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Ambulance UK October 2021

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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

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