chest<br />
surgical decompression the<br />
most common (n=31);<br />
• The median time from incident<br />
occurring to arriving in hospital<br />
was 1.5 hours, with HEMS<br />
arriving in a median of 39<br />
minutes to start critical care,<br />
before the patient arrived in<br />
hospital;<br />
• Heat map incidence data<br />
closely correlated with County<br />
Lines.<br />
Penetrating trauma patients<br />
pose a significant challenge to<br />
pre-hospital emergency medical<br />
care providers. Time-critical<br />
non-compressible hemorrhage<br />
requires rapid assessment and<br />
typically transport to a Major<br />
Trauma Centre (MTC). In this<br />
study, 54 patients required one or<br />
more HEMS-specific time-critical<br />
interventions in the pre-hospital<br />
setting, and in total 78% of<br />
patients were transferred to a<br />
MTC.<br />
Penetrating trauma has been a<br />
substantial part of the trauma<br />
workload in urban areas in the<br />
<strong>UK</strong> for the last decade [1] and<br />
more recently it has increased in<br />
rural and semi-rural areas, where<br />
patients are frequently significantly<br />
further away from a tertiary care<br />
centre. In this study, the town<br />
of Margate in Kent, located 73<br />
miles and two hours away from<br />
its nearest MTC, had a significant<br />
number of penetrating torso<br />
trauma patients. The involvement<br />
of KSS resulted in transfer time for<br />
these patients being halved.<br />
Professor Richard Lyon MBE,<br />
Associate Medical Director at KSS<br />
and Professor of Pre-Hospital<br />
Emergency Care at the University<br />
of Surrey, said:<br />
“We know that time is absolutely<br />
critical to patients who have<br />
suffered penetrating torso trauma<br />
from a knife or gunshot injury. It<br />
can be challenging to discern<br />
which injuries require immediate<br />
intervention. Penetrating trauma<br />
patients can initially present as<br />
stable but can quickly deteriorate<br />
into a life-threatening condition.<br />
Getting the advanced clinical<br />
skills and clinical decision-making<br />
of HEMS teams to patients<br />
as quickly as possible can<br />
significantly improve outcomes for<br />
these patients.”<br />
“From their significant clinical<br />
experience, HEMS teams are<br />
more aware of underlying injuries<br />
and, in addition to providing<br />
emergency treatment at the<br />
scene, also have the capability<br />
to intervene en route to hospital if<br />
required. 34 patients in our study<br />
required a blood transfusion<br />
whilst being transferred by KSS to<br />
hospital.”<br />
He continued:<br />
“Previous studies have<br />
demonstrated that the accuracy<br />
of clinical examination to establish<br />
the degree of bleeding and<br />
potential for internal damage<br />
after penetrating injury is poor,<br />
making it difficult to predict which<br />
patients will deteriorate before<br />
they reach hospital. Our study<br />
confirms this, and also shows<br />
that HEMS attendance can be<br />
crucial. Several of the patients in<br />
this study received pre-hospital<br />
interventions, without which they<br />
would not have survived.”<br />
The research also highlighted<br />
the geographical distribution of<br />
penetrating trauma across KSS’s<br />
region over the six-year study<br />
period and identifies a specific<br />
pattern which mirrors existing<br />
drug trafficking County Lines.<br />
This information will help knife<br />
crime prevention strategy and will<br />
also support the safeguarding of<br />
vulnerable people at risk.<br />
The research has been published<br />
in the Scandinavian Journal<br />
of Trauma, Resuscitation and<br />
Emergency Medicine.<br />
NWAS<br />
New major multisports<br />
event, The<br />
Gratitude Games,<br />
launches to support<br />
the mental health of<br />
emergency service<br />
and NHS workers<br />
• The Gratitude Games aims<br />
to generate £10 million<br />
in funding to support<br />
Emergency Responders’<br />
mental health over the next<br />
five years<br />
• The Cities of Manchester<br />
and Salford will hold the<br />
inaugural games next year<br />
for over 20,000 Emergency<br />
Responders and their families<br />
The Gratitude Games, a new<br />
sporting event to support the<br />
mental health of emergency<br />
service and NHS workers is<br />
calling on the British public and<br />
businesses to donate to their<br />
fundraising appeal.<br />
1 in 4 (27%) emergency service<br />
workers have considered ending<br />
their lives due to stress and other<br />
factors 1 , and this has only been<br />
amplified by the pandemic, with<br />
69% 2 reporting that their mental<br />
health has worsened since the<br />
start of Covid-19. 3<br />
The first Gratitude Games<br />
will be hosted by the Cities of<br />
Manchester and Salford from 27th<br />
April – 29th May 2022 at leading<br />
venues, including the iconic<br />
Etihad campus. The Games will<br />
unite over 20,000 Emergency<br />
Responders and their families,<br />
across 20 different sports. From<br />
the whole of the NHS and the Fire<br />
and Rescue Service, to RNLI and<br />
Cave Rescue, workers from 17<br />
different Emergency Services will<br />
156<br />
For further recruitment vacancies visit: www.ambulanceukonline.com