Wales Air Ambulance introduces first night flight

walesWales Air Ambulance has made its first night flight, saving a 59-year-old man from Welshpool who was suffering from a heart attack.

The charity made its maiden night flight during the early hours of 25 March. After receiving an emergency 999 call, the air ambulance was able to transport the man to the nearest cardiac centre at North Staffordshire University Hospital in just 45 minutes.

By using the Air Ambulance service, transport time for the patient was reduced by at least an hour, and meant that a life-saving procedure could be delivered where a cardiac stent was inserted into the coronary arteries to improve blood flow to the heart.

The flight comes following weeks of training, where pilots and paramedics at Welshpool have been learning how to extend their work into the hours of darkness.

National clinical and operations manager for Wales Ambulance Service, Jason Williams, said:

‘We can now fly in the hours of darkness, and this means that we can now provide more of a service and are working towards a 24-hour service.’

When questioned on the night flight, Williams said: ‘In this example, “time is muscle”, and every minute that the heart muscle is deprived of blood the chances of survival are greatly reduced as the heart muscle dies.’

Throughout the trial of the night service, paramedics have been getting used to using night vision goggles, allowing them to pick out places and people that wouldn’t be possible without their aid.

Currently, only three hospitals in Wales can allow night time arrivals from the air ambulance: Ysbyty Gwynedd in Bangor, Ysbyty Glan Clwyd in Bodelwyddan, and Morriston in Swansea.

During the trial, the Welshpool Air Ambulance service is working from 09:00 to 21:00 BST.

The Air Ambulance, which costs £6 million a year to run, has carried out more than 17,600 missions since its launch in 2001, and carries out approximately 2,000 missions a year.

Taken from Journal of Paramedic Practice, published 25 April 2013.

Antimicrobial resistance is a ‘ticking time bomb’

antibiotics_2506419bThe Chief Medical Officer Professor Dame Sally Davies has announced that global action is needed if we are to overcome the ‘catastrophic threat’ of antimicrobial resistance.

The warning, made in her second annual report, highlighted the lack of new antibiotics discovered in the past two decades.

Despite new infectious diseases being discovered on an almost yearly basis, very few new antibiotics have been developed.

This means that we have limited resources to manage the increasing number of infectious diseases that are ever evolving to become resistant to current drugs.

‘We need to work with everyone to ensure the apocalyptic scenario of widespread antimicrobial resistance does not become a reality,’ said Professor Davies. ‘This is a threat arguably as important as climate change for the world.’

The importance of preserving current antibiotics was also emphasized. Professor Davies argued that in order to retain the effectiveness of existing antibiotics, responsible prescribing must be adhered to.

‘All physicians who prescribe antibiotics have a responsibility to their patients (and public health) to prescribe optimally,’ she said.

To help meet the challenges set out by Professor Davies, the Department of Health is planning to publish a UK Antimicrobial Resistance Strategy.

This five-year strategy will focus on championing the responsible use of antibiotics by ensuring NHS staff have the necessary knowledge, skills and training to prescribe antibiotics effectively.

Professor Davies stressed that governments and organizations across the world, including the World Health Organization and G8, need to realize the seriousness of the problem.

‘If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics.’

Taken from Practice Nursing, published 19 Mar 2013.

NHS Diabetes calls for introduction of specialist foot care teams

article-1314208810593-0D699E8C000005DC-422646_636x420A report published by NHS Diabetes has announced the NHS spent an estimated £639 million–£662 million on diabetic foot ulceration and amputation in 2010–11.

Each year around 6 000 people with diabetes have leg, foot or toe amputations in England, substantially reducing their quality of life.

However, many of these are avoidable. The NHS Diabetes report suggests rapid access to multidisciplinary foot care teams (MDTs) with strong links to community podiatry services could lead to faster healing, fewer amputations and improved survival.

The reduction in NHS expenditure on diabetic foot problems as a result of the introduction of such services would far outstrip the cost of having MDTs.

Lower-extremity amputation rates at James Cook University, Middlesbrough, fell by two-thirds after the introduction of an MDT.

In 2010-2011 it was estimated that the cost of an MDT was £33 000, whereas the annual saving to the NHS due to averted amputation was £249 000.

Currently, one-fifth of hospitals providing inpatient care for people with diabetes have no MDT.

Anne Morton, Director of NHS Diabetes said: ‘It is not acceptable that thousands of people with diabetes lose a limb each year because of poor quality care. It is even less easy to accept when we now have such a strong economic case for change.’

Taken from Practice Nursing, published 19 Mar 2013.

Why Brains Matter

brain graphic 001The Neurological Alliance launched a survey entitled ‘Our Brains Matter’ as part of the 2013 Brain Awareness Week, 11-17 March.

Brain Awareness Week is a global campaign to increase public awareness of the progress and benefits of brain research.

The aim of the Our Brains Matter survey is to develop a clear picture of the experience of being diagnosed with a neurological condition in the UK. With the evidence gathered, the Neurological Alliance will push for improvements in the diagnosis of all neurological conditions.

The Neurological Alliance is the collective voice for 10 million children, young people and adults in England with a neurological condition. It is a membership organization consisting of more than 70 national brain and spine organizations.

The coalition of charities has warned that a ‘legacy of neglect’ is preventing an estimated 12 million people living with neurological conditions in the UK from gaining vital treatment.

According to the Neurological alliance this is due to a lack of specialist knowledge and haphazard services.

‘Around one in six people in the UK will experience a neurological condition in their lifetime,’ explains Arlene Wilkie, Chief Executive of the Neurological Alliance, ‘Yet little is being done to ensure that the NHS is fit for purpose when it comes to responding to these complex conditions.’

Taken from Practice Nursing, published 19 Mar 2013.

LAS improves out of hospital cardiac arrest survival rates

heart_attack_640As part of a call to action from health secretary Jeremy Hunt to reduce the number of avoidable deaths in the UK, the Department of Health has published an outcomes strategy on cardiovascular disease (CVD), which will support the NHS and local authorities in delivering improved outcomes for those with or at risk of CVD.

The announcement comes following The Lancet’s recent report on the UK’s health performance, which highlighted that the UK was a long way behind many other countries.

CVD affects the lives of millions of people and is one of the largest causes of death and disability in the UK. However, fast responses to emergencies can save lives and, in some cases, reduce disability.

According to the strategy about 50 000 out of hospital cardiac arrests (OHCA) occur each year in England. Due to a variety of reasons, such as co-morbidity, resuscitation may be inappropriate, and so attempted resuscitation by ambulance services occurs in less than 50% of cases.

However, there is significant variability between ambulance services in rates of successful initial resuscitation (13-27%) and survival to hospital discharge (2-12%) following an OHCA. If survival rates were increased from the overall average (around 7%) to that of the best reported (12%), it is estimated that an additional 1 000 lives could be saved each year.

The strategy revealed that since 2004/2005 the London Ambulance Service (LAS) has improved overall OHCA survival to hospital discharge from a rate of 4% to 11% in 2011/2012. This is as a result of quicker response times; taking heart attack and cardiac arrest patients direct to heart attack centres; and improving bystander resuscitation.

Despite improvement in the LAS, variation in the quality of acute care in other parts of the country mean that much can still be done if patient mortality from CVD is to see considerable change.

The CVD outcomes strategy claims that the NHS Commissioning Board (CB) will work with the Resuscitation Council, the British Heart Foundation and others to promote automatic external defibrillator (AED) site mapping/registration and first responder programmes by ambulance services, and consider ways of increasing the numbers trained in cardiopulmonary resuscitation (CPR) and using automated AEDs.

Taken from Journal of Paramedic Practice, published 14 Mar 2013.

East Anglia Ambulance Service under Fire

2359721920A damning report has revealed Suffolk, Norfolk and Cambridgeshire Ambulance Services have failed to meet response targets every month of the last financial year.

National standards require emergency services to reach targets of 75% of most urgent cases in eight minutes and 95% of incidents in 19 minutes.

Ambulance bosses have claimed the failing of these two key targets by the East Anglia Ambulance Service is due to high staff sickness rates, an increase in calls this winter and hospital handover delays.

Suffolk MP and health minister, Dan Poulter, said the findings were ‘hugely disappointing but sadly unsurprising.’

He added: ‘These figures are a sobering reminder of the complete failure of leadership within the ambulance service to face up to the challenge of providing high quality and speedy ambulance cover for Suffolk.’

In an attempt to ease pressure on the service, 15 new ambulances have been introduced to the East of England Ambulance Service Trust.

However, due to a lack of paramedics willing to work overtime, so far the extra vehicles have been unable to be put to proper use.

It is hoped that performance will improve following the planned recruitment of 75 new paramedics and 124 care assistants by the Trust.

The Care Quality Commission (CQC) has found the Trust non-compliant when it comes to the care and welfare of patients, and the results of a full investigation into the Trust are due to be published next month.

Taken from Journal of Paramedic Practice, published 14 Mar 2013.

Paramedics unable to go to emergency calls

_50872382_newslineLast month paramedics in Belfast were forced to queue with patients for up to four hours as a result of severe bed shortages at Ulster hospital, Dondonald, Northern Ireland.

The South Eastern Trust confirmed that Ulster Hospital was operating at 20% above capacity, meaning patients were unable to receive necessary treatment.

Following the closure of Belfast City Hospital’s emergency department in 2011, Ulster hospital’s A&E has seen an extra 10 000 patients.

Despite cause for concern, health minister, Edwin Poots, denied patients’ lives had been put at risk. ‘People’s lives aren’t being compromised. People who needed to see doctors in an emergency situation – that happened.’

Chairman of the Health Committee, Sue Ramsay, argued that problems with waiting times in emergency departments had been a concern for a number of years.

‘We need to hear from the minister,’ she said. ‘The minister needs to tell us, is the action group he set up last April working? We need to hear from him and what the next step is.’

Taken from Journal of Paramedic Practice, published 14 Mar 2013.

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