Ambulance Service Institute Annual Awards 2014

ASI_Awards_2014-0219

South East Coast Ambulance Service’s Thameside Ambulance Station team celebrate winning the Special Incident Award.      Photo Credit: Simon Hayward

Friends and family gathered at the Cholmondeley Room and Terrace, House of Lords, on 8 May to celebrate the Ambulance Service Institute (ASI) Annual Awards. The occasion recognised those in the pre-hospital care sector who have performed above and beyond the call of duty, in their dedication to saving lives.

Presented by Lord Ian McColl, professor of surgery and politician, the opening words of his address commended the great work being carried out by ambulance services up and down the country:

‘It’s been a great joy for me to be here and to hear all the amazing things that you have done. It must be absolutely horrendous; some of the situations you have had to deal with. We are just so grateful that you risk your lives to do all these wonderful things. Greater love hath no man who gives his life for another—or risks doing so.’

Set up in 2000 and originally held at AMBEX in Harrogate, the ASI Awards were initially only for NHS ambulance service personnel. However, the awards now incorporate accolades for military, private and voluntary services, and an international award was introduced in 2011.

2014 saw a 55% increase in nominations over the 11 award categories, resulting in the awards committee being split into six smaller committees deciding on two to three categories each.

Among the winners, Fellowship was awarded to past ASI president Carl Ledbury, and Honorary Fellowship to Prof Ian Greaves, professor of emergency medicine at James Cook University Hospital, Middlesburgh; and Prof Sir Keith Porter, clinical service lead for trauma services at the Queen Elizabeth Hospital Birmingham.

The President’s Commendation for Long Service went to Dennis Oakes of South Western Ambulance Service NHS Foundation Trust, who retired recently after 50 years of service. Oakes was praised for dedicating his entire life to caring for others.

The Innovations Award went to East Midlands Ambulance Service NHS Trust for the use of USB ECG leads linked to Toughbook PCs to improve efficiency and governance, as well as to reduce cost.

The Control Room Award went to Fiona Dinkel of Yorkshire Ambulance Service NHS Trust, who was noted as an outstanding emergency medical dispatcher with an almost exemplary audit history.

The First Aid/Community First Responder Award went to Craig Singleton of West Midlands Ambulance Service NHS Foundation Trust for his management of an incident in Gnosall involving a 4-year-old child who had been attacked at home by a Staffordshire Bull Terrier.

Recalling the event, Singleton said:

‘It was a traumatic experience. At the time, when I was in the house with the family and when the paramedics arrived I kept it together, but when I got outside it hit me how traumatic it was.’

The Private/Voluntary Ambulance Service Award was presented to St John Ambulance, District 5, South East Region for exceptional contributions made in support of a number of critical incidents.

The Patient Transport Service Award went to Alex Laston and Louise Ormsby of West Midlands Ambulance Service NHS Foundation Trust for their involvement in attending to a road traffic collision involving a female pedestrian and a large goods vehicle.

The Special Incident Award went to South East Coast Ambulance Service NHS Foundation Trust for their management of the Sheppey Bridge Incident, the biggest road traffic accident in Kent’s history, with more than 300 cars caught up in the early morning crash.

The Air Ambulance Team of the Year Award was presented to Helimed 03 and Helimed 09 from Midlands Air Ambulance, who demonstrated excellent team work in treating a 33-year-old male worker trapped in a tunnel under a large potato-sorting machine.

The Front-line Ambulance Award was given to Lance Corporal Malcolm Martindale of the Royal Army Medical Corps for his provision of front-line ambulance medical support to deployed British forces in Afghanistan.

The Military Award was presented to Sergeant Ryan Briggs, an RAF medic who helped form a small quick response force which treated casualties of the Taliban raid of Camp Bastion in Helmand Province, Afghanistan on 14 September 2012.

The Paramedic/Emergency Care Practitioner Award went to Paul Gibson of East of England Ambulance Service NHS Trust, who selflessly saved a woman from a flat in Ipswich that was engulfed in flames after learning that she was trapped inside.

George Reader, dock master at Watchet Mariner in Somerset, received the Public Spirited Award for his bravery in saving a 6-month-old baby who was plunged into the icy waters at Watchet Harbour when a gust of wind swept the child’s buggy into the water.

Speaking to the Journal of Paramedic Practice after the event, Dr Anthony Marsh, chief executive officer of both East of England Ambulance Service NHS Trust and West Midlands Ambulance Service NHS Foundation Trust, and chairman of the Association of Ambulance Chief Executives, said:

‘I think this event is a fantastic opportunity to publicly recognise the great work of ambulance staff and all those people that support the ambulance service in our country.

‘Our staff do a fantastic job every day, often in difficult circumstances, so to have an event such as today, where we can recognise excellence, thank them personally, but also their families, is a great occasion.’

Dr Peter Griffin, president of the Ambulance Service Institute, added:

‘I have been responsible for chairing the ASI Awards Committee and reading out the Award Citations since 2002 and I never cease to be amazed by the outstanding professionalism and often extreme acts of bravery that are detailed in the nominations.

‘Typically, the ambulance personnel concerned make light of their actions with comments like “I was only doing my job” or “it is all in a day’s work”. I see the ASI Awards as a way of making these dedicated people feel special for a day with a trip to London and a visit to the House of Lords. It is my greatest wish to get more publicity for the ASI Awards Ceremony so that these actions and the people involved can get the wider publicity that they most rightly deserve.’

Taken from Journal of Paramedic Practice, published 6 June 2014.

Getting more AEDs in public places

shockinglyeasy-logo 300x275Sudden cardiac arrest (SCA) is a leading cause of premature death. In the UK alone, approximately 30 000 people sustain cardiac arrest outside hospital and are treated by emergency medical services (EMS) each year (Pell et al, 2003). However, many SCA victims can be saved by bystanders who recognise what has happened, summon the ambulance service as soon as possible, perform basic CPR and use an AED to provide a high-energy electric shock to restore the heart’s normal rhythm (Resuscitation Council (UK) and British Heart Foundation, 2013).

It has been shown that a strong predictor of SCA survival is the interval from collapse of the patient to defibrillation (Valenzuela et al, 1997). While this generally applies to defibrillation as carried out by healthcare professionals—from emergency physicians, to paramedics, to first responders—it also extends to defibrillation carried out by the layperson (Rea and Page, 2010). The introduction of public access defibrillation (PAD) programmes has produced positive results. One US study, which looked at a prospective series of cases of SCA in casinos, attended to by security officers instructed in the use of AEDs, recorded survival rates as high as 74% (Valenzuela et al, 2000).

In April, the Department for Education announced a plan to allow schools to purchase defibrillators at a lower cost. As a result, the Government is currently working to identify a supplier who will offer defibrillators at a competitive price, affirming that the deal will be sealed in time for the autumn term. Around 270 cardiac arrests occur in schools in the UK each year, highlighting the evident need to have AEDs on hand.

Ambulance services have played their part in encouraging PAD as well as the number of defibrillators in the community. On 1 May 2014, London Ambulance Service NHS Trust launched a campaign to get 1 000 defibrillators in shops, businesses and gyms across the capital, while South Central Ambulance Service NHS Foundation Trust have launched an app that uses GPS functionality to show where the nearest AED is, as well as a list of other AEDs in the area, as part of its ‘Start a Heart’ campaign.

Undoubtedly, there are considerations to take into account with regards to PAD, such as the investment to purchase AEDs and maintain layperson responder proficiency (Rea and Page, 2010). However, given that AEDs are designed to be used by laypersons, with the machine guiding the operator through the defibrillation process by verbal instructions and visual prompts (Resuscitation Council (UK) and British Heart Foundation, 2013), there is plenty of argument in favour of PAD.

References:

Pell JP, Sirel JM, Marsden AK, Ford I, Walker NL, Cobbe SM (2003) Presentation, management, and outcome of out of hospital cardiopulmonary arrest: comparison by underlying aetiology. Heart 89(8): 839–42

Rea T, Page RL (2010) Community approaches to improve resuscitation after out-of-hospital sudden cardiac arrest. Circulation 121(9): 1134–40

Resuscitation Council (UK) And British Heart Foundation (2013) A Guide to Automated External Defibrillators (AEDS). Resuscitation Council (UK), London

Valenzuela TD, Roe DJ, Cretin S, Spaite DW, Larsen MP (1997) Estimating effectiveness of cardiac arrest interventions: a logistic regression survival model. Circulation 96(10): 3308–13

Valenzuela TD, Roe DJ, Nichol G, Clark LL, Spaite DW, Hardman RG (2000) Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med 343(17): 1206–9

Taken from Journal of Paramedic Practice, published 6 June 2014.

AACE launch review into ambulance demand

aaceA new project launched by the Association of Ambulance Chief Executives (AACE) aims to establish how the ambulance service in the UK is used.

AACE is calling for volunteers who have recently called 999 to answer questions about the occasion on which an ambulance was called and other services that may have been contacted for help prior to calling 999.

The use of ambulance services has increased by 59% over the last decade, but it is still unclear as to what the specific factors are which have contributed to this change.

‘The overall aim of the review is to investigate the underlying causes of increasing demand on the ambulance service,’ said Dr Melanie Edwards, project researcher for AACE.

‘During the review, we are examining how demand has changed nationally over the past 10 years, investigating what factors have contributed to the rise in emergency ambulance demand, exploring how demand on the emergency ambulance service relates to demand elsewhere in the urgent and emergency care system, and exploring steps that could be taken to mitigate rising demand.

She added: ‘We are using various strands of methodology, which have included a literature review, analysis of operational data from each ambulance service in England, and interviews with key stakeholders (representatives from ambulance services, representatives from organisations relevant to urgent and emergency care, and recent users of the ambulance service).’

Taken from Journal of Paramedic Practice, published 2 June 2014.

Schools to be able to purchase AEDs at lower costs

aed-plus-in-schoolThe Department for Education has announced a plan to allow schools to purchase defibrillators at a lower cost.

The Government is currently working to identify a supplier who will offer defibrillators at a competitive price, affirming that the deal will be sealed in time for the autumn term.

The Department of Health estimates that around 88 children per year die of sudden cardiac arrest; however, there is currently no data on how many of these occur in schools.

This announcement comes at the same time as new statutory guidance for schools on supporting pupils with medical conditions has been published.

Supporting pupils at school with medical conditions covers a range of issues including developing the roles and responsibilities of those involved in supporting pupils at school, information on staff training and advice on emergency procedures.

Schools Minister, Lord Nash, said:

‘There is nothing more important than keeping children safe at school. That is why this Government is today publishing updated guidance to schools on managing children with medical conditions.

‘By securing defibrillators at a reduced price, schools will find it much easier to install these potentially life-saving devices. We hope schools right across the country will take advantage of this.’

Anne Jolly, founder of the cardiac charity SADS UK, said:

‘It is crucial that schools have immediate access to defibrillators. Around 270 cardiac arrests occur in schools in the UK each year; the earlier CPR and defibrillation are administered the better the chance is of survival. Heart conditions, both diagnosed and undiagnosed can predispose a person of any age to sudden cardiac arrest. Sports and exercise at school can be a precursor to cardiac emergency and any trauma or accident can also trigger cardiac arrest. Having defibrillators and emergency action plans in place if a cardiac arrest occurs in school is very important.

‘Cost of the defibrillator is a consideration for some schools,’ she added. ‘However, it is important that its not just a defibrillator they have on the school premises, it is a complete defibrillator package that the school feels confident with and suits the needs of their school and age range of pupils. SADS UK has found that more schools are researching into the defibrillator and ancillaries and are more concerned that the defibrillator package they obtain is suitable, discussing with SADS UK how many defibrillators they need dependent on the size and layout of their school and how quickly they are able to access the equipment. Many schools have found as SADS UK organise the defibrillator for them together with initial defibrillator training this frees up valuable school administration time.

‘Using an AED prior to the arrival of the emergency services can make the difference between life and death. Research shows that for every minute that passes without defibrillation the chances of survival decrease by 10–14%, and to give the best chance of survival a therapeutic shock should be given within 5 minutes of collapse from a cardiac arrest. Ambulance services endorse defibrillators being available in schools as they know when they arrive on the scene they have a better chance of sustaining life as they administer more advanced therapy as required.’

Mark Whitbread, clinical practice manager of London Ambulance Service NHS Trust, commented:

‘Even if an ambulance is parked round the corner from a cardiac arrest it can too often be too late. Devastatingly, eight minutes after a cardiac arrest, the chance of a child surviving will have decreased by 80%. Using life-saving AEDs prior to the arrival of the emergency services increases the likelihood of the child surviving ten-fold.

The statutory guidance Supporting pupils at school with medical conditions, will come into effect in September, replacing current guidance issued in 2005.

Taken from Journal of Paramedic Practice, published 2 June 2014.

Investigation launched by London Ambulance Service into alleged exam cheating

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London Ambulance Service NHS Trust (LAS) has had to suspend its paramedic final examinations following claims by an anonymous whistle blower that student paramedics had access to their final papers.

An external investigation has been launched that will look into the allegations that students going through the Trust’s in-house training programme between 2008 and 2012 had access to exam papers.

850 students went through the training programme during the four years but it is unclear as to the number who had access to the papers or how they may have gained access to them.

Ann Radmore, chief executive of LAS, said:

‘I was shocked and disappointed to hear this anonymous allegation and will not tolerate any form of cheating.

‘I am committed to sharing the findings of this independent investigation and being transparent throughout.’

It is unclear how long the investigation will take but it is thought the suspension of exams may cause a short delay in paramedics qualifying.

The external investigation will be led by Simon Brown, assistant medical director, north, for South Central Ambulance Service Trust, and chair of the Joint Royal Colleges Ambulance Liaison Committee Guidelines Subcommittee.

Taken from Journal of Paramedic Practice, published 2 June 2014.

Ambulance Service Institute celebrate excellence at annual awards

Photo Credit: Simon Hayward

Photo Credit: Simon Hayward

The Ambulance Service Institute recognised those in the pre-hospital care sector who have performed above and beyond the call of duty on 8 May at the Cholmondeley Room and Terrace, House of Lords.

Presenting the awards, Lord Ian McColl said:

‘It’s been a great joy for me to be here and to hear all the amazing things that you have done. It must be absolutely horrendous; some of the situations you have had to deal with. We are just so grateful that you risk your lives to do all these wonderful things. Greater love hath no man who gives his life for another—or risks doing so.’

Dr Anthony Marsh, chief executive officer of both East of England Ambulance Service NHS Trust and West Midlands Ambulance Service NHS Foundation Trust, and chairman of the Association of Ambulance Chief Executives, said:

‘I think this event is a fantastic opportunity to publicly recognise the great work of ambulance staff and all those people that support the ambulance service in our country.

‘Our staff do a fantastic job every day, often in difficult circumstances, so to have an event such as today, where we can recognise excellence, thank them personally, but also their families, is a great occasion.’

Dr Peter Griffin, President of the Ambulance Service Institute, said:

‘I have been responsible for chairing the ASI Awards Committee and reading out the Award Citations since 2002 and I never cease to be amazed by the outstanding professionalism and often extreme acts of bravery that are detailed in the nominations.

‘Typically, the ambulance personnel concerned make light of their actions with comments like “I was only doing my job” or “it is all in a day’s work”. I see the ASI Awards as a way of making these dedicated people feel special for a day with a trip to London and a visit to the House of Lords. It is my greatest wish to get more publicity for the ASI Awards Ceremony so that these actions and the people involved can get the wider publicity that they most rightly deserve.’

The full list of winners is as follows:

Air Ambulance Team of the Year Award
Helimed 03 and 09 (Midlands Air Ambulance Service)

Control Room Award
Fiona Dinkel (Yorkshire Ambulance Service NHS Trust)

First Aid/CFR Award
Craig Singleton (West Midlands Ambulance Service NHS Foundation Trust)

Front-Line Ambulance Award
L Cpl Malcolm Martindale (225 Medical Regiment)

Innovations Award
East Midlands Ambulance Service NHS Trust

Military Award
Sgt Ryan Briggs (RAF Medic Tactical Medical Wing)

Paramedic/ECP Award
Paul Gibson (East of England Ambulance Service NHS Trust)

Patient Transport Service Award
Alex Laston and Louise Ormsby (West Midlands Ambulance Service NHS Foundation Trust)

President’s Commendation for Long Service
Dennis Oakes (South Western Ambulance Service)

Private/Voluntary Ambulance Service Award
St John Ambulance (District 5, South East Region)

Public Spirited Award
George Reeder (Dock Master – Watchet Marina)

Special Incident Award
South East Coast Ambulance Service NHS Foundation Trust (Sheppey Bridge incident)

Fellowship
Carl Ledbury (ASI Past President)

Honorary Fellowship
Professor Ian Greaves
Professor Sir Keith Porter

Taken from Journal of Paramedic Practice, published 2 June 2014.

Expanding the role of paramedics

As populations worldwide continue to grow and life expectancy rises, there has been a corresponding demand placed on health care services. Emergency medical services (EMS) in particular have found themselves under increasing pressure, with some ambulance services experiencing a rise in the number of emergency calls received by as much as 8% annually (Department of Health, 2004).

Traditionally, EMS systems have focused on providing patient care for acute illnesses and emergencies. However, studies have suggested that 10–40% of EMS responses are for non-emergent situations (Joint Committee on Rural Emergency Care and National Association of State EMS Officials (JCREC and NASEMSO), 2010). The need for an EMS role, which can improve individual and community health, reduce unnecessary hospitalisations and emergency department visits, and reduce health care costs, has led to the introduction of community paramedic programmes in the United States, Canada, Australia and New Zealand. In the United Kingdom, similar work has been carried out by paramedic practitioners and/or emergency care practitioners, although without the same level of community engagement found in the community paramedic role.

The inaugural meeting of the International Roundtable on Community Paramedicine (IRCP) in 2005 gave the opportunity for the international exchange of ideas on integrating rural EMS providers into rural health care delivery systems (IRCP, 2014). The IRCP has continued to meet annually, promoting the international exchange of information and experience related to the provision of flexible and reliable health care services to residents of rural and remote areas using novel health care delivery models, and acting as a resource to Government agencies, emergency service providers, and others (IRCP, 2014).

In this issue of International Paramedic Practice, O’Meara conducts a scoping review of the emergence of community paramedics and their potential impact. His findings illustrate that although there are few empirical studies on community paramedics, with much of the literature consisting of commentaries and opinion papers, there is still an emerging research literature that is contributing to the development of community paramedicine programme models and the evaluation tools that will contribute to the future evolution of the model.

Also in this issue, Raynovich et al present the findings of a survey of community course offerings and planned offerings sent to every recipient of a standardised community paramedic curriculum. The responses indicated that many community paramedic courses were in the planning stages by programmes that had received the standardised curriculum, both in the United States and Internationally.

Both these papers illustrate the need for further research to examine the impact of community paramedicine, but also highlight the potential of extended scope of practice of paramedics who are based in the community.

References:

Department of Health (2004) Statistical Bulletin Ambulance Services, England 2003–04. DH, London, UK

International Roundtable on Community Paramedicine (2014) IRCP History. http://www.ircp. info (accessed 20 May 2014)

Joint Committee on Rural Emergency Care, National Association of State EMS Officials (2010) Beyond 911: State and Community Strategies for Expanding the Primary Care Role of First Responders. National Conference of State Legislators December 2010

Taken from International Paramedic Practice, published 21 May 2014.

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