Ambulance UK February 2022

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Volume 37 No. 1<br />

<strong>February</strong> <strong>2022</strong><br />



The perfect pairing for synchronised resuscitation<br />

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<strong>Ambulance</strong> <strong>UK</strong><br />


7 FEATURES<br />

Lessons learned from the first 50 COVID-19 critical care transfer<br />

missions<br />

16 NEWSLINE<br />

26 IN PERSON<br />





corpuls 3 / C3T<br />

With its revolutionary modular design, the corpuls3 & C3T can be used<br />

as a compact unit or separated into the Monitoring Unit, Patient Box and<br />

Defi brillator/Pacer. The modules communicate wirelessly and adapt to<br />

the requirements of the paramedic on scene, or inside the ambulance.<br />

This issue edited by:<br />

Sam English<br />

c/o Media Publishing Company<br />

Greenoaks, Lockhill<br />

Upper Sapey, Worcester, WR6 6XR<br />


Terry Gardner, Samantha Marsh<br />


Media Publishing Company<br />

Greenoaks, Lockhill<br />

Upper Sapey, Worcester, WR6 6XR<br />

Tel: 01886 853715<br />

E: info@mediapublishingcompany.com<br />

www.ambulanceukonline.com<br />


<strong>February</strong>, April, June, August,<br />

October, December<br />


Media Publishing Company<br />

Greenoaks<br />

Lockhill<br />

Upper Sapey, Worcester, WR6 6XR<br />

corpuls cpr<br />

The unique rotating arm of the corpuls cpr grants free access to the patient’s thorax<br />

at all times, meaning the emergency responders are able to provide additional lifesaving<br />

therapy during CPR. The various back boards are designed for fl exibility on scene and<br />

during patient transport.<br />

The corpuls cpr ensures fully automatic, fatigue proof thorax compressions, and the<br />

compression depth, rate and mode can be tailored to the patient. The device can<br />

accommodate a thorax height of 14-34cm with no restrictions regarding the patient’s<br />

weight and breadth of the thorax.<br />

Synchronised Therapy<br />

Thanks to the Bluetooth connectivity, the corpuls cpr is effectively the fourth module of the<br />

corpuls 3 . The modular design of the corpuls 3 allows the monitor to be taken by a medic to<br />

a safe distance to observe the patient’s vitals and control the corpuls cpr and defi brillator.<br />

With corpuls synchronised resuscitation, chances of ROSC can be higher thanks to<br />

automatic pre-shock CPR capabilities. Stress amongst the team can also be signifi cantly<br />

reduced with shorter hands-off time.<br />

This can reduce the number of rescuers needed in the event of a<br />

cardiac arrest. It is a huge benefi t during prolonged resuscitation,<br />

especially when providing treatment in small, confi ned spaces<br />

and during patient transport in an ambulance. Built-in connectivity<br />

functions of the corpuls 3 / C3T are ideal for telemedicine and the<br />

corpuls communication platform corpuls.mission.<br />

Learn more at: https://pages.theortusgroup.com/synchronisation<br />


The views and opinions expressed in<br />

this issue are not necessarily those of<br />

the Publisher, the Editors or Media<br />

Publishing Company.<br />

Next Issue April <strong>2022</strong><br />

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Welcome to this issue of A<strong>UK</strong>.<br />

Let me start by passing on condolences from the team here at A<strong>UK</strong> to the family, friends, colleagues and all<br />

at SECAM on the tragic loss of a young Paramedic, Alice Clark, who lost her life in a crash early in January.<br />

Our thoughts are with you all at this sad time and we wish her colleagues, who were also involved, a speedy<br />

recovery. At times like these you reflect on the family that is the ambulance service and share in the shock<br />

and grief.<br />

“But we<br />

must look<br />

forward, not<br />

backward, and<br />

remember<br />

the Chinese<br />

proverb, ‘in<br />

the midst of<br />

chaos there<br />

is always<br />

opportunity’...”<br />

<strong>February</strong> is a particularly grim month, not just because of the post New Year lull and the gloomy outlook<br />

with little hope of decent weather for another two months, but also because the pressures do not get any<br />

better. I’ve just watched a story on TV about the mother of a young man who died waiting for a delayed<br />

response. There was nothing that could have been done to match demand and supply during that awful<br />

couple of months around Christmas, especially with the staff absence factor created by Covid. It was not an<br />

isolated incident, nor specific to any particular region, the point is that there doesn’t seem to be any way to<br />

keep up with rising demand and public expectations.<br />

Furthermore the vicious circle of delayed discharge, delayed admission, delayed handover is seemingly<br />

impossible to break without significant input into a social care system which has been broken for years<br />

and will not get any better with the staffing pressures brought into place with mandatory vaccination.<br />

It’s just my opinion but when I hear such stories I’m disappointed and saddened because no-one wants<br />

to make patients wait. I’ve been in the Control room and watched the pressure on dispatchers struggling<br />

to find something, anything, to send out and I’ve seen them cry when there isn’t anything available.<br />

They take it personally as do the Paramedics who know they’re arriving way out of the time frame and<br />

spend the first minutes of an interaction apologising and sometimes, as the front end, becoming the object<br />

of their frustrations for those who have had to wait. I don’t know what the answer is, I’m not sure anyone<br />

really does. We work at handover schemes and put as much into resource as we can but the simple truth<br />

is there is a clear gap between what we need and when we can have it. It takes two years to address the<br />

increased Paramedic resource needed to meet this year’s growth, not to mention the funding. But we must<br />

look forward, not backward, and remember the Chinese proverb, ‘in the midst of chaos there is always<br />

opportunity’…<br />

Anyway, on a less depressing note, travel restrictions are slowly being removed so with luck some of you<br />

might get a well-deserved holiday abroad this year. It’s been a long slog over the last two years and it really<br />

is time for all of us to recharge the batteries…<br />

Sam English, Co-Editor <strong>Ambulance</strong> <strong>UK</strong><br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

4<br />

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J. Jeyanathan 1 , D. Bootland 1 , A. Al-Rais 1 , J. Leung 1 , J. Wijesuriya 1 , L. Banks 1 , T. Breen 1 , R. DeCoverly 1 , L. Curtis 1 ,<br />

A. McHenry 1 , D. Wright 1 , J. E. Griggs 1,2 and R. M. Lyon 1,2*<br />

Scand J Trauma Resusc Emerg Med (<strong>2022</strong>) 30:6 https://doi.org/10.1186/s13049-022-00994-7 © The Author(s) <strong>2022</strong>.<br />

Abstract<br />

Background: The COVID-19 pandemic has placed exceptional<br />

demand on Intensive Care Units, necessitating the critical care<br />

transfer of patients on a regional and national scale. Performing these<br />

transfers required specialist expertise and involved moving patients<br />

over signifi cant distances. Air <strong>Ambulance</strong> Kent Surrey Sussex<br />

created a designated critical care transfer team and was one of the<br />

fi rst civilian air ambulances in the United Kingdom to move ventilated<br />

COVID-19 patients by air. We describe the practical set up of such a<br />

service and the key lessons learned from the fi rst 50 transfers.<br />

Methods: Retrospective review of air critical care transfer service set<br />

up and case review of fi rst 50 transfers.<br />

Results: We describe key elements of the critical care transfer<br />

service, including coordination and activation; case interrogation;<br />

workforce; training; equipment; aircraft modifications; human factors<br />

and clinical governance. A total of 50 missions are described<br />

between 18 December 2020 and 1 <strong>February</strong> 2021. 94% of the<br />

transfer missions were conducted by road. The mean age of these<br />

patients was 58 years (29–83). 30 (60%) were male and 20 (40%)<br />

were female. The mean total mission cycle (time of referral until the<br />

time team declared free at receiving hospital) was 264 min (range<br />

149–440 min). The mean time spent at the referring hospital prior<br />

to leaving for the receiving unit was 72 min (31–158). The mean<br />

transfer transit time between referring and receiving units was<br />

72 min (9–182).<br />

Conclusion: Critically ill COVID-19 patients have highly complex<br />

medical needs during transport. Critical care transfer of COVID-19-<br />

positive patients by civilian HEMS services, including air transfer, can<br />

be achieved safely with specifi c planning, protocols and precautions.<br />

Regional planning of COVID-19 critical care transfers is required to<br />

optimise the time available of critical care transfer teams.<br />

Keywords: COVID-19, Critical care, Transfer medicine, Helicopter<br />

Emergency Medical Services, Intensive care<br />

Background<br />

The coronavirus (SARS-CoV-2) pandemic (COVID-19) has challenged<br />

health systems across the globe [1]. In particular, a major demand<br />

has been placed on critical care facilities. A signifi cant proportion of<br />

COVID-19 patients required treatment with critical care interventions,<br />

including ventilatory support [2]. This unprecedented demand led to<br />

Intensive Care Unit (ICU) resources being put under signifi cant strain<br />

on both regional and national levels. At a local level, ICU bed pressures<br />

necessitated the rapid creation of acute surge capacity. Despite<br />

these expanded footprints, the critical care capacity in many hospitals<br />

remained under signifi cant pressure. In order to preserve standards<br />

of critical care and mitigate these demands, it became necessary for<br />

hospitals experiencing acute demand to request critical care transfers<br />

to other ICUs, utilising system resources across the region and then<br />

beyond. During the height of the pandemic in early 2021, there were<br />

several requests on a daily basis within our region requesting critical<br />

care transfers of COVID-19 patients. These demands could not be met<br />

by the existing hospital workforce. The unprecedented level of demand<br />

led to resource strain at both regional and national levels and mandated<br />

the creation of de novo critical care transport teams in order to maintain<br />

equitable access to intensive care. The number of necessitated transfers<br />

also meant that many of these were undertaken over large distances to<br />

other regions [3].<br />

The demand for critical care transfers during the height of the pandemic<br />

was unprecedented [2]. Emergency Medical Services (EMS) with<br />

experience and capability to undertake critical care transfers were<br />

asked, at very short notice, to increase their capacity and adapt to being<br />

able to transfer critically unwell COVID-19 positive patients. The highly<br />

infectious nature of COVID-19, particularly in relation to performing<br />

Aerosol Generating Procedures (AGPs), required specifi c protective<br />

measures to be taken to safely transfer COVID-19 patients, without<br />

putting EMS or associated personnel, such as pilots, at risk [4]. In the<br />

<strong>UK</strong>, pre-hospital critical care teams such as Helicopter Emergency<br />

Medical Services (HEMS) have adapted, overcome, and continued to<br />

deliver high acuity trauma and medical care to patients at their time of<br />

need. In addition, several HEMS services rapidly adapted to provide<br />

a critical care transfer capability. Indeed, the combination of highly<br />

experienced senior clinicians working within a mature governance<br />

framework alongside an established transport platform, lent itself well to<br />

HEMS services adapting to undertake work of this nature.<br />

Critical care transfer medicine has several essential areas which<br />

require careful consideration [5]. These considerations were especially<br />

highlighted in the context of ICU-level COVID-19 patients, due to their<br />

need for complex multi-organ support, particularly advanced ventilatory<br />

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support, and their physiological fragility. The challenge of these<br />

transfer cases was often exacerbated by short notice, urgent referrals<br />

for transfers over significant distances and the need for escorting<br />

clinicians to wear level 3 /ICU Personal Protective Equipment (PPE)<br />

throughout. This paper provides a descriptive overview of how our <strong>UK</strong><br />

HEMS service, in collaboration with our local National Health Service<br />

(NHS) ambulance provider (South East Coast <strong>Ambulance</strong> Service NHS<br />

Foundation Trust—SECAmb), rapidly evolved to provide an aeromedical<br />

transfer capability for COVID-19 patients. We present a pragmatic<br />

review of the first 50 COVID-19 transfers undertaken by Air <strong>Ambulance</strong><br />

Kent Surrey Sussex and highlight key lessons learned that would be<br />

useful to other EMS services tasked with setting up such a service.<br />

Methods<br />

Air <strong>Ambulance</strong> Kent Surrey Sussex (AAKSS) delivers care to a mixed<br />

urban and rural area, covering 4.5 million people across the south east<br />

of England. The HEMS team comprises of an experienced physician<br />

and paramedic, capable of delivering enhanced care, including<br />

pre-hospital emergency anaesthesia, blood product administration,<br />

procedural sedation and emergency surgery. These interventions<br />

cannot be routinely performed by land ambulance crews. The HEMS<br />

service operates from two separate bases, responds 24/7 and can<br />

respond in either a helicopter or response car, depending on geography<br />

and weather limitations. Patients are transported to hospital either by<br />

helicopter or land ambulance.<br />

In December 2020, a so-called “Kent” variant (subsequently known as<br />

B.1.1.7.) of COVID-19 which appeared more contagious than other<br />

variants, rapidly spread through the south east of England, the region<br />

which AAKSS serves. The number of critically unwell patients rapidly<br />

challenged the intensive care unit (ICU) capacities within many of the<br />

hospitals of Kent, Surrey and Sussex. As part of a national strategy,<br />

overseen by the NHS, to maintain equitable access to critical care,<br />

coordination and provision of a robust critical care transfer capability<br />

became a necessity [3]. With a notice period of just a few weeks,<br />

AAKSS developed a Critical Care Transfer Service to dovetail with<br />

its primary pre-hospital emergency medicine (PHEM) duties. To build<br />

in layers of safety, a number of standardised processes were rapidly<br />

implemented.<br />

Results<br />

The key elements that needed to be established for a dedicated<br />

aeromedical transfer service to launch are described below. These<br />

elements were considered by all authors as the most important when<br />

having to rapidly adapt from primary HEMS work to secondary COVID<br />

transfers.<br />

Coordination and activation of a specifically tailored and<br />

rehearsed level 3 COVID-19 transfer process<br />

Transfer requests were identified via a central process to SECAmb<br />

following a daily regional meeting and subsequently passed to the<br />

AAKSS Duty Clinical Manager. This would commence a chain of defined<br />

concurrent activity in order to plan the conduct of the tasking. Each<br />

individual transfer request was overseen by the Duty Clinical Manager<br />

and an on-call AAKSS HEMS Transfer Consultant (with experience<br />

in both pre-hospital emergency medicine and current ICU COVID-19<br />

care). The Duty Transfer crew consisted of a Transfer Doctor (who<br />

was an AAKSS HEMS doctor from an ICU-Anaesthesia specialty) and<br />

an AAKSS Transfer Paramedic. The temporal nature of identifying<br />

and tasking a transfer following the receipt of requests after regional<br />

meetings meant that transfers typically occurred in the afternoon and<br />

evening. The process overview is shown in Fig. 1.<br />

Case “Interrogation” process<br />

Requests for COVID-19 transfers were coordinated at regional level<br />

by the NHS England Improvement critical care coordination cell and<br />

SECAmb. Each request was considered on an individual basis by<br />

AAKSS. A patient selection proforma utilised a specifically tailored case<br />

interrogation template, as shown in Fig. 2. The complexity, instability and<br />

physiological fragility of COVID-19 patients meant that rigorous clinical<br />

interrogation, with case-by-case consideration of the challenges posed<br />

by moving these patients was required on each occasion.<br />

Prior to deploying on a transfer tasking, a “command huddle” was<br />

conducted. At the command huddle the transfer team, duty transfer<br />

consultant and duty clinical manager would appraise the clinical and<br />

logistic aspects of the case, identify potential risks and pitfalls, discuss<br />

mitigation strategies, and decide the most appropriate course of action.<br />

Particularly complex or high risk transfers were escalated to the Medical<br />

Director for further review and final decision making.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

At the time of implementation, ICUs in the south east of England were<br />

under unprecedented pressure. There would often be several patients<br />

on particular hospital sites requiring admission to ICU when the local<br />

unit was already at capacity. To manage system capacity, patients were<br />

transferred between ICUs, with the most stable patients being selected<br />

for transfer. These would often involve non-COVID patients.<br />

We review the steps required to set up an aeromedical transfer service<br />

capable of safely and robustly moving Level 3 COVID-19 positive<br />

patients; the training, operational and medical elements needed to<br />

deliver such a service safely and effectively and we present key lessons<br />

learned from the first 50 COVID-19 transfers. The key elements were<br />

based on internal expert opinion and we sought to present a pragmatic,<br />

descriptive approach to inform other pre-hospital services involved in the<br />

transport of COVID-19 patients.<br />

Workforce<br />

The AAKSS crew was a doctor and paramedic. The doctors were all<br />

experienced, long-standing AAKSS PHEM doctors and were additionally<br />

Consultants in Anaesthesia and Intensive Care Medicine and had recent<br />

and regular ongoing exposure to patients who were critically unwell with<br />

COVID-19. The AAKSS paramedics had undertaken concurrent training<br />

in specific elements of critical care and COVID-19 [6]. This specific crew<br />

configuration allowed for a familiarity in caring for the critically unwell<br />

patient in the out-of-hospital environment. Familiarity between members<br />

of the workforce was a particularly important factor in overcoming the<br />

additional and significant challenges posed by operating in full Level 3<br />

PPE. Personal protective equipment need to be in-line with standard<br />

hospital practice including eye protection, FFP3 masks and surgical<br />

gowns. Crews were also given the option of wearing Positive Airway<br />

Pressure Respirator hoods.<br />

8<br />

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AAKSSCCTT Request<br />

AAKSS Critical Care Transfer Team (CCTT) Process<br />

SECAmb Critical Care Transfer desk<br />

request<br />

Duty Manager<br />

Initial AAKSS Call Handler. Attains:-<br />

1)Patient demographics and basic clinical<br />

synopsis. 2) Details and contacts of<br />

Referring and Receiving ICU Consultants<br />

andNurses-In-Charge<br />

Critical Care<br />

Transfer Team<br />

Activation<br />

Flowchart<br />

CCTT Pre-Alert<br />

Transfer Doctor Paramedic Duty Manager&HEMS Pilot<br />

Case Interrogation &Preparation<br />

Communication&CCTT Activation<br />

Clinical Interrogation<br />

Process, viaReferring<br />

andreceiving ICU<br />

Consultants.<br />

Issue Transfer “Wish-<br />

List” request<br />

Equipmentand<br />

logistical<br />

preparation.<br />

CCTT Pre-missionCommand Huddle<br />

Tactical &Logistic<br />

assessment:-<br />

Land<br />

Aviation<br />

Hybrid –Land-<br />

Aviation<br />

Oncall Transfer Consultant,Critical Care Transfer Team,Duty Manager<br />

+/- Pilots.<br />

Discussthe case together,assessing theclinical, transfer andaviation<br />

riskswithappropriate mitigation strategies. Concludewitha“plan<br />

proposed”for theTransferMission Cycle<br />

Transfer Doctor<br />

Inform ReferringICU of<br />

CCTT activation andETA<br />

Reaffirm Communication<br />

on Comprehensive<br />

DischargeSummary,<br />

Equipment, Packaging<br />

andDrugpreparation:-<br />

- Infusions<br />

- Emergency drug<br />

Transfer accepted<br />

Paramedic<br />

Inform HEMS desk<br />

on CCTT activation<br />

andthe proposed<br />

logistical details<br />

Pre-Departure<br />

Checklist<br />

Transfer declined<br />

Duty Managerinforms<br />

HEMS desk &SECAmb<br />

Critical Care transfer<br />

desk<br />

Doctor informs<br />

ReferringICU<br />

30 mins<br />

15 mins 10 mins<br />

Team Activation<br />

Team StandDown<br />

Fig. 1 AAKSS critical care transfer process<br />

Training<br />

A competency-based critical care transfer training module was<br />

developed and instituted to ensure specific training and currency in<br />

critical care practice and the management of patients with multi-organ<br />

dysfunction. Training built upon the pre-existing PHEM practices and<br />

expertise and, as the service developed, was further enhanced, and<br />

standardised to a formal training pathway for Critical Care Transfer<br />

Medicine. All transfer team members undertook a HEMS Transfer<br />

Training day, alongside a half day Critical Care COVID Transfer Medicine<br />

Package, with a specific focus on the physiology, pharmacology and<br />

practical techniques required to manage complex and critically ill<br />

patients. Individual crew members were then required to complete a<br />

curriculum of core clinical topics, equipment competencies and logistic<br />

considerations. It took varying amounts of time for crew members to<br />

develop competence and confidence in critical care transfer and while<br />

there was no set time to complete the training log, 2–4 weeks was<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

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AAKSSCriticalCareTransfer TeamInterrogation Template<br />

Transfer Details [Completed by HEMS Duty Clinical Manager]<br />

Date of transfer<br />

Time<br />

request<br />

Referring<br />

Name andcontact<br />

Hospital<br />

Referringhospital<br />

Consultant and<br />

Nurse-in-charge<br />

Contactnumber:<br />

Receiving<br />

Hospital<br />

Precise<br />

DestinationDetails<br />

Name andcontact<br />

Receiving hospital<br />

Consultant and<br />

Nurse-in-charge<br />

PatientDetails [Completed by HEMS Duty Clinical Manager]<br />

Name : DoB :<br />

Reasonsfor<br />

Transfer<br />

Specialist<br />

requirement:<br />

COVIDStatus<br />

Briefclinical<br />

synopsis<br />

Capacity<br />

Clinical<br />

Repatriation<br />

Positive<br />

Negative<br />

Patient’sWeight<br />

(Kg)<br />

Specific access<br />

instruction:<br />

Clinical information [Completed by Duty Crew Transfer Doctor]<br />

ReferringHospital<br />

ReceivingHospital<br />

andprecise<br />

andprecise<br />

location<br />

location<br />

Referring<br />

Consultant<br />

Receiving<br />

Consultant<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

Family informed<br />

Clinical Overview<br />

Clinical history:<br />

Fig. 2 AAKSS critical care transfer planning sheet<br />

Yes<br />

No<br />

suggested. During this period the crew member also undertook at<br />

least four transfer shifts under the supervision of a Transfer Consultant.<br />

Family Contacts<br />

[Ifavailable]<br />

Name:<br />

Contactnumber:<br />

Training culminated in a full day sign-off assessment, including a clinical<br />

viva, equipment test and clinical long case discussion.<br />

10<br />

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Equipment<br />

A specific, dedicated set of transfer equipment and bags were<br />

assembled. The content was based on the need to maintain the highest<br />

standards of intensive care throughout the duration of the transfer.<br />

Ventilation was provided with a Dräger Oxylog 3000 ventilator in line with<br />

our primary HEMS work and monitoring maintained using the Tempus<br />

Pro Monitor (Phillips RDT). This allowed for the added advantage of<br />

recording physiological data directly into the electronic clinical record.<br />

Infused medicines were delivered via Braun perfusor syringe drivers.<br />

Using identical equipment to that used in primary HEMS work was<br />

an important consideration in order to enhance the safety of this type<br />

of work and minimise the cognitive load that comes with managing<br />

patients of this complexity. The transfer kit was physically entirely<br />

separate to the HEMS kit and could be deployed onto a land ambulance<br />

or helicopter.<br />

Transfer platform and infrastructure<br />

All critical care transfers were considered for transfer via land, air or<br />

a land-air hybrid. Given the complicated geography in our region,<br />

with a mix of urban areas within rural and coastal settings, the<br />

potential opportunity for air or hybrid transfer mission cycles allowed<br />

an enhancement in care by decreasing the period a sick COVID-19<br />

patient was out of a hospital ICU environment. This also accelerated the<br />

regeneration of the critical care transfer crew. Several transfers, including<br />

the long distance mission cycles, whilst considered for air transfers,<br />

often resulted in either pure land or hybrid transfers. Overall, 94% of the<br />

transfer missions were conducted by land. This was due to the time<br />

of year being winter (December-<strong>February</strong>), with both light and weather<br />

restrictions, which made long distance critical care transfers by air using<br />

visual flight rules challenging to undertake.<br />

Care of the COVID-19 patient during transfer<br />

Meticulous handling of the COVID-19 patient was required prior to,<br />

during, and after transfer. Respiratory failure was the overwhelming<br />

organ failure, requiring multi-faceted management strategies, particularly<br />

for refractory hypoxia. Stabilising the patient on the transport ventilator<br />

was a particular challenge for some patients and was typically<br />

attempted early in the transfer process. In practice, our transfer team<br />

most commonly encountered pressure-controlled ventilation. Our team<br />

mirror the pressure setting as the initial step of ventilator transition.<br />

We then closely observe the changes of the patient’s minute volume.<br />

If minute volume reduced, our team will implement an incremental<br />

increase to inspiratory pressure until the desired minute volume is<br />

achieved. We allowed permissive hypercapnia. We obtained an arterial<br />

blood gas sample 15 min after the transition to the transport ventilator<br />

(Oxylog 3000). To avoid patient-ventilator asynchrony during the mission,<br />

deep sedation and paralysis were used for the entire transfer journey.<br />

Interpersonal relationships, human factors and communication<br />

The management of a COVID-19 patient is made harder by the need<br />

to work carefully in full PPE. Clear communication was therefore<br />

imperative. As a Critical Care Transfer Team, it was important to forge<br />

relationships with referring critical care teams, clearly communicate<br />

with the receiving ICU and work cohesively alongside a number of new<br />

groups of health professionals and team members. The primary PHEM<br />

training and practices, particularly in crew resource management (CRM)<br />

and communication skills, proved a core strength and foundation for the<br />

critical care transfer capability response.<br />

Aircraft modification<br />

To protect the pilots, a sealed barrier curtain was installed between<br />

the cockpit and cabin section of the AW169 helicopter. This achieved<br />

a hermetic seal with different air supplies to the pilot and patient cabin<br />

sections. Pilots flew with standard surgical masks, following testing<br />

and approval of radio communications whilst wearing them. The size<br />

and specification of the AW169 cabin allowed for excellent access to<br />

the patients throughout flight, and the ability to maintain monitoring<br />

and titrate infusions presented no problems. A closed suction system<br />

allowed for in-flight suction of the trachea if required.<br />

Clinical Governance<br />

A specific Clinical Governance framework was established that<br />

mirrored that of AAKSS primary missions but stood as an independent<br />

framework. Whilst this specific process was created de novo to address<br />

a specific challenge in the critical care transfer of level 3 COVID-19<br />

patients (Fig. 1), it was embedded in a mature system of standard<br />

operating procedures, governance and logistics. A dedicated Transfer<br />

Consultant was on-call for remote support and all cases underwent<br />

detailed case review.<br />

Analysis of the 50 critical care transfers<br />

during the <strong>UK</strong> COVID-19 s wave<br />

Between 18 December 2020 and 1 <strong>February</strong> 2021, AAKSS in<br />

collaboration with SECAmb performed 50 adult critical care transfers in<br />

support of the <strong>UK</strong> COVID-19 response.<br />

All 50 of these critical care transfers were undertaken to urgently help<br />

with ICU capacity across the region. These ICUs were all managing<br />

patient numbers significantly beyond their normal footprint. As a result,<br />

through a nationally coordinated initiative, other ICUs with capacity were<br />

identified to provide mutual aid, often in areas a significant distance<br />

away.<br />

The complex implications of COVID-19 on the vascular structure and<br />

haematological dynamics, often with a pro-thrombotic propensity,<br />

gave these patients a uniquely precarious physiological fragility. The<br />

interrogation process between the referring ICU consultant and transfer<br />

team was important, but a further dynamic assessment of the patient<br />

was essential on transfer team arrival at the referring ICU. Gentle<br />

bridging on to transfer specific infusion pumps, ventilator, monitoring<br />

and bed was essential followed by careful handling of the patient’s<br />

complex pathophysiology. Pre-arrival requests were structured, as<br />

shown in Fig. 3.<br />

Of the 50 critical care transfers, 45 (90%) were critically unwell patients<br />

receiving Level 3 multi-organ support. 5 (10%) patients were receiving<br />

Level 2 care and all of these were for non-COVID-19 disease processes.<br />

All missions had data entered in real time into the AAKSS patient record/<br />

mission data system (HEMSbase, Medic One Systems Ltd). A specific<br />

section had already been created to record secondary transfer missions.<br />

All data were then analysed retrospectively.<br />

The mean age of these patients was 58 years (range 29–83). 30 (60%)<br />

were male and 20 (40%) were female.<br />

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Transfer team communicationchecklist and“wish list”<br />

Airway<br />

ETT/ Tracheostomy well secured<br />

Sparetracheostomypackwithinner cannula<br />

In-linesuction catheter<br />

NewHME filter made ready for transfer<br />

Blue Soft-tooth blue clamp/metalclamp with gauze<br />

Breathing<br />

Stable on ventilator<br />

CD cylinder<br />

Circulation<br />

CentralAccess(ideallyright Internal jugular)<br />

Twoperipheralcannula (ideally oneright sided)<br />

Arterial line (ideally rightradial)<br />

Rationalisenon-essential infusions<br />

Capoff allunusedlines<br />

1x 1000ml Crystalloidattachedtodedicated line (orlumen of CVC)<br />

Disability<br />

Ensure patientsedation+/- muscle relaxation<br />

Exposure and NG tube aspirated&capped<br />

packaging<br />

Urinarycatheterinsitu&Catheter bagemptied<br />

2x sheets /blankets<br />

Drugs&infusion preparation Will need to be Tailored to MissionCycle<br />

Infusions<br />

Propofol 1% in 50ml Luer lock syringex2<br />

Fentanyl 50mcg/ml in 50ml Luer lock syringes x1<br />

Noradrenaline4mg in 50ml Luer lock syringes x2<br />

Otheressential drug spareinfusion<br />

Boluses<br />

Rocuronium 100mgin10mlx2<br />

Propofol 1% in 20ml x1<br />

Fentanyl 500mcg in 10ml x1<br />

Emergencydrugs Metaraminol10mgin20mlx1<br />

Adrenaline 1mgin10mlmini-jet<br />

Documentation&Communication<br />

Comprehensivedischarge summarycopiesx2<br />

Allclinicalnotes photocopied/printed<br />

Family informed<br />

Fig. 3 Transfer team communication checklist<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

The AAKSS aircraft was used for 3 (6%) transfers and 47 (94%) were<br />

moved by road. To our knowledge, this represented the first civilian air<br />

transfers of COVID-19 positive patients in the <strong>UK</strong>.<br />

All of these patients were invasively ventilated with mandatory or<br />

pressure support ventilation. 45 (90%) of these patients had an<br />

endotracheal tube in situ and 5 (10%) had a tracheostomy sited to<br />

facilitate weaning from mechanical ventilation.<br />

The mean FiO 2<br />

at referral was 0.45 (0.21–0.8). 17 (34%) patients were<br />

established on vasopressor support at the point of referral, versus 33<br />

(66%) on no cardiovascular support. All 17 patients on vasopressor<br />

support were receiving noradrenaline, with 1 patient also receiving<br />

dobutamine.<br />

The mean total mission cycle (time of referral until the time team<br />

declared free at receiving hospital) was 264 min (range 149–440 min).<br />

The mean time spent at the referring hospital prior to leaving for the<br />

receiving unit was 72 min (31–158). The mean transfer transit time<br />

between referring and receiving units was 72 min (9–182).<br />

During this period, no significant adverse events occurred and there<br />

were no instances of transfer team members or pilots contracting<br />

COVID-19 as a result of a transfer mission.<br />

Discussion<br />

AAKSS successfully implemented a fully functional critical care<br />

transfer service capable of moving critically ill COVID-19 patients by<br />

air. The majority of these patients were in multi-organ failure due to<br />

COVID-19 infection. The adherence to a standardised pathway with an<br />

interrogation process allowed for an efficient service, which focussed on<br />

patient safety. The investment in the workforce and subsequent crew<br />

configuration was labour intensive, but ensured a robust and consistent<br />

service. The training elements and governance were imperative in<br />

12<br />

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ensuring responsive practices, especially as our clinical approach to<br />

COVID-19 evolved. Having a dedicated AAKSS Transfer Consultant and<br />

the ability to activate “Command Huddles” throughout a critical care<br />

mission were both useful for patient care but also for supporting crews<br />

and fostering interpersonal relationships across healthcare providers<br />

during a very challenging time. The authors of this paper would<br />

recommend using these interventions, which we believe enhanced<br />

mission and organisational safety.<br />

The need for local, regional and national coordination of critical care<br />

assets and transfer requirements is imperative for future pandemic<br />

initiatives. To optimise the available time of the critical care transfer<br />

teams, planning should ideally occur on an ongoing basis, with patients<br />

identified for transfer the preceding night. This allows transfer teams<br />

to maximise their impact. This is particularly important for aeromedical<br />

teams who may be better operated in daylight conditions. The<br />

number of COVID-19 transfers conducted by air was limited, largely<br />

by environmental factors. As familiarity and efficiency of the transfer<br />

systems evolves, we anticipate increased air transfers.<br />

To our knowledge, AAKSS was the first civilian air ambulance service to<br />

move COVID-19 patients by air in the <strong>UK</strong>. This was achieved through<br />

early engagement with the required authorities to gain approval for the<br />

safety procedures put in place to protect pilots from the risk of infection.<br />

The use of an aeromedical transport platform has the potential to<br />

confer a significant advantage for patients moved over large distances.<br />

Any concerns regarding the potential physiological insult posed by<br />

altitude are negligible by helicopter transport in our region, with flights<br />

undertaken at around 1000 ft above sea level.<br />

Our teams spent a significant amount of time on arrival at the referring<br />

hospital when compared to our scene times for primary HEMS work.<br />

The time was largely due to the physiological complexity of COVID-19<br />

patients, including, for example, the careful transfer of the patient from an<br />

ICU to a transport ventilator and the associated interventions required to<br />

ensure a safe and stable critical care transfer. In this particular example,<br />

although the assessment of stability and suitability to be moved on a<br />

transport ventilator could be streamlined by having the referring hospital<br />

undertake ventilator exchange prior to transfer team arrival.<br />

presented in this paper will likely be useful to other services.<br />

Further research is warranted, particularly with regards PPE and how<br />

best to prevent cross-infection during transfer of COVID-19 patients [9,<br />

10]. As further waves of COVID-19 patients stretch emergency medical<br />

services globally, sharing of experience will be invaluable.<br />

Conclusions<br />

The COVID-19 pandemic has placed unprecedented pressures on<br />

critical care resources, necessitating the rapid establishment of adult<br />

critical care transfer services to decompress overwhelmed hospitals,<br />

to support clinicians and minimise preventable loss of life due to<br />

resource depletion. Critically ill COVID-19 patients have highly complex<br />

medical needs during transport. Critical care transfer of COVID-19<br />

positive patients by civilian HEMS services, including air-transfer, can<br />

be achieved safely with specific planning, protocols and precautions.<br />

Regional planning of COVID-19 critical care transfers is required to<br />

optimise the time available of critical care transfer teams.<br />

Abbreviations<br />

AAKSS: Air <strong>Ambulance</strong> Kent Surrey Sussex; AGP: Aerosol generating<br />

procedure; EMS: Emergency Medical Service; HEMS: Helicopter<br />

Emergency Medical Service; ICU: Intensive Care Unit; PHEM: Pre-hospital<br />

emergency medicine; PIU: Patient isolation unit; PPE: Personal protective<br />

equipment; SECAmb: South East Coast <strong>Ambulance</strong> Service Trust.<br />

Acknowledgements<br />

At AAKSS we would like to acknowledge and thank South East Coast<br />

<strong>Ambulance</strong> Service NHS Trust for its support in setting up of our Critical<br />

Care Transfer capability. Similarly, thank you to the Independent <strong>Ambulance</strong><br />

Providers, Platinum and Medi-4. We also wish to thank Specialist Aviation<br />

Services, who supported the aircraft modification process, allowing for air<br />

transfer of COVID-19 confirmed or suspected patients.<br />

Authors’ contributions<br />

All authors were involved in the service provision, data collection, analysis<br />

and manuscript writing. All authors read and approved the final manuscript.<br />

Other pre-hospital services have published their experience of<br />

transferring critical COVID-19 patients [1, 7]. Several providers described<br />

the effective use of patient isolation units (PIU) [1]. AAKSS was<br />

concerned about the limitations of being able to treat critically unwell<br />

patients whilst in a PIU and therefore focussed on securing the entire<br />

rear of the helicopter to prevent infection. Similar to other published<br />

research, only a minority of transfers were completed by air, highlighting<br />

the technical challenges of air transport of COVID-19 patients. However,<br />

for long distance transfer of COVID-19 patients, air is likely to be the<br />

faster and more effective transport platform [8].<br />

We recognise that this is a relatively small descriptive study over a short<br />

time period. We acknowledge that our experience will not necessarily be<br />

applicable to all services, particularly outside the <strong>UK</strong>. However, we have<br />

demonstrated a method for a HEMS service to rapidly, effectively and<br />

safely stand up a critical care transfer service capable of moving level 3<br />

COVID-19 patients by both land, air or a hybrid model. We have shown<br />

this is possible in the civilian setting and the policies and protocols<br />

Funding<br />

No funding was received for this study.<br />

Availability of data and materials<br />

All data is presented.<br />

Declarations<br />

Ethical approval and consent to participate<br />

This study met criteria for service evaluation, as defined by the <strong>UK</strong> National<br />

Institute of Healthcare Research. Formal ethical approval was therefore<br />

not required. All data was sourced from the internal AAKSS database. No<br />

competing interests were declared. No funding was received for this study.<br />

All authors contributed to data review and manuscript writing.<br />

Consent for publication<br />

All authors give consent for publication. Patient consent is not required<br />

as this paper met <strong>UK</strong> NIHR criteria as a service evaluation.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

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Competing interests<br />

None to declare.<br />

Author details<br />

*<br />

Correspondence: RichardL@aakss.org.uk<br />

1<br />

Air <strong>Ambulance</strong> Kent Surrey Sussex, Redhill Aerodrome, Redhill, Surrey<br />

RH1 5YP, <strong>UK</strong>.<br />

2<br />

University of Surrey, Guildford, <strong>UK</strong>.<br />

Received: 25 September 2021 Accepted: 4 January <strong>2022</strong><br />

Published online: 15 January <strong>2022</strong><br />

References<br />

1. Hilbert-Carius P, Braun J, Abu-Zidan F, Adler J, Knapp J,<br />

Dandrifosse D, et al. Pre-hospital care & interfacility transport of<br />

385 COVID-19 emergency patients: an air ambulance perspective.<br />

Scand J Trauma Resusc Emerg Med. 2020;28(1):94.<br />

2. Martin-Loeches I, Arabi Y, Citerio G. If not now, when? A clinical<br />

perspective on the unprecedented challenges facing ICUs during<br />

the COVID-19 pandemic. Intensive Care Med. 2021;47(5):588–90.<br />

3. Pett E, Leung HL, Taylor E, Chong MSF, Hla TTW, Sartori G,<br />

Sathianathan V, Husain T, Suntharalingam G, Rosenberg A, Walsh<br />

A, Wigmore T. Critical care transfers and COVID-19: managing<br />

capacity challenges through critical care networks. 2020.<br />

2020100125. https://doi.org/10.20944/preprints202010.0125.v1.<br />

4. El-Boghdadly K, Wong DJN, Owen R, Neuman MD, Pocock S,<br />

Carlisle JB, et al. Risks to healthcare workers following tracheal<br />

intubation of patients with COVID-19: a prospective international<br />

multicentre cohort study. Anaesthesia. 2020;75(11):1437–47.<br />

5. Intensive Care Society. Clinical Guidance: Assessing<br />

whether COVID-19 patients will benefi t from critical care,<br />

and an objective approach to capacity challenges. 2020.<br />

www.wcctn.wales.nhs.uk/sitesplus/documents/1210/<br />

COVID%5F19%5Fcare%5Fguidance%5F5may%5Fendorsed.pdf.<br />

Accessed 13 July 2020.<br />

6. Foex B, Van Zwanenberg G, Handy J et al. Guidance on: the<br />

transfer of the critically ill adult. The Faculty of Intensive Care<br />

Medicine. 2019. www.fi cm.ac.uk/sites/default/fi les/transfer_<br />

critically_ill_adult_2019.pdf. Accessed 15 June 2020.<br />

7. Albrecht R, Knapp J, Theiler L, Eder M, Pietsch U. Transport of<br />

COVID-19 and other highly contagious patients by helicopter and<br />

fi xed-wing air ambulance: a narrative review and experience of<br />

the Swiss air rescue Rega. Scand J Trauma Resusc Emerg Med.<br />

2020;28(1):40.<br />

8. Reimer AP, Dalton JE. Predictive accuracy of medical transport<br />

information for in-hospital mortality. J Crit Care. 2018;44:238–42.<br />

9. COVID-19 infection prevention and control guidance: aerosol<br />

generating procedures [Internet]. GOV.<strong>UK</strong>. Cited 8 May 2021.<br />

https://www.gov.uk/government/publications/wuhan-novelcoronavirus-infection-prevention-and-control/covid-19-infectionprevention-and-control-guidance-aerosol-generating-procedures<br />

10. Liu Z, Wu Z, Zhao H, Zuo M. Personal protective equipment during<br />

tracheal intubation in patients with COVID-19 in China: a crosssectional<br />

survey. Br J Anaesth. 2020;125(5):e420–2.<br />

Publisher’s Note<br />

Springer Nature remains neutral with regard to jurisdictional claims in<br />

published maps and institutional affi liations.<br />





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County Air<br />

<strong>Ambulance</strong> HELP<br />

Appeal makes third<br />

£250,000 donation to<br />

British Association<br />

for Immediate Care<br />

In addition to new RRVs<br />

and PPE, the main focus for<br />

schemes eligible for funding this<br />

year, will be acquiring lifesaving<br />

capital equipment such as<br />

defibrillators and monitors.<br />

The County Air <strong>Ambulance</strong> HELP<br />

Appeal, the only charity in the<br />

country dedicated to funding<br />

hospital helipads and to ensuring<br />

patients with life threatening<br />

conditions get the fastest<br />

treatment possible, has given its<br />

third annual grant of £250,000<br />

to the British Association for<br />

Immediate Care.<br />

Divided into 32 regional schemes,<br />

the Association is a national<br />

network of medical, nursing and<br />

paramedic volunteers, who give<br />

up their free time to be on call to<br />

help NHS <strong>Ambulance</strong> Services,<br />

ensuring they get support for<br />

critical incidents 24 / 7. This<br />

third grant from the County Air<br />

<strong>Ambulance</strong> HELP Appeal, brings<br />

the total amount donated to<br />

£750,000.<br />

All schemes across the country<br />

were invited to apply for a share<br />

of the latest £250,000 donation.<br />

Previous grant rounds have funded<br />

emergency response vehicles in<br />

different parts of the <strong>UK</strong> along with<br />

essential clinical and protective<br />

equipment. This round of funds<br />

has been similarly available with the<br />

focus being on capital equipment<br />

such as defibrillators and monitors<br />

- each costing in the region of<br />

£12,000 to £15,000.<br />

Robert Bertram, Chief Executive<br />

of the County Air <strong>Ambulance</strong><br />

HELP Appeal said: “Our donations<br />

support these wonderful<br />

volunteers in making huge,<br />

practical improvements to their<br />

lifesaving services. New rapid<br />

response vehicles enable more<br />

medics to join their schemes,<br />

which increases the number of<br />

emergency incidents they can<br />

respond to. Meanwhile, new<br />

state-of-the-art technology for<br />

volunteers’ own vehicles, help<br />

them to arrive at a critical scene<br />

quickly and safely – a must during<br />

the winter months when driving<br />

conditions can be treacherous.<br />

I’m delighted that our funding this<br />

year will support patients directly<br />

through the purchase of lifesaving<br />

defibrillators and monitors.”<br />

Tony Kemp, Chief Officer, British<br />

Association for Immediate Care<br />

said: “The work of the British<br />

Association for Immediate Care<br />

has benefited so much from<br />

the previous two donations<br />

from the HELP Appeal and I am<br />

delighted that once again, on the<br />

back of what has been a very<br />

difficult 18-months, we are again<br />

beneficiaries of a further £250,000<br />

donation. The work of the<br />

Association’s affiliated schemes<br />

has continued throughout the<br />

pandemic and in common with<br />

so many other areas of life, the<br />

cost of lifesaving equipment has<br />

increased. This donation, being<br />

shared by a number of schemes<br />

will ensure that their lifesaving<br />

work continues, we are so grateful<br />

to the HELP Appeal for their<br />

ongoing generosity.”<br />

Paul Gates, Chairman, British<br />

Association for Immediate Care<br />

said: “This year the grant will be<br />

used for a range of lifesaving<br />

equipment to be used as our<br />

volunteers respond to 999 calls for<br />

their local NHS <strong>Ambulance</strong> service.”<br />

The County Air <strong>Ambulance</strong><br />

HELP Appeal’s latest grant has<br />

been distributed to the following<br />

schemes, which so far totals<br />

£134,000:<br />

• BASICS Dorset<br />

• BASICS Essex<br />

• BHECCS (Bedfordshire &<br />

Hertfordshire)<br />

• BRAVO Medics (Bristol)<br />

• CSI BASICS (Cheshire &<br />

Shropshire)<br />

• LIVES (Lincolnshire)<br />

• MARS BASICS (Mercia)<br />

• SWIFT Medics (Wiltshire)<br />

• West Yorkshire Medic<br />

Response Team<br />

The remaining £116,000 will be<br />

distributed to schemes early next<br />

year.<br />

Joe Blissett from LIVES in<br />

Lincolnshire said on receiving<br />

£10,000, which will fund<br />

dedicated blood transport bags<br />

for transporting blood to the<br />

scene of accidents across the<br />

county, “Fantastic news…this<br />

project is going to save many lives<br />

every year.”<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

(L-R) Dr Jon Barratt (Trustee), Mr Paul Gates (chair) & Dr Andy Pountney (vice-chair) with a cheque<br />

from the County Air <strong>Ambulance</strong> HELP Appeal.<br />

Junaid Mughal, speaking on<br />

behalf of the newly formed Beds<br />

and Herts Emergency Critical<br />

Care Scheme (BHECCS) said:<br />

“This is fantastic news, it will help<br />

a new scheme like BHECCS go a<br />

long way. It’s an early Christmas<br />

present for us as this grant will<br />

definitely be put to good use<br />

serving the people of Bedfordshire<br />

and Hertfordshire.”<br />

16<br />

For more news visit: www.ambulanceukonline.com


Gordon Tollefson, West Yorkshire<br />

Medic Response Team added:<br />

“This grant from BASICS, enabled<br />

by a donation from the HELP<br />

appeal, allows us to go ahead<br />

with the purchase of the ventilator<br />

and this will be a major step for<br />

us in saving lives when West<br />

Yorkshire Medic Response Team<br />

is first on scene.”<br />

NWAS<br />

NWAS helps develop<br />

a new mental health<br />

support programme<br />

for male NHS<br />

frontline workers<br />

We will be involved in the codevelopment<br />

of a new research<br />

project to support male NHS<br />

frontline workers, particularly<br />

those who have experienced<br />

emotional and mental health<br />

problems due to the COVID-19<br />

pandemic.<br />

The programme, called behavioural<br />

activation for low mood and<br />

anxiety in male NHS frontline<br />

workers, know and BALM, is<br />

funded by Movember and The<br />

Distinguished Gentleman’s<br />

Ride. BALM is being led by the<br />

University of York, delivered in<br />

partnership with our trust, York<br />

and Scarborough Teaching<br />

Hospitals NHS Foundation Trust<br />

and Tees Esk & Wear Valleys NHS<br />

Foundation Trust.<br />

Research from previous infectious<br />

disease epidemics shows that<br />

frontline health workers are at<br />

increased risk of developing<br />

both short and long-term mental<br />

health problems, with up to onethird<br />

experiencing high levels of<br />

distress.<br />

To combat this, the researchers<br />

will develop, deliver and evaluate<br />

this early intervention programme<br />

that aims to improve common<br />

mental health challenges such as<br />

low mood, burn-out, anxiety and<br />

depression faced by male frontline<br />

NHS workers. Around 45 male<br />

NHS frontline workers at risk of<br />

low mood will be recruited for the<br />

pilot, which starts in <strong>2022</strong>.<br />

They will receive a behavioural<br />

activation booklet and support<br />

from specially trained experts on<br />

how to get the most out of the<br />

programme. It’s expected to be<br />

rolled out across the NHS towards<br />

the end of the project in two<br />

years’ time.<br />

Consultant Paramedic, Steve<br />

Bell, who is a co-investigator<br />

of this programme and our<br />

Research Lead said, “It is clear<br />

that the COVID-19 pandemic has<br />

placed extreme demands on the<br />

emergency services provided<br />

by the NHS, and those frontline<br />

workers in these services have<br />

faced unprecedented pressures<br />

over this time. Ensuring male<br />

frontline workers, who are often<br />

disinclined to speak out and seek<br />

help, are supported is vital and<br />

this project offers the opportunity<br />

to study proven behavioural<br />

activation methods to support<br />

this potentially vulnerable group of<br />

NHS staff.”<br />

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AMBULANCE <strong>UK</strong> - FEBRUARY<br />

For the latest <strong>Ambulance</strong> Service <strong>Ambulance</strong><strong>UK</strong>_Ad_FINAL.indd News visit: www.ambulancenewsdesk.com<br />

1 13/01/<strong>2022</strong> 15:32<br />



YAS<br />

‘Significant progress’<br />

for apprenticeships at<br />

region’s ambulance<br />

service<br />

benefi cial impact on learners.<br />

Less than 10% of apprenticeship<br />

providers have achieved<br />

signifi cant progress across all<br />

three inspection themes.<br />

The Trust has been offering<br />

apprentices developing a wide<br />

range of substantial new skills and<br />

knowledge which they successfully<br />

put into practice in their jobs.<br />

Dawn Adams, Head of YAS<br />

Academy, said:<br />

Earlier last year, the Trust’s<br />

<strong>Ambulance</strong> Support Worker role<br />

won the gold Apprenticeship<br />

Programme of the Year award,<br />

ahead of seven other public and<br />

private sector fi nalists, at the<br />

national 2021 Learning Awards.<br />

Following an Ofsted (Office<br />

for Standards in Education,<br />

Children’s Services and Skills)<br />

inspection which took place<br />

in October 2021, Yorkshire<br />

<strong>Ambulance</strong> Service NHS Trust<br />

(YAS) has formally achieved<br />

significant progress in the three<br />

themes assessed.<br />

apprenticeships since October<br />

2018 and there are currently<br />

298 apprentices enrolled on<br />

level 3 and level 4 standardsbased<br />

apprenticeships including<br />

<strong>Ambulance</strong> Support Worker and<br />

Associate <strong>Ambulance</strong> Practitioner.<br />

The Ofsted inspection lasted two<br />

days and the areas which were<br />

“We are delighted with the<br />

outcome of the Ofsted inspection,<br />

and I am very proud of our<br />

Academy team. The Trust is<br />

highly committed to the provision<br />

of learning and apprenticeships,<br />

and the excellent support we<br />

have from stakeholders, learners<br />

and clinicians has helped us<br />

In addition, Morrisons has<br />

agreed to transfer £2.1m of its<br />

Apprenticeship Levy fund to<br />

Yorkshire <strong>Ambulance</strong> Service NHS<br />

Trust to help train the county’s<br />

future paramedics. The two-year<br />

programme is helping to pay for<br />

200 apprentices to be trained and<br />

means that the Trust will not have<br />

The Trust was commended for<br />

having a clear vision, an ambitious<br />

curriculum for apprenticeship<br />

provision which goes beyond<br />

the requirements of the<br />

qualifi cation, and experienced<br />

and knowledgeable educators<br />

delivering high quality training.<br />

assessed were quality of education,<br />

leadership and management and<br />

effectiveness of safeguarding<br />

arrangements in place.<br />

The inspection report highlighted<br />

many positives, including<br />

helpful careers guidance with<br />

a clear progression pathway to<br />

to develop and deliver the<br />

programmes.<br />

“We started the journey three<br />

years ago and, after a lot of<br />

hard work, being recognised<br />

by Ofsted with this rating is a<br />

huge achievement for everyone<br />

involved. We welcome the<br />

to access additional Government<br />

Apprenticeship Levy funding; the<br />

cost of this to the Trust would<br />

have been £100,000 (5%) and this<br />

is now being re-invested in patient<br />

care in the region.<br />

Mike Long, ESFA (Education and<br />

Skills Funding Agency) Senior<br />

Progress is deemed signifi cant<br />

paramedic, rigorous governance<br />

very positive feedback and look<br />

Skills Development Manager, said:<br />

when it has been rapid and is<br />

arrangements, exceptionally<br />

forward to building future success<br />

“It is great to see a new employer<br />

already having considerable<br />

well-planned curriculum with<br />

on this fi rm foundation.”<br />

provider being recognised as<br />


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making signifi cant progress<br />

with the implementation of<br />

an ambitious and high-quality<br />

apprenticeship programme which<br />

shows how apprenticeships can<br />

help tackle skills shortages in<br />

critical roles in the community.<br />

The programme has been<br />

well planned and excellently<br />

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challenging of circumstances and<br />

times and the Academy team fully<br />

deserves this recognition and I<br />

look forward to continuing to work<br />

with the team as the programme<br />

develops further.”<br />

Information on both clinical and<br />

non-clinical apprenticeships<br />

is available on the Yorkshire<br />

<strong>Ambulance</strong> Service website:<br />

www.yas.nhs.uk<br />

The Inspection report can be<br />

viewed at:<br />

https://reports.ofsted.gov.uk/<br />

provider/30/2539228<br />

WAST<br />

New technology<br />

to better support<br />

victims of domestic<br />

violence<br />

The Welsh <strong>Ambulance</strong> Service<br />

has introduced new technology<br />

to better support victims of<br />

domestic violence.<br />

<strong>Ambulance</strong> crews have been<br />

supporting patients to access<br />

Live Fear Free for help and advice<br />

on domestic violence since<br />

its creation using a bespoke<br />

telephone number.<br />

Now crews now have the ability to<br />

assist patients via an app on their<br />

Trust-issue iPad to speed up and<br />

streamline the process.<br />

Live Fear Free is a 24/7 helpline<br />

for women, children and men<br />

experiencing domestic abuse,<br />

sexual violence or other forms of<br />

violence against women.<br />

It is a main point of contact<br />

in Wales to access support,<br />

information, safety-planning,<br />

advocacy, refuge and counselling<br />

services.<br />

Nikki Harvey, the Welsh<br />

<strong>Ambulance</strong> Service’s Head of<br />

Safeguarding, said: “The Live Fear<br />

Free helpline is a free, confi dential<br />

24/7 specialist resource that<br />

anyone can access, at any time.<br />

“Welsh <strong>Ambulance</strong> Service crews<br />

have been using it for some<br />

years to signpost patients to help<br />

and support, using the good old<br />

fashioned telephone – until now.<br />

“Having the technology to refer<br />

patients digitally using iPads is not<br />

only more effi cient for crews, but<br />

it means that vulnerable patients<br />

get the support they need more<br />

quickly.<br />

“We all deserve to live without fear<br />

and in an environment which is<br />

safe, and modernising this referral<br />

pathway brings us a step closer<br />

to that.”<br />

Live Fear Free helpline manager,<br />

Ann Williams, said: “We are<br />

delighted to be working alongside<br />

the Welsh <strong>Ambulance</strong> Service,<br />

making our joint support of those<br />

most in need across Wales even<br />

more effi cient.<br />

“For staff at the helpline and the<br />

ambulance service alike, time is<br />

critical.<br />

“Using updated technology means<br />

that we can strengthen vital, timesaving<br />

communication methods,<br />

which will directly benefi t the<br />

women, men and children getting<br />

in touch, for whom support can<br />

often be life changing or even<br />

life-saving.”<br />

You can contact Live Fear Free by<br />

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07860 077333, emailing info@<br />

livefearfreehelpline.wales or by<br />

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AMBULANCE <strong>UK</strong> - FEBRUARY<br />

Stroke Association<br />

warns number of<br />

untreated strokes<br />

likely to increase<br />

during winter, due to<br />

rise in Omicron cases<br />

The <strong>UK</strong>’s largest stroke charity<br />

is warning people not to delay<br />

seeking treatment for stroke<br />

due to fear of Omicron.<br />

The Stroke Association is<br />

concerned that public fear of<br />

increasing COVID-19 rates, due to<br />

the Omicron variant, is likely to see<br />

a similar drop in stroke admissions<br />

seen at the start of the pandemic.<br />

During the first wave of the<br />

pandemic there was a significant<br />

decrease in admissions to stroke<br />

wards, when the COVID-19<br />

infection rate rose rapidly. The<br />

Stroke Association’s Recoveries<br />

at Risk report found this was due<br />

to patient worries over catching<br />

COVID-19 or being a burden on<br />

the NHS. Nearly a third (32%)<br />

of people who survived a stroke<br />

between March and June 2020<br />

said they delayed seeking medical<br />

attention due to COVID-19 (i) .<br />

With the added impact of reported<br />

ambulance delays, this is likely to<br />

intensify feelings of being a burden<br />

on the NHS, causing people to<br />

delay seeking medical treatment.<br />

To add to this potential crisis,<br />

new data shows that more<br />

people are living with unmanaged<br />

hypertension (high blood pressure)<br />

and other major stroke risk<br />

factors due to fewer regular<br />

in-person appointments where<br />

cardiovascular conditions (like<br />

high blood pressure) are spotted.<br />

Hypertension is the biggest risk<br />

factor for stroke, contributing to<br />

55.4% of stroke cases (ii) . This<br />

means that the stroke rate could<br />

rise as more people live with<br />

unmanaged hypertension than in<br />

previous years.<br />

In the <strong>UK</strong> there are over 100,000<br />

strokes per year and 1.3 million<br />

stroke survivors. A stroke is a<br />

medical emergency which is<br />

caused by a blockage or bleed<br />

in the brain cutting off blood<br />

supply. For every minute a stroke<br />

is untreated, 1.9 million brain cells<br />

die (iii) . Stroke is fatal in over one in<br />

eight (13.1%) patients (iv) . The main<br />

treatments for stroke, thrombolysis<br />

and thrombectomy, must be<br />

delivered as soon as possible<br />

within four and a half hours of<br />

symptoms starting, which is why<br />

is it vital to call 999 as soon as any<br />

sign of stroke appears. Stroke is<br />

the <strong>UK</strong>’s fourth biggest killer and<br />

the leading cause of adult disability.<br />

Key stats:<br />

• Acute stroke admissions fell by<br />

10.3% in England, Wales and<br />

Northern Ireland in the period<br />

23rd March to the end of May<br />

2020 (iv) , meaning a drop of over<br />

2,000 admissions in just over<br />

two months<br />

• This may have caused the<br />

54% rise in at home deaths for<br />

stroke in England and Wales (v) .<br />

• Of those who delayed seeking<br />

emergency medical attention,<br />

42% hadn’t wanted to burden<br />

emergency services (i)<br />

• And 34% of those who delayed<br />

seeking emergency medical<br />

attention were afraid of catching<br />

COVID-19 in hospital. (i)<br />

• 43% reduction in the rate of<br />

diagnosis of cardiovascular<br />

conditions (including high<br />

blood pressure) and a 29-52%<br />

reduction in first prescriptions<br />

of medications in March – May<br />

2020 (vi)<br />

• In 2015, it was reported that<br />

high blood pressure affected<br />

more than 1 in 4 adults in<br />

England (31% of men; 26% of<br />

women), which is around 13.5<br />

million people (vii)<br />

Juliet Bouverie, Chief Executive of<br />

the Stroke Association said: “When<br />

COVID cases rise as quickly as<br />

they are doing now, that sets<br />

off alarm bells at our charity and<br />

everyone involved in the treatment<br />

of stroke. More Omicron cases is<br />

likely to mean more preventable<br />

deaths and disability due to<br />

stroke, as people delay seeking<br />

emergency medical attention.<br />

“We know that people get scared to<br />

go to hospital when cases rise but<br />

stroke is a life-threatening condition.<br />

Fear of catching COVID and feeling<br />

like a burden on the NHS stopped<br />

people calling 999 in the past. This<br />

is likely to be even worse due to<br />

the news about ambulance delays.<br />

Stroke is an emergency medical<br />

condition and should be treated as<br />

an emergency from the moment<br />

you ring 999.<br />

“You have to remember that stroke<br />

is a brain attack and when you see<br />

any of the FAST signs of stroke in<br />

someone, this means that their brain<br />

is dying. You must raise the alarm;<br />

you must call 999 immediately.<br />

“After nearly two years in the<br />

pandemic we know that many<br />

people haven’t had their high blood<br />

pressure diagnosed because there<br />

haven’t been as many regular, inperson<br />

appointments with medical<br />

professionals such as GPs. That<br />

means more people are living with<br />

undetected high blood pressure<br />

and are at high risk of stroke. As<br />

a result, we could see even more<br />

people having a stroke than in<br />

previous years.”<br />

“Stroke clinicians and nurses as<br />

well as paramedics and therapists<br />

have worked tirelessly throughout<br />

the pandemic to maintain stroke<br />

services. Everyone at our charity<br />

is thankful for their hard work and<br />

support.”<br />

Gerald McMullen, Cardiff: “I had<br />

my stroke during lockdown and<br />

I’m so glad that my wife called<br />

999. It was a lifesaver. If you’re<br />

with someone who might be<br />

showing the symptoms of stroke,<br />

please make that 999 call. It’s vital<br />

that you do.<br />

“I got up in the morning and<br />

felt OK. I was sitting in my chair<br />

having a cup of tea when my wife,<br />

Linda, suddenly asked if I was OK.<br />

I said ‘yes’. However, she noticed<br />

that something was amiss. My<br />

outstretched arm, holding my cup,<br />

seemed rigid to her.”<br />

McMullen’s speech became “a little<br />

slurry”, and despite his insistence<br />

he was fine, his wife ignored him<br />

and called an ambulance. “Thank<br />

goodness,” he says.<br />

“She was on the phone to 999<br />

and was asked if my face had<br />

dropped – it hadn’t – and whether<br />

I could lift my arms, which by then<br />

I couldn’t. My speech did not<br />

make sense by this time either.”<br />

About 15 minutes later, two<br />

paramedics arrived and examined<br />

McMullen in his chair. “One of the<br />

paramedics got on the phone to<br />

hurry the ambulance along. The<br />

ambulance arrived and I managed<br />

to walk to it with support from a<br />

paramedic and my wife,”<br />

Due to the coronavirus pandemic,<br />

Linda could not accompany<br />

McMullen to the hospital, adding<br />

to an already scary situation. In<br />

the ambulance, his symptoms<br />

worsened.<br />

On arrival, he was taken for a<br />

scan, then taken to another<br />

department where his head<br />

was taped to a table and the<br />

thrombectomy carried out.<br />

“The stroke has left me with a<br />

legacy of a weak right arm,”<br />

McMullen says, “but I’m getting<br />

that back now too.” A minor<br />

inconvenience, he notes, which is<br />

much better than the alternative.<br />

“My foot is slightly swollen but<br />

that’s nothing, nothing at all.<br />

Without the thrombectomy I<br />

would have been in a much<br />

worse state. The doctors said I<br />

would have been catastrophically<br />

damaged. I could have died. I<br />

came through and I’m here now.<br />

“I thought ‘my God, I’ve had a<br />

stroke’. I’m so grateful that I was<br />

able to be up and about so quickly.<br />

Friends couldn’t believe it.”<br />

20<br />

For more news visit: www.ambulanceukonline.com


London’s Air<br />

<strong>Ambulance</strong> launches<br />

extra team to reach<br />

more critically-injured<br />

patients during winter<br />

months<br />

• New advanced trauma team<br />

on call for London during peak<br />

hours, bringing the hospital to<br />

the roadside<br />

• Additional team, ‘Medic 3’, will<br />

help London’s Air <strong>Ambulance</strong><br />

reach hundreds more trauma<br />

patients<br />

For the first time in its 32-year<br />

history, London’s Air <strong>Ambulance</strong><br />

is now operating with two duty<br />

teams on call for London this<br />

winter. Beginning in December,<br />

an additional medical team will<br />

support the service, responding<br />

to the most critically injured<br />

trauma patients in the capital<br />

by rapid response car.<br />

The extra team, known as<br />

‘Medic 3’, will operate Monday<br />

to Saturday from 14:00 to 24:00<br />

helping the advanced trauma<br />

teams of London’s Air <strong>Ambulance</strong><br />

be more resilient and ultimately<br />

reach more critically injured<br />

patients and respond more quickly<br />

during the winter rush hour. The<br />

team will consist of one senior<br />

doctor and one paramedic and<br />

the arrangement will be trialled<br />

for twelve months to analyse its<br />

impact.<br />

London’s Air <strong>Ambulance</strong> currently<br />

provides one advanced trauma<br />

team 24 hours per day, 365 days<br />

per year and attends around<br />

1,700 patients each year. The<br />

service uses a helicopter from<br />

08:00 to sunset switching to<br />

rapid response cars at night or<br />

in adverse weather conditions.<br />

London’s Air <strong>Ambulance</strong> expert<br />

teams can deliver complex lifesaving<br />

interventions at the scene<br />

of an incident such as pre-hospital<br />

emergency anaesthesia; blood<br />

transfusion; thoracotomy (a<br />

surgical procedure which opens<br />

up the rib cage cavity to manually<br />

massage the heart) and REBOA<br />

(where a balloon is fed into the<br />

major blood vessels through an<br />

injection into the leg), all of which<br />

are known to have increased<br />

patient survival rates after<br />

traumatic injury.<br />

London’s Air <strong>Ambulance</strong> forms<br />

part of the blue light community<br />

alongside its partners Barts NHS<br />

Health Trust and the London<br />

<strong>Ambulance</strong> Service (LAS), working<br />

collaboratively to deliver the best<br />

possible care to all major trauma<br />

patients, and this additional<br />

resource will operate as part of<br />

this wider team.<br />

As winter evenings draw in<br />

the aircraft goes offline earlier,<br />

currently around 16:00, meaning<br />

the team moves to deliver<br />

the service by rapid response<br />

vehicle at this time, significantly<br />

before rush hour and leaving the<br />

service reliant on only one team<br />

operating by road for the whole of<br />

London. Analysis of response time<br />

data, based on a single team,<br />

demonstrates that patients more<br />

distant from central London are<br />

not always reached as quickly<br />

during this window. Alongside<br />

this, the team may already be<br />

on scene with a patient when<br />

required elsewhere which results<br />

in cancelled missions for the<br />

service.<br />

This has meant that London’s Air<br />

<strong>Ambulance</strong> has been unable to<br />

attend all the patients who could<br />

have benefited from their expertise<br />

and on-scene interventions. The<br />

service estimates that in 2019,<br />

there were 195 additional patients<br />

to whom London’s Air <strong>Ambulance</strong><br />

would have gone to, which<br />

equates to around 60 additional<br />

emergency anaesthetics, 5<br />

thoracotomies and 18 code<br />

red patients (when a patient is<br />

bleeding to death and needs<br />

immediate intervention). The extra<br />

team will be able to respond to<br />

these sorts of emergencies as<br />

well as providing greater resilience<br />

for the service in the event of a<br />

major incident. Currently in these<br />

instances the London <strong>Ambulance</strong><br />

Service (LAS) will work alongside<br />

London’s Air <strong>Ambulance</strong> to ensure<br />

patients are treated as quickly as<br />

possible.<br />

Medical Director of London’s Air<br />

<strong>Ambulance</strong>, Dr Tom Hurst, said:<br />

“Time is precious when a life is on<br />

the line and we know that during<br />

the winter when the hours of dark<br />

overlap with peak travel times we<br />

are constrained in our response,<br />

particularly when our one team is<br />

already on scene with a patient.<br />

This additional team will help<br />

us reach more critically injured<br />

patients quickly when time is of<br />

the essence.<br />

“London’s Air <strong>Ambulance</strong> does<br />

not stand still and is constantly<br />

striving to better the service we<br />

provide to the people of London.<br />

Thanks to our partners at Barts<br />

NHS Health Trust and the London<br />

<strong>Ambulance</strong> Service and of course<br />

to our incredible supporters<br />

we’ve been able to get this extra<br />

team up and running, providing<br />

much-needed clinical support<br />

and helping ensure that, should<br />

the worst happen, London’s Air<br />

<strong>Ambulance</strong> will be there.”<br />

London <strong>Ambulance</strong> Service<br />

Deputy Chief Executive and Chief<br />

Medical Officer, Dr Fenella Wrigley<br />

said:<br />

“The introduction of an additional<br />

advanced trauma team this winter<br />

will be an incredibly valuable<br />

resource for the people of<br />

London.<br />

“The team, operated by a London<br />

<strong>Ambulance</strong> paramedic and<br />

Barts Health senior doctor, is an<br />

excellent example of collaborative<br />

working to help achieve the best<br />

possible care for trauma patients<br />

in the capital. The timing of<br />

this new expansion is also very<br />

welcome as the reduction in day<br />

light hours reduces the time the<br />

aircraft can operate. As we head<br />

into a challenging winter it will<br />

help us continue to bring clinical<br />

expertise to trauma scenes to<br />

help our most seriously injured<br />

patients.”<br />

Alistair Chesser, Group Chief<br />

Medical Officer at Barts Health<br />

NHS Trust, said:<br />

“The extra London Air <strong>Ambulance</strong><br />

team is well timed coming into<br />

winter and will be a great help<br />

in ensuring the most seriously<br />

injured patients get the specialist,<br />

life-saving care they need as<br />

soon as possible, both on the<br />

scene and in hospital.<br />

“We’re very happy to be working<br />

in collaboration with the London<br />

<strong>Ambulance</strong> Service and London<br />

Air <strong>Ambulance</strong> to allow us to<br />

reach hundreds more trauma<br />

patients.”<br />

London’s Air <strong>Ambulance</strong> is a<br />

charity, operating in partnership<br />

with Barts NHS Health Trust<br />

and London <strong>Ambulance</strong> Service<br />

(LAS) NHS Trust. Barts Health<br />

NHS Trust employs and pays<br />

the doctors who will form part<br />

of the Medic 3 team and LAS<br />

provide the paramedics who will<br />

also form part of the duty team,<br />

as well as the flight paramedic<br />

situated in the control room who<br />

is responsible for dispatching<br />

London’s Air <strong>Ambulance</strong> to the<br />

most critically injured people in<br />

London, 24 hours a day.<br />

Since its inception London’s<br />

Air <strong>Ambulance</strong> has developed<br />

cutting-edge medical care<br />

normally only found in the<br />

hospital Emergency Department<br />

for use at the roadside. The<br />

innovations and procedures it has<br />

developed have been adopted<br />

across the world.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

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AMBULANCE <strong>UK</strong> - FEBRUARY<br />

HELP Appeal funds<br />

new rapid response<br />

vehicle for BASICS<br />

Devon<br />

Thanks to the HELP Appeal<br />

- BASICS Devon, a network<br />

of volunteer doctors,<br />

who support the South<br />

Western <strong>Ambulance</strong> Service<br />

NHS Foundation Trust at<br />

emergency incidents, have<br />

launched their very own rapid<br />

response vehicle to support<br />

their emergency responders<br />

across Devon.<br />

BASICS Devon is one of a<br />

national network of 32 regional<br />

schemes across the <strong>UK</strong>, which<br />

operates under the umbrella<br />

of the British Association for<br />

Immediate Care. The new<br />

vehicle has been made possible<br />

after the group successfully<br />

bid for a total of £44,000 from<br />

a grant of £250,000, which<br />

is given to the Association<br />

every year by the County Air<br />

<strong>Ambulance</strong> HELP Appeal - the<br />

only charity in the country<br />

dedicated to funding NHS<br />

hospital helipads.<br />

The vehicle has hi-visibility and<br />

reflective markings; fitted with<br />

communication and navigation<br />

equipment; blue lights, sirens,<br />

and a dash cam, to ensure its<br />

volunteer doctors can drive<br />

safely to an emergency incident.<br />

The 4 x 4 Skoda Kodiaq, is now<br />

active across Devon, carrying<br />

volunteer doctors, to the<br />

scene of critically ill or injured<br />

patients in the community or<br />

at the roadside. This vehicle<br />

also provides the opportunity<br />

for education in pre-hospital<br />

medicine to other healthcare<br />

professionals.<br />

This will be the first scheme<br />

response vehicle for BASICS<br />

Devon. Having their own<br />

emergency response vehicle<br />

to access critical, isolated,<br />

sick, and injured patients will<br />

help to ease pain and suffering<br />

and save lives across one of<br />

the most rural counties in the<br />

country. It will enable their<br />

volunteers to reach remote<br />

communities with ease, safely<br />

and quickly, in all weather<br />

conditions and in most cases<br />

arrive before the ambulance.<br />

Since January the volunteer<br />

doctors have responded to 415<br />

call outs, 144 of which were at<br />

night, arriving first on the scene<br />

at 31% of them.<br />

BASICS Devon volunteer<br />

Immediate Care Doctor and<br />

Chair, Dr Simon Scott Hayward<br />

said: ‘The doctors are all so<br />

pleased with the vehicle. It has<br />

already been put to good use<br />

with 31 shifts, responding to<br />

callouts across the county. With<br />

winter setting in, we are pleased<br />

to have a vehicle fit for purpose<br />

both practical and safe. It is<br />

also a platform for clinicians<br />

interested in pre-hospital care<br />

to attend as observers. The<br />

recent branding of the car we<br />

hope, reflects the community<br />

that we serve. We would like to<br />

thank our funders and everyone<br />

that helped to get the car on<br />

the road.’<br />

Robert Bertram, Chief Executive<br />

of the County Air <strong>Ambulance</strong><br />

HELP Appeal added: “These<br />

volunteers are the unsung<br />

heroes of emergency care<br />

– giving up their free time to<br />

support their local ambulance<br />

service. This donation ensures<br />

they have the highest standard<br />

of transport at their disposal to<br />

ensure they can treat patients<br />

quickly and safely, giving them<br />

the best possible chance of<br />

survival and recovery.”<br />

Last year, BASICS Devon<br />

also secured £39,000 from<br />

the County Air <strong>Ambulance</strong><br />

HELP Appeal’s annual grant of<br />

£250,000 given to the British<br />

Association of Immediate<br />

Care. It was used to equip<br />

members’ existing vehicles for<br />

an emergency role, such as the<br />

installation of CCTV technology<br />

and winter tyres. The funding<br />

also enabled one new doctor<br />

to join the scheme after their<br />

vehicles were equipped to<br />

reach emergency incidents. This<br />

has helped with callouts in the<br />

North Devon area enabling the<br />

scheme to reach more people in<br />

the community to save lives.<br />

The HELP Appeal was created<br />

12 years ago by the County<br />

Air <strong>Ambulance</strong> Trust. It is the<br />

only charity in the country<br />

dedicated to funding NHS<br />

hospital helipads. To date it<br />

has funded over 40 helipads,<br />

which have received almost<br />

20,000 landings, including at<br />

Derriford Hospital, Plymouth<br />

and the Royal Devon and Exeter<br />

Hospital. The HELP Appeal<br />

relies solely on charitable<br />

donations and does not receive<br />

any government funding or<br />

money from the National<br />

Lottery.<br />

SAS<br />

SAS’s Mobile Testing<br />

Units deliver 2 million<br />

tests<br />

The Scottish <strong>Ambulance</strong><br />

Service’s Mobile Testing<br />

Units (MTUs) have reached<br />

the monumental milestone<br />

of delivering 2 million tests<br />

across Scotland, since the<br />

service was launched at the<br />

end of August 2020.<br />

As the country faces further<br />

challenges with the Omicron<br />

variant of the Covid-19 virus,<br />

the MTUs have been delivering<br />

15,000 tests a day, helping the<br />

country to tackle the newest<br />

threat in the ongoing pandemic.<br />

The MTUs have been one of<br />

biggest projects ever carried<br />

out at the Scottish <strong>Ambulance</strong><br />

Service (SAS) and is one of<br />

the key measures in place to<br />

support the <strong>UK</strong>’s action plan<br />

against COVID-19. There are<br />

now 39 SAS-run MTU teams<br />

across the country and more<br />

than 1100 people employed<br />

by the Scottish <strong>Ambulance</strong><br />

Service, providing a vital service<br />

to Scotland.<br />

The MTUS can be dispatched<br />

quickly across the country<br />

so people in urban, rural and<br />

remote areas have easy access<br />

to a coronavirus test. The<br />

location of the units, which are<br />

22<br />

For further recruitment vacancies visit: www.ambulanceukonline.com


requested by National Services<br />

Scotland through the Scottish<br />

Government, local authorities<br />

and health Boards, changes<br />

regularly to reflect demand.<br />

John Alexander, General<br />

Manager for the<br />

Mobile Testing Units<br />

(MTUs), said: “Our<br />

dedicated MTU staff<br />

have been working<br />

tirelessly across<br />

Scotland to deliver<br />

tests, particularly<br />

over the last month<br />

as the programme<br />

has been ramped<br />

up to combat the<br />

Omicron virus.<br />

“All of our MTU<br />

staff have done<br />

a fantastic job in<br />

providing tests<br />

to the people of<br />

Scotland over the<br />

past year and I’m<br />

extremely proud<br />

they’ve delivered<br />

two million tests<br />

since August 2020.<br />

We reached the<br />

1 million mark on<br />

1st September<br />

2021, one year and<br />

one day from the<br />

date of the MTUs<br />

going live, so to<br />

carry out another<br />

million tests in just<br />

over four months<br />

is a considerable<br />

achievement, and<br />

it’s testament to<br />

their dedication and<br />

hard work.”<br />

Cabinet Secretary<br />

for Health and<br />

Social Care Humza<br />

Yousaf said:<br />

“Our COVID-19<br />

Mobile Testing<br />

units continue<br />

to play a crucial<br />

role in bringing<br />

testing capacity<br />

to communities who need it<br />

most. And reaching two million<br />

tests is incredible work. This is<br />

a reflection of the hard work,<br />

dedication and professionalism<br />

of Scottish <strong>Ambulance</strong><br />

Service staff who are doing<br />

a challenging job in difficult<br />

circumstances.<br />

“Through the work they are<br />

doing they are helping to<br />

identify and isolate cases and<br />

breaking chains of transmission.<br />

My thanks goes to every<br />

member of SAS staff for all<br />

that they are doing to care and<br />

support people across Scotland<br />

– and for working throughout<br />

the festive break to ensure that<br />

testing continued.”<br />

IPRS Aeromed are now recruiting Paramedics & Nurses<br />

What sets us apart is the<br />

experience and skills of our<br />

valued clinicians who are<br />

well-versed in managing<br />

repatriations to and from<br />

some of the most interesting<br />

countries around the world.<br />

Primarily established to work in<br />

the world of international<br />

medical repatriation, the<br />

business has evolved to provide<br />

expert clinical solutions across<br />

a variety of specialist sectors<br />

and services.<br />

Join a team that's really going places!<br />

https://iprsaeromed.com/jobs/ or email IPRS Aeromed<br />

Recruitment aeromed.recruitment@iprsgroup.com<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

For the latest <strong>Ambulance</strong> Service News visit: www.ambulancenewsdesk.com<br />



SWAST<br />

Patient helps buy<br />

defibrillator after<br />

community first<br />

responder and<br />

paramedic save her<br />

life<br />

A grateful patient inspired by<br />

the South Western <strong>Ambulance</strong><br />

Service NHS Foundation Trust<br />

(SWASFT) team who saved her<br />

life, has helped raised funds to<br />

buy a defibrillator.<br />

Dulcie, from Penzance, Cornwall,<br />

suffered a cardiac arrest and<br />

collapsed, falling off her fixed<br />

exercise bike at home. She was<br />

treated with a defibrillator by a<br />

community first responder and a<br />

paramedic, convincing her that<br />

a community defibrillator was<br />

needed at her gym.<br />

Luckily for her, expert help<br />

was only seconds away when<br />

SWASFT volunteer community<br />

first responder Jack Bushell<br />

responded to a 999 call on his<br />

way from helping another casualty.<br />

He took over from Dulcie’s partner<br />

who was giving effective CPR and<br />

immediately applied defibrillator<br />

pads and gave CPR himself to try<br />

and restart her heart and breathing.<br />

the ambulance service is, but<br />

when there is a life-threatening<br />

emergency they are still able to<br />

respond magnificently.<br />

“I can’t really put into words<br />

how grateful I am to my partner,<br />

to Jack, and to the ambulance<br />

service for their quick response,<br />

skill, professionalism and kindness<br />

that they showed. I clearly would<br />

not be here today was it not for all<br />

of them.’’<br />

Jack said: “I was just heading<br />

back from another incident when<br />

I received the top priority category<br />

1 response call to Dulcie. At the<br />

time the only details I had was that<br />

it was a person who’d fallen off a<br />

bike and was in cardiac arrest.<br />

“I’ve been to a number of arrests<br />

so felt calm and collected enroute<br />

and on arrival, this meant I<br />

could think about what I’d need<br />

to do and whether this may be a<br />

traumatic or medical arrest.’’<br />

He said Dulcie was fighting to<br />

recover as she was being treated<br />

and he was confident at the time<br />

that emergency treatment would<br />

get results. His patient had also<br />

been given the best chance of<br />

recovery due to the prompt and<br />

effective CPR care by her partner.<br />

“It was an incredibly surreal<br />

and rare moment to go from a<br />

resuscitation attempt to talking<br />

to that patient. It was a fantastic<br />

outcome and I’m proud to be part<br />

of the team which treated Dulcie.<br />

WMAS<br />

Top award for going<br />

above and beyond<br />

during the pandemic<br />

A University of Wolverhampton<br />

Paramedic Science graduate<br />

has scooped a top award<br />

recently for going above and<br />

beyond during the pandemic.<br />

Will Matthews, 22 from Gloucester,<br />

graduated from the Paramedic<br />

Science degree course which was<br />

delivered at the University’s Walsall<br />

Campus earlier last year and was<br />

named Outstanding Direct Entry<br />

Student Paramedic of the Year by<br />

West Midlands <strong>Ambulance</strong> Service<br />

(WMAS).<br />

He picked up his award from<br />

Anthony Marsh, Chief Executive<br />

Officer at WMAS.<br />

Will was nominated by his<br />

lecturer, Richard Howarth, for his<br />

commitment and dedication to<br />

learning and his excellent grades<br />

and he was chosen as the winner<br />

out of hundreds of nominations from<br />

five universities across the region.<br />

Will said: “When I heard that I’d<br />

won the award I just sat smiling<br />

and couldn’t believe it - especially<br />

considering how competitive<br />

these awards are locally.<br />

biomedical science, and I’m so<br />

glad I didn’t.<br />

“I really loved Paramedic the<br />

course, it was the most difficult<br />

thing I’ve ever done, but I put<br />

myself forward for all kinds of<br />

things, helping out in lecturers and<br />

mentoring other students.<br />

“I love my job. There’s something<br />

different happening every<br />

day, the team bonding and<br />

spirit is amazing and you build<br />

relationships really quickly.<br />

“I’m hoping to continue to expand<br />

on my knowledge, gain more<br />

experience, and then hopefully move<br />

fields to specialise in minor injuries.”<br />

Richard Howarth, Lecturer in<br />

Paramedic Science at the University,<br />

said: “I was Will’s personal tutor<br />

throughout the majority of his course<br />

and he is an exemplary student who<br />

always strives for the best in both<br />

his academic work and practice<br />

placement.<br />

“The feedback received from Will’s<br />

mentors has been amazing and<br />

despite the pandemic causing<br />

Will to miss a period of placement<br />

he has never lost his drive and<br />

determination to succeed. He is<br />

always a highly reflective student<br />

who is always looking at ways<br />

to improve himself in an effort to<br />

improve the patient care he delivers.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

When his colleague, paramedic<br />

Jess Leah arrived, they delivered a<br />

further defibrillator shock and Dulcie<br />

started breathing herself shortly<br />

before regaining consciousness<br />

and soon began talking to the<br />

paramedics. Further help arrived<br />

with a second ambulance crew and<br />

the air ambulance with a doctor on<br />

board to help stabilise Dulcie and<br />

take over her care.<br />

Dulcie, a public health doctor<br />

working for Cornwall Council,<br />

thanked the SWASFT team<br />

and stressed how important<br />

defibrillators and trained<br />

community volunteer paramedics<br />

were to saving her life. She said:<br />

“We all know how under pressure<br />

“Having since spoken to Dulcie<br />

and found out she’s fully recovered<br />

and raised money to fund a<br />

defibrillator, I think it’s amazing and<br />

an important reminder of good<br />

“bystander” CPR. These outcomes<br />

are very rare and it reminded me of<br />

why I do this job.’’<br />

The public defibrillator, outside<br />

Crossfit Penzance, was paid<br />

through a community effort<br />

including a sponsored gym<br />

competition and prize raffle<br />

donated to by local businesses.<br />

“I had kind of fallen into the career<br />

as no one in my immediate family is<br />

medically trained. I just went for it.<br />

“I studied chemistry and biology<br />

at A Level but didn’t get into my<br />

first-choice university to study<br />

“Will is always willing to go above<br />

and beyond in the support of<br />

his peers, he is a peer mentor<br />

for both First and Second year<br />

students and is always happy<br />

to share his knowledge and<br />

experiences with them. I have<br />

24<br />

For more news visit: www.ambulanceukonline.com


no doubt that Will is going to be<br />

an exemplary paramedic and an<br />

asset to the profession.”<br />

West Midlands <strong>Ambulance</strong> Service<br />

Chief Executive, Anthony Marsh,<br />

said: “I wanted to demonstrate<br />

my personal appreciation for<br />

everything the winners of these<br />

awards, like Will, have done and<br />

continue to do. The NHS is under<br />

more pressure now than it has<br />

been before, and I know that<br />

each of our staff, students and<br />

volunteers, feel that every day.<br />

“The last 18 months or so have not<br />

been easy for external students,<br />

with tough decisions having to be<br />

made around their placements in<br />

order to best protect the patients<br />

we serve. However, people like<br />

Will are an absolute testament to<br />

the NHS, always striving to do<br />

their utmost regardless of any<br />

adversities that come their way.<br />

“The winners of last year’s awards<br />

have demonstrated a dedication<br />

to their role and the patients of<br />

the West Midlands, whether that<br />

be out on the road or behind the<br />

scenes. A huge congratulations<br />

once again to all the winners.”<br />

Anyone looking to study at the<br />

University of Wolverhampton<br />

should register for one of our<br />

forthcoming Open Days.<br />

For more information contact the<br />

Corporate Communications Team<br />

comms@wlv.ac.uk.<br />

Guernsey’s<br />

Emergency<br />

<strong>Ambulance</strong> Service<br />

takes delivery of two<br />

new ambulances<br />

Guernsey’s Emergency<br />

<strong>Ambulance</strong> Service has taken<br />

delivery of two new ambulances<br />

in a ceremony that recreated<br />

the scenes of 84 years ago,<br />

when the St John <strong>Ambulance</strong><br />

Brigade received its new Morris<br />

ambulance.<br />

As the reprint of a Guernsey<br />

Press article from June 1937<br />

illustrates, a dedication ceremony<br />

was held on the Albert Pier, St<br />

Peter Port where the Morris<br />

ambulance was handed over, by<br />

the island government (the States<br />

of Guernsey) to St John which<br />

had taken on the responsibility of<br />

running the ambulance service for<br />

the island just a year before.<br />

The two modern day, state-ofthe-art<br />

WAS 500 Mercedes Benz<br />

Sprinter emergency ambulances<br />

were officially presented to St John<br />

Emergency <strong>Ambulance</strong> Service by<br />

the States of Guernsey and were<br />

blessed by the Chaplain of St John<br />

Guernsey, in a similar event at<br />

virtually the same spot in St Peter<br />

Port. The ceremony was attended<br />

by local dignitaries, representatives<br />

of the States of Guernsey and<br />

frontline staff from the Emergency<br />

<strong>Ambulance</strong> Service.<br />

Mark Mapp, Guernsey’s Chief<br />

<strong>Ambulance</strong> Officer, took official<br />

delivery of two new vehicles for St<br />

John. “I am delighted and grateful<br />

to take delivery of two new<br />

emergency ambulances funded<br />

by the States of Guernsey. These<br />

two new ambulances replace two<br />

of our existing fleet which are now<br />

over 12 years old and which have<br />

now exceeded the practical lives<br />

as frontline ambulances with high<br />

demands we place on them.”<br />

He added, “My colleagues and<br />

I at St John thank the States for<br />

their responsive procurement<br />

efforts, which have enabled<br />

this to happen more promptly<br />

than we had initially feared.<br />

These are specialist vehicles,<br />

somewhat narrower than standard<br />

international vehicles in order to<br />

better operate on Guernsey’s<br />

narrow roads. Delivery timescales<br />

can sometimes be prolonged,<br />

because these specialist versions<br />

are produced in Germany,<br />

generally in change-over gaps<br />

between longer production runs.<br />

However, with the assistance of<br />

the States, we have managed to<br />

secure delivery more promptly<br />

than usual.”<br />

The new ambulances are fitted<br />

with state-of-the-art diagnostic<br />

and treatment equipment which<br />

allows clinicians to administer<br />

urgent and emergency prehospital<br />

care on scene at a<br />

patient’s home or by the roadside.<br />

The vehicles are designed to give<br />

maximum comfort for patients and<br />

a practical working environment<br />

for medical crews.<br />

Guernsey is not part of the NHS<br />

so under current arrangements,<br />

users of an Emergency<br />

<strong>Ambulance</strong> in Guernsey are<br />

charged a government-subsidised<br />

cost for call-outs and treatment by<br />

paramedics, and for conveyance<br />

to hospital. However, St John<br />

offers an annual subscription<br />

scheme which covers individuals<br />

for up to 50 emergency<br />

ambulance call outs in that year.<br />

The States of Guernsey provides<br />

an annual grant to fund the<br />

balance of the costs of St<br />

John providing the Emergency<br />

<strong>Ambulance</strong> Service, subject to<br />

various operational performance<br />

indicators being met.<br />

Deputy Al Brouard, President of<br />

Health & Social Care (HSC) was<br />

the senior politician present at<br />

the new ambulance handover<br />

ceremony. “As we are seeing in<br />

many jurisdictions, the funding of<br />

health and social care services<br />

is one of the most challenging<br />

issues for governments in our<br />

time. Difficult priorities have to be<br />

set as we aim to provide the full<br />

range of services needed by the<br />

community in the most costeffective<br />

manner. St John is a key<br />

partner and I am pleased that<br />

we are able to invest to keep our<br />

services properly equipped for the<br />

demands they face.”<br />

Mark de Garis, interim CEO of the<br />

States of Guernsey and former<br />

Chief Secretary for HSC said:<br />

“During 2018, HSC worked with a<br />

range of service providers to offer<br />

better coordination for the care<br />

islanders receive on a daily basis.<br />

Our joint aim was to provide new<br />

ways of working and solutions<br />

which address the core pressures<br />

of an ageing demographic, fewer<br />

working age tax payers, and the<br />

long-term inherent trend of above<br />

inflation healthcare cost increases<br />

which lead to real term impacts<br />

upon public expenditure unless<br />

positively addressed. Later that<br />

year, HSC and St John defined and<br />

agreed a future operating model<br />

for ‘Patient-intense Emergency<br />

Response’ and ambulance services<br />

over the following years and we<br />

continue to implement that model<br />

in a phased manner. As with many<br />

things, the arrival of Covid-19<br />

delayed some initiatives, but we are<br />

grateful for the responsiveness of<br />

all parts of the St John operation<br />

during the pandemic.<br />

During the Covid pandemic<br />

frontline ambulance crews were<br />

supported by St John volunteers<br />

who took on tasks including the<br />

deep cleaning of ambulance<br />

vehicles.<br />

Thanks to the Guernsey Press for giving permission for the use<br />

of this 1937 photograph<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

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AMBULANCE <strong>UK</strong> - FEBRUARY<br />

SAS News<br />

Scottish <strong>Ambulance</strong> Service<br />

staff member awarded<br />

Queen’s <strong>Ambulance</strong> Medal in<br />

<strong>2022</strong> New Year Honours list<br />

A Scottish <strong>Ambulance</strong> Service (SAS) staff<br />

member who has been instrumental in<br />

dealing with some of Scotland’s biggest<br />

incidents has today been awarded the<br />

Queen’s <strong>Ambulance</strong> Medal (QAM).<br />

The prestigious honour - which acknowledges<br />

ambulance personnel who have shown<br />

exceptional devotion to duty, merit and<br />

conduct - has been awarded to Patrick (Pat)<br />

O’Meara, General Manager of Events.<br />

Pat, 57, joined SAS in 1998, after 17 years at<br />

the London <strong>Ambulance</strong> Service.<br />

Throughout the past four decades, he has<br />

been involved in some of the <strong>UK</strong>’s most<br />

significant incidents, including the Clutha Bar<br />

crash where he was incident commander,<br />

the George Square bin lorry tragedy, and the<br />

Stockline Plastics Factory explosion.<br />

Most recently, he has led the Service’s<br />

planning and response to COP26 and in<br />

the early stages of the pandemic, led on<br />

the development and implementation of the<br />

Service’s Mobile Testing Units.<br />

Speaking of the award, Pat, who lives in East<br />

Kilbride, said: “I am very humbled and grateful<br />

and it’s a great honour to receive the award.<br />

In saying that, you never work on your own<br />

and any success is always down to being a<br />

member of a team.”<br />

Pat started with the Scottish <strong>Ambulance</strong><br />

Service as an Operations Room Officer,<br />

where he was responsible for control room<br />

emergency operations across Glasgow. Over<br />

the years at SAS, he has worked as a General<br />

Manager for <strong>Ambulance</strong> Control Centres,<br />

Community Resilience, and South East<br />

Scotland, which included the responsibility<br />

for the visit of Pope Benedict. Pat is also<br />

the Chief Medical Support Officer of the<br />

Army Cadet Force and is a Trustee of the<br />

Poppyscotland charity.<br />

The dad-of-one joined the London <strong>Ambulance</strong><br />

Service in 1981. Growing up wanting to be<br />

a policeman, he said: “I learnt first aid as an<br />

Army Cadet and had to use those skills with a<br />

serious leg wound on a fellow pupil who was<br />

pushed from a second floor window and later<br />

on another pupil having a fit. I then felt that<br />

the ambulance service was a career I should<br />

look at.<br />

“The ambulance service was very different<br />

to today. The skills were not as advanced as<br />

they are now, we did not have defibrillators<br />

and there was no such role as a paramedic,<br />

only advanced trained ambulance men.”<br />

Speaking on some of his memorable jobs<br />

throughout his career - in addition to Clutha<br />

and the Glasgow Bin Lorry incident - he said:<br />

“A young man aged 15 had been stabbed<br />

with a machete and despite my efforts and<br />

those of others, he sadly died. I remember<br />

him pleading with me not to let him die. I have<br />

also attended a bombing, an aircraft crash at<br />

Heathrow Airport, I’ve been held hostage and<br />

attended an incident where I was chased with<br />

a knife!”<br />

SAS Chief Operating Officer Paul Bassett<br />

said: “Pat has been an amazing ambassador<br />

for the Scottish <strong>Ambulance</strong> Service over the<br />

past 23 years and this award is testament<br />

to Pat’s dedication and professionalism. He<br />

has been heavily involved in several major<br />

incidents, leading as incident commander, and<br />

most recently, he successfully led the Service<br />

provision to COP26. We are truly grateful for<br />

everything he has done for the Service.”<br />

LAS News<br />

LAS appoints new Director of<br />

Strategy & Transformation<br />

London <strong>Ambulance</strong> Service has appointed<br />

Roger Davidson as its new Director of<br />

Strategy and Transformation.<br />

Roger will join the Service on Monday 31<br />

January from NHS England, where he is<br />

currently Director of System Partnerships,<br />

working to join up health and care and<br />

improve population health through<br />

development of integrated care systems<br />

(ICSs) across England.<br />

In his new leadership role at LAS, he will<br />

focus on developing a strategic vision for<br />

London <strong>Ambulance</strong> Service to build beyond<br />

the existing organisational strategy which<br />

comes to an end in 2023.<br />

In his most recent position at NHS England,<br />

Roger has played a national leadership role in<br />

the development of the 42 ICSs, which now<br />

cover the whole of England and are set to be<br />

put on a statutory footing next year.<br />

Since the start of 2016, he has worked with<br />

health and care leaders across the country<br />

on system transformation strategy and policy,<br />

system leadership development, clinical and<br />

professional leadership, local government<br />

and voluntary sector partnerships,<br />

public involvement, communications and<br />

stakeholder relationships.<br />

Prior to this, Roger was Director of<br />

Communications and Head of Media and<br />

Public Affairs at NHS England.<br />

In 2013, he helped to establish the newlyindependent<br />

organisation and then to set a<br />

new strategic direction for the NHS focussed<br />

on integrated care through the NHS Five Year<br />

Forward View.<br />

26<br />

For further recruitment vacancies visit: www.ambulanceukonline.com


Earlier in his career, Roger also held<br />

senior communications and public affairs<br />

roles at organisations including the<br />

NHS Confederation, the Care Quality<br />

Commission and the Confederation of<br />

British Industry.<br />

He is also a Trustee at the English Football<br />

League (EFL) Trust, the charity overseeing<br />

the community organisations of the 72 EFL<br />

football clubs in England which run health<br />

and wellbeing initiatives across the country.<br />

Speaking about his new appointment at<br />

LAS, Roger said:<br />

“As a Londoner, I am excited to be joining<br />

one of the most visible healthcare providers<br />

in the capital and making a positive<br />

difference to the lives of patients.<br />

“It’s a challenging time to be joining and<br />

I am looking forward to working with<br />

dedicated colleagues to help build the<br />

ambulance service London needs in the<br />

years ahead.”<br />

London <strong>Ambulance</strong> Service chief executive<br />

Daniel Elkeles said:<br />

“While we continue to manage the<br />

unprecedented pressure created by the<br />

coronavirus pandemic, it’s essential we do<br />

not lose sight of the vital change needed<br />

to drive forward our vision for London<br />

<strong>Ambulance</strong> Service.<br />

“Roger brings a wealth of experience of<br />

strategy, public affairs and transformational<br />

change and I’m delighted to welcome him<br />

to the team.”<br />

WAS News<br />

Long-serving paramedic<br />

recognised in Queen’s New<br />

Year Honours List<br />

A long-serving paramedic at the Welsh<br />

<strong>Ambulance</strong> Service has been recognised in<br />

the Queen’s New Year Honours List.<br />

Paramedic and Duty Operations Manager<br />

Jenny Lewis has been awarded the Queen’s<br />

<strong>Ambulance</strong> Service Medal for distinguished<br />

service, which was announced on Friday 31<br />

January 2021.<br />

The mother-of-two, who is based in Dobshill,<br />

Flintshire, has more than 30 years of service<br />

having joined Clwyd <strong>Ambulance</strong> Service as an<br />

Emergency Medical Technician in 1991.<br />

Jenny played an instrumental role in the move<br />

to the purpose-built Area <strong>Ambulance</strong> Centre in<br />

Dobshill in 2012, home to the Trust’s flagship<br />

Make Ready Depot.<br />

In November, Jenny and her Operations<br />

Manager colleagues in North East Wales won a<br />

WAST Award for delivering outstanding patient<br />

care and supporting frontline colleagues.<br />

Chief Executive Jason Killens said: “We’re<br />

beyond thrilled that Jenny has been<br />

recognised in the Queen’s New Year Honours<br />

List.<br />

“It is testament not just to her contribution<br />

through the Covid-19 pandemic but to her<br />

broader commitment to the NHS in Wales over<br />

her 30-year career.<br />

“We’re incredibly proud of all colleagues who<br />

go that extra mile for patients and contribute<br />

to the development and progression of the<br />

ambulance service, at all levels.<br />

and management skills, and has led the<br />

Flintshire team through adversity in recent<br />

years following the unexpected death of two<br />

colleagues.<br />

“We are delighted that Jenny is being<br />

celebrated for her enduring and positive<br />

contribution to the Trust and its people.”<br />

The Queen’s New Year Honours List has<br />

recognised 1,278 people for their exceptional<br />

contributions to business, charity, culture,<br />

development, education, foreign policy, health,<br />

security and sport.<br />

Among the other Welsh emergency service<br />

colleagues recognised is South Wales Police<br />

Constable Anne Overton, who has been<br />

awarded the Queen’s Police Medal, and<br />

Jennifer Griffiths, Group Manager at South<br />

Wales Fire and Rescue Service, who is the<br />

recipient of a Queen’s Fire Service Medal.<br />

Meanwhile, Wales’ Chief Medical Officer Dr<br />

Frank Atherton has been given a knighthood<br />

for services to public health.<br />

Prime Minister Boris Johnson said: “These<br />

recipients have inspired and entertained us and<br />

given so much to their communities in the <strong>UK</strong><br />

or in many cases around the world.<br />

“The honours are an opportunity for us to<br />

thank them, as a country, for their dedication<br />

and outstanding contribution.”<br />

SCAS News<br />

SCAS Board of Directors –<br />

Appointment of new Chair<br />

and Non-Executive Director<br />

“These awards recognise the hard work and<br />

dedication of some of our very best ambulance<br />

professionals, and I’d like to extend a huge<br />

congratulations to Jenny.”<br />

Jonathan Sweet, Head of Service for the<br />

Trust’s Operational Delivery Unit, who<br />

nominated Jenny, added: “Jenny is a<br />

respected leader and a trusted peer among<br />

colleagues in North Wales, not to mention a<br />

compassionate paramedic.<br />

“She has worked relentlessly throughout her<br />

career to sharpen her clinical knowledge<br />

South Central <strong>Ambulance</strong> Service NHS<br />

Foundation Trust’s Council of Governors has<br />

approved the appointment of Professor Sir<br />

Keith Willett CBE as the new Chair of SCAS<br />

with effect from 1 April.<br />

For the latest <strong>Ambulance</strong> Service News visit: www.ambulancenewsdesk.com<br />

>>><br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />



He will replace current Chair Lena Samuels<br />

who will be leaving SCAS at the end of March<br />

to take up the role of Chair of the Hampshire<br />

and Isle of Wight Integrated Care System (ICS).<br />

Professor Sir Keith is a highly experienced<br />

and respected clinician having worked in<br />

the NHS for over 40 years. As Professor of<br />

Trauma Surgery at the University of Oxford,<br />

he has extensive experience of trauma and<br />

emergency care, healthcare management<br />

and has been instrumental in driving service<br />

transformation, working collaboratively with<br />

partners in the NHS and beyond.<br />

He will join SCAS from his role as the National<br />

Director for Emergency Planning and Incident<br />

Response at NHSE/I. In January 2020, he was<br />

appointed as the Strategic Incident Director,<br />

responsible for the operational response to the<br />

coronavirus pandemic across the whole NHS<br />

in England. He also led the Covid Vaccination<br />

Deployment programme from July to October<br />

2021.<br />

Professor Sir Keith, who resides in Oxfordshire<br />

and has been appointed initially for three years,<br />

said: “I am delighted and privileged to be<br />

appointed the new Chair of SCAS and build<br />

on the outstanding work of Lena Samuels, the<br />

Board and everyone in SCAS. I am acutely<br />

aware of the enormous contributions and<br />

sacrifices made in recent times. SCAS, like all<br />

the NHS, is made up of people treating people,<br />

so I look forward to working with all of you<br />

as we collectively restore ourselves and our<br />

services for an exciting future.”<br />

In addition, Dr Henrietta Hughes has been<br />

appointed by the Council of Governors as<br />

a new Non-Executive Director for SCAS to<br />

replace Priya Singh who left at the end of<br />

December to take up the role of Chair of<br />

Frimley Integrated Care System. Dr Hughes will<br />

join SCAS on 1 <strong>February</strong>.<br />

In 2016, Dr Hughes was appointed as the<br />

National Guardian for the NHS and set up<br />

Freedom to Speak Up across England into<br />

more than 400 NHS and Independent sector<br />

organisations. Guardians have handled over<br />

50,000 cases relating to patient safety and<br />

worker wellbeing with a view to making<br />

speaking up business as usual.<br />

Previously a Medical Director at NHS<br />

England, she continues her clinical role as a<br />

GP in central London. She has an excellent<br />

understanding of the health care landscape<br />

and the challenges affecting the NHS.<br />

She said: “I am deeply honoured to be joining<br />

SCAS at this important time and would like<br />

to send my heartfelt thanks to everyone for<br />

the amazing work that you have been doing<br />

throughout the Pandemic. I look forward to<br />

seeing you soon, learning more about your<br />

work and contributing to keeping patients, and<br />

those who care for them, safe and well.”<br />

Dr Hughes resides in London and has also<br />

been appointed for an initial three-year term.<br />

Ms Samuels said: “It has been an enormous<br />

privilege to work for the last five years<br />

with CEO Will Hancock, the SCAS Board,<br />

Governors and a truly amazing body of<br />

professionals who are so passionate about<br />

supporting and delivering the best possible<br />

care for our patients and their families.<br />

“Our vision and values have always placed<br />

the best interests of patients at the very<br />

centre of everything we do and for that reason<br />

we couldn’t be more delighted with these<br />

appointments.”<br />

Mr Hancock said: “I am delighted to welcome<br />

both Keith and Henrietta to the SCAS Board.<br />

These are outstanding appointments for the<br />

Trust and both individuals bring a fabulous<br />

breadth of experience and skills which will<br />

support SCAS with the delivery of its future<br />

strategy and ambitions.”<br />

has been awarded the Queen’s <strong>Ambulance</strong><br />

Medal for Distinguished Service (QAM) in<br />

the Queen’s New Year’s Honours List.<br />

Julian qualified in Medicine from Leeds<br />

University in 1994 (BSc Hons, MB ChB)<br />

and has been a senior leader at the region’s<br />

ambulance service for 14 years. He has been<br />

the Trust’s Executive Medical Director since<br />

October 2013.<br />

During the last two years he has been at<br />

the forefront of the <strong>UK</strong> ambulance sector’s<br />

response to the COVID-19 pandemic, leading<br />

national work, as well as the clinical response<br />

in Yorkshire. He has supported colleagues<br />

through the challenging clinical environment of<br />

COVID-19, rising to the challenge of being at<br />

the helm of the national ambulance response<br />

as Chair of the National <strong>Ambulance</strong> Service<br />

Medical Directors (NASMeD) group, a subgroup<br />

of the Association of <strong>Ambulance</strong> Chief<br />

Executives (AACE).<br />

Julian has been Chair of NASMeD since<br />

March 2015 and was unanimously re-elected<br />

for a further three-year term in 2018. His<br />

numerous achievements include developing<br />

national clinical best practice including airway<br />

management, care of children, standardising<br />

equipment for paediatric and maternity care,<br />

leading the establishment of learning from<br />

deaths processes and complex coroners’<br />

inquests.<br />

He is passionate about ensuring patient<br />

safety and reducing harm. In his quest for<br />

safe, evidence-based, high-quality patient<br />

care, Julian engages and liaises with many<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

YAS News<br />

Queen’s <strong>Ambulance</strong> Medal<br />

for Distinguished Service<br />

awarded to Yorkshire<br />

<strong>Ambulance</strong> Service Doctor<br />

Dr Julian Mark, Executive Medical Director<br />

at Yorkshire <strong>Ambulance</strong> Service NHS Trust,<br />

28<br />

For further recruitment vacancies visit: www.ambulanceukonline.com


organisations and partners at local and<br />

national levels, including the Healthcare Safety<br />

Investigation Branch (HSIB), NHS England/<br />

Improvement and the Department of Health<br />

and Social Care. Julian also sits on the <strong>UK</strong><br />

Council of Caldicott Guardians and co-chairs<br />

the National Advisory Board for The Circuit<br />

(British Heart Foundation).<br />

Rod Barnes, Chief Executive of Yorkshire<br />

<strong>Ambulance</strong> Service NHS Trust, said: “This<br />

is a huge honour which recognises Julian’s<br />

tremendous contribution to the ambulance<br />

sector’s response to the pandemic. It also<br />

makes Julian one of a very small number<br />

of ambulance service staff who have been<br />

recognised for exceptional dedication to duty,<br />

outstanding ability, merit and conduct in their<br />

roles.<br />

“Julian is a consummate professional and his<br />

dedication to improving patient care has been<br />

outstanding. He is held in the highest esteem<br />

by his colleagues both within and outside the<br />

ambulance sector. His work with AACE and<br />

NASMeD, as well as other national groups, has<br />

undoubtedly improved the standards of care<br />

delivered to patients by the ambulance sector<br />

nationally and has been pivotal in helping<br />

ambulance services navigate the enormous<br />

clinical challenges of the pandemic.<br />

“On behalf of Yorkshire <strong>Ambulance</strong> Service<br />

and all ambulance services across the <strong>UK</strong>, I<br />

would like to thank Julian for all he has done<br />

for the benefit of patients over many years. He<br />

thoroughly deserves this honour and should be<br />

rightly proud of this fantastic achievement.”<br />

Dr Julian Mark said: “I am proud to play my<br />

part in the development of the ambulance<br />

sector response to the public in their time of<br />

greatest need. The past two years have been<br />

particularly challenging and I would like to<br />

pay tribute to all ambulance service staff for<br />

their continued dedication to patient care in<br />

these difficult times. I am humbled for being<br />

recognised for my contribution, which would<br />

have been impossible without the unwavering<br />

support from my colleagues in YAS, NASMeD,<br />

AACE and NHS England.”<br />

Julian also holds the Diploma in Immediate<br />

Medical Care (DIMC) from the Faculty of<br />

Pre-Hospital Care of the Royal College of<br />

Surgeons of Edinburgh (2010) and a Post<br />

Graduate Certificate in Medical Law from<br />

Northumbria University (2012). In 2017 he<br />

was awarded Founding Senior Fellowship<br />

of the Faculty of Medical Leadership and<br />

Management (SFFMLM). His base clinical<br />

speciality was in Anaesthesia and held the<br />

post of honorary Senior Staff Anaesthetist<br />

at Harrogate and District Hospital NHS<br />

Foundation Trust until April 2014, subsequently<br />

continuing to practise clinically in immediate<br />

medical care as a member of his local British<br />

Association for Immediate Care (BASICS)<br />

scheme. He is a former member of the Clinical<br />

Advisory Board for the Faculty of Pre-Hospital<br />

Care (RCSEd), the Clinical Advisory Forum<br />

for NHS Improvement, the Department of<br />

Health Clinical Advisory Group for Major<br />

Trauma in England, and contributed to the<br />

development of the national Hazardous Area<br />

Response Team capability and NHS England’s<br />

<strong>Ambulance</strong> Response Programme. He is<br />

currently a member of the Out of Hospital<br />

Cardiac Arrest steering group and the Adult<br />

Critical Care Transport oversight group.<br />

Julian will be presented with his medal at<br />

Buckingham Palace in due course.<br />

LAS News<br />

Chief Executive of London<br />

<strong>Ambulance</strong> Service<br />

appointed permanently<br />

The Chair of the London <strong>Ambulance</strong><br />

Service (LAS), Heather Lawrence OBE, has<br />

announced the permanent appointment of<br />

Daniel Elkeles as the Trust’s Chief Executive.<br />

Daniel joined the Service in August 2021 on<br />

secondment, and following a competitive<br />

recruitment process that concluded on<br />

Thursday 27 January, has now been appointed<br />

substantively.<br />

Heather Lawrence OBE, Trust Chair, said: “I<br />

am delighted to announce Daniel’s permanent<br />

appointment as Chief Executive following a<br />

rigorous interview process.<br />

“Daniel joined the Service at a very challenging<br />

time and has led us through the latest wave<br />

of the COVID-19 pandemic which saw<br />

demand for our services increase dramatically,<br />

combined with significant levels of staff and<br />

volunteer sickness and isolations. Working<br />

with teams from across the Service, he has<br />

supported our staff and volunteers to rise to<br />

the challenge and, despite the pressure, deliver<br />

the best possible care for our patients.<br />

“Not only that but in the six months since he<br />

joined us, Daniel has proved a genuine drive to<br />

protect the health and wellbeing of our teams,<br />

kick-starting a dedicated programme of work<br />

with all of our staff that is designed to improve<br />

working lives and make LAS an even better<br />

place to work.<br />

“Daniel has already made a positive impact on<br />

our staff and Service, and as he takes up the<br />

mantle of the permanent position, we can be<br />

confident that is set to continue.”<br />

Daniel Elkeles said: “London <strong>Ambulance</strong><br />

Service plays a vital role in providing care for<br />

nearly nine million people across the capital,<br />

and it as an absolute honour to serve as the<br />

Chief Executive of this incredible organisation.<br />

“I am very passionate about the future strategy<br />

for LAS, including ensuring staff and volunteers<br />

receive the best possible support after what<br />

has been the most challenging couple of years<br />

in the NHS’s history.”<br />

The interview panel included representatives<br />

from within the organisation, as well as from<br />

NHS England (London) and the Association<br />

of <strong>Ambulance</strong> Chief Executives (AACE).<br />

Prior to being interviewed, Daniel addressed<br />

and answered questions from a 30 strong<br />

stakeholder panel including our staff unions<br />

and patient representatives.<br />

Heather added: “Daniel’s 25 years’ experience<br />

in the NHS and his hard work, commitment<br />

and enthusiasm since joining us at the London<br />

<strong>Ambulance</strong> Service made him the perfect<br />

candidate for the permanent position. The<br />

decision of the interview panel was unanimous.”<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

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GWAAC News<br />

Air <strong>Ambulance</strong> Advanced<br />

Practitioner in Critical Care,<br />

Vicki Brown, breaks barriers<br />

Vicki Brown, Advanced Practitioner<br />

in Critical Care at Great Western Air<br />

<strong>Ambulance</strong> Charity, has become the first<br />

person in the country to get on the Faculty<br />

of Pre Hospital Care (FPHC) Register<br />

of Consultant (Level 8) Practitioners<br />

by qualifying from a purely, paramedic<br />

background. She is also the first female<br />

paramedic on the list.<br />

This is an amazing achievement for Vicki and is<br />

a wonderful recognition of years of hard work<br />

and expertise. This is also a big achievement<br />

for the paramedic profession and is great<br />

for Great Western Air <strong>Ambulance</strong> Charity<br />

(GWAAC). Its crew’s capabilities and combined<br />

experience as a team are constantly growing<br />

and evolving, meaning the best possible care<br />

can be delivered to patients.<br />

Vicki joins GWAAC Drs Matt Campbell, Matt<br />

Thomas, and Cosmo Scurr on the very short<br />

list of people qualified. Other doctors, who<br />

completed their training with GWAAC, are also<br />

on the register.<br />

Since the first registration in 2015, there<br />

are only 70 individuals on the list. Just 20%<br />

of these are female, which makes Vicki’s<br />

achievement even more unique.<br />

paramedic background, and being the first<br />

female paramedic on the register, means she<br />

will be an inspiration to other paramedics up<br />

and down the country.<br />

After achieving the Diploma in Immediate Care,<br />

Vicki spent a few years going through the<br />

process of providing evidence to the Faculty<br />

of Pre-Hospital Care of her experience and<br />

knowledge. This culminated in submitting<br />

portfolios of clinical and operational<br />

experience, and attending an interview.<br />

She found out she’d made it on the Register<br />

after an interview (on Friday 17th December<br />

2021) with the Faculty of Pre-Hospital Care,<br />

which is associated with the Royal College of<br />

Surgeons of Edinburgh.<br />

Vicki said: “I’m feeling very proud to have<br />

achieved this level and hope other paramedics<br />

will follow as pre-hospital medicine is very<br />

much multi-professional. I hope this shows that<br />

paramedics can achieve this level of practice.<br />

I intend to continue pushing the boundaries<br />

of paramedic practice and hope there is more<br />

success to come.”<br />

Getting on the FPHC Register of Consultant<br />

(Level 8) Practitioners, after just 18 months of<br />

being appointed the first Advanced Practitioner<br />

in Critical Care (APCC) in the South West, is<br />

even more remarkable.<br />

Vicki’s quest to keep on reaching new heights<br />

is why she’s an inspiration to all of us at<br />

GWAAC, as well as aspiring paramedics.<br />

EEAST News<br />

EEAST Paramedic awarded<br />

Station Commander’s<br />

Commendation<br />

EEAST Paramedic, Paul Chittock, has<br />

been awarded a Station Commander’s<br />

Commendation, marking 15 years of<br />

voluntary support for RAF colleagues<br />

based at Marham air force base in Norfolk.<br />

Paul’s volunteering has seen him working on<br />

everything from events and first aid training to<br />

critical incident scenarios, this is all alongside<br />

his day job with EEAST as a Paramedic, based<br />

at Kings Lynn.<br />

Over the years Paul has provided medical cover<br />

and education for Family and Friends Days at the<br />

base, regularly facilitates the use of fully equipped<br />

ambulances and is passionate about passing on<br />

life-saving skills for Marham staff who frequently<br />

come across road traffic incidents on Norfolk’s<br />

roads. He also encourages colleagues from<br />

EEAST to offer their support as well.<br />

In addition, Paul is actively involved with the<br />

Co-Response Team, who offer support at major<br />

incidents, spending hundreds of hours mentoring<br />

and developing them, with members benefitting<br />

from his training and experience as a paramedic.<br />

In 2015, Paul oversaw the training of 30+ RAF<br />

personnel in a large and complex road collision<br />

scene management exercise. His expertise<br />

ensured that the Fire Section, Medical Centre<br />

and Co-Response Team were fully prepared for<br />

challenging winter conditions going forward.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

Vicki’s ambitions and desire to be the best she<br />

can be in her profession, is helping GWAAC<br />

meet two strategic objectives:<br />

• To act Locally to provide an excellent and<br />

innovative Pre-Hospital Emergency Care<br />

service that supplements and supports NHS<br />

services<br />

• To impact Nationally and Influence Globally<br />

by improving Pre-Hospital Emergency Care<br />

for the benefit of all patients, identifying<br />

effective interventions, promoting good<br />

practice, and developing innovative new<br />

approaches<br />

On a local level, Vicki is delivering first-class<br />

pre-hospital care to patients wherever they are<br />

and whenever they need it. And on a national<br />

level, her ground-breaking achievement<br />

of being the first to qualify with a purely<br />

Paul received the award from Air Commodore<br />

Townsend. The award citation read:<br />

‘Mr Chittock is the linchpin of the team, keeping<br />

the Station highly trained in first aid response,<br />

and his support to Station major events has<br />

been first class. At no cost to the Station,<br />

advanced life-saving medical care has always<br />

been seconds away. What a great friend and<br />

ally for the Station to have, and what a fantastic<br />

contribution he has made over many years.’<br />

30<br />

For more news visit: www.ambulanceukonline.com


First electric<br />

ambulance for<br />

Homerton University<br />

Hospital<br />

ERS Medical, the <strong>UK</strong>’s<br />

leading health and social<br />

care transport provider, has<br />

rolled out its first electric<br />

ambulance for Homerton<br />

University Hospital and its<br />

community services.<br />

transport. The vehicle’s charging<br />

time means that this is a practical<br />

and long-term solution for<br />

greener patient transport.”<br />

Back to life Defibs<br />

Welcoming the first patient on<br />

board on Friday 19 November,<br />

this is another step in supporting<br />

the NHS’s net zero goals.<br />

To mark the occasion, ERS<br />

Medical welcomed Mr Rodrigues<br />

as the very first patient to be<br />

transported on their electric<br />

ambulance. He said: “It’s very<br />

nice and I’ve enjoyed going on it.”<br />

The electric ambulance has a<br />

range of 219/185 miles (city/<br />

combined) and saves over<br />

4000kg of CO 2<br />

emissions per<br />

year when compared to a diesel<br />

vehicle equivalent driving 10,000<br />

miles per annum. This saving of<br />

CO 2<br />

per annum is equivalent to<br />

424 gallons of diesel consumed<br />

or 4769 pounds of coal burned.<br />

Graham Snowling, Environmental<br />

Sustainability Manager at<br />

Homerton, said: “This is another<br />

stage in our journey to net zero.<br />

This new electric ambulance is<br />

dedicated to our patients being<br />

transported to and from the<br />

hospital for their appointments<br />

and also to clinics at our<br />

community sites. It not only<br />

reflects our commitment to net<br />

zero, but it is also a pledge to the<br />

residents of Hackney to improve<br />

the air quality in the area.”<br />

ERS Medical’s electric ambulance<br />

boasts a charging time of 45<br />

minutes to reach 80% battery<br />

with a DC charge – making it<br />

convenient and practical for<br />

continuous use on patient<br />

transport journeys.<br />

Andrew Pooley, Chief Executive<br />

at ERS Medical, added: “As the<br />

leading non-emergency patient<br />

transport provider for the <strong>UK</strong>,<br />

our electric ambulance paves<br />

the path for greener patient<br />

Horsham based business<br />

Trimbio felt it was time to<br />

stop disposing of Medical<br />

Devices just because they<br />

were deemd to be old, after<br />

seeing many older devices<br />

such as defibrillators<br />

and suction units being<br />

disposed of in landfill<br />

after coming out of the<br />

manufacturer’s warranty.<br />

They decided that this really<br />

was not acceptable and that<br />

they should be recycled. With<br />

a history of over 30 years of<br />

working with Medical Devices<br />

across many sectors, Simon<br />

Francis, the business owner,<br />

invested in additional test<br />

equipment, internal tracking<br />

systems and training for staff<br />

to ensure they conformed to<br />

the insurance requirements for<br />

recycling these devices. The<br />

business now supplies a wide<br />

range of Automated External<br />

Defibrillators and <strong>Ambulance</strong><br />

based Defibrillators / Monitors.<br />

During the process, the devices<br />

will have new batteries and<br />

accessories fitted, be fully tested<br />

ready to be deployed back into<br />

the public and medical sectors.<br />

These recycled devices can<br />

deliver many years of continued<br />

service at a fraction of the cost<br />

of new. Price for an AED starts<br />

from around £375+vat for a unit<br />

with new battery & pads. Trimbio -<br />

www.trimbio.co.uk<br />

Tel: 01403 597597.<br />

AMBULANCE <strong>UK</strong> - FEBRUARY<br />

For the latest <strong>Ambulance</strong> Service News visit: www.ambulancenewsdesk.com<br />



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