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Showing results for tags 'Ambulance'.
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News Article
Fast response to terror attacks saves lives. UK medics should not be held back
Patient Safety Learning posted a news article in News
The Streatham terrorist attack has again highlighted one of the most difficult decisions the emergency services face – deciding when it is safe to treat wounded people. In the aftermath of the stabbings by Sudesh Amman, a passer-by who helped a man lying on the pavement bleeding claimed ambulance crews took 30 minutes to arrive. The London Ambulance Service (LAS) said the first medics arrived in four minutes, but waited at the assigned rendezvous point until the Metropolitan police confirmed it was safe to move in. Last summer, the inquest into the London Bridge attack heard it took three hours for paramedics to reach some of the wounded. Prompt treatment might have saved the life of French chef Sebastian Belanger, who received CPR from members of the public and police officers for half an hour. A LAS debriefing revealed paramedics’ frustration at not being deployed sooner. A group of UK and international experts in delivering medical care during terrorist attacks have highlighted alternative approaches in the BMJ. In Paris in 2015, the integration of doctors with specialist police teams enabled about 100 wounded people in the Bataclan concert hall to be triaged and evacuated 30 minutes before the terrorists were killed. The experts writing in the BMJ believe the UK approach would have delayed any medical care reaching these victims for three hours. These are perilously hard judgment calls. Policymakers and commanders on the scene have to balance the likelihood that long delays in intervening will lead to more victims dying from their injuries against the increased risk to the lives of medical staff who are potentially putting themselves in the line of fire by entering the so-called 'hot zone'. First responders themselves need to be at the forefront of this debate. As the people who have the experience, face the risks and want more than anyone to save as many lives as possible, their leadership and insights are vital. In the wake of the Streatham attack the government is looking at everything from sentencing policy to deradicalisation. Deciding how best to save the wounded needs equal priority in the response to terrorism. Read full story Source: The Guardian, 7 February 2020 -
News Article
East of England Ambulance Service staff 'silenced' over bullying
Patient Safety Learning posted a news article in News
Concerns have been raised that NHS ambulance staff are being "silenced" over bullying allegations. Hundreds of East of England Ambulance Service (EEAS) employees reported bullying in 2018, while 28 non-disclosure agreements (NDAs) have been issued since 2016. The GMB union said the figures showed a "heavy-handed culture". The service said it took bullying and harassment "extremely seriously" and had policies to prevent such behaviour. EEAS faced scrutiny in November when it emerged three members of staff died in 11 days. One, Luke Wright, 24, is believed to have taken his own life. An independent investigation, which dealt in part with bullying claims, has been carried out with the results reported to the trust in January. The 28 NDAs had been made in cases where bullying, harassment or abuse by colleagues had been reported, according to figures obtained under the Freedom of Information Act. These involved an individual agreement, often with a payment, which prevented the person speaking about their case. In the latest staff survey from 2018, 23% of staff reported bullying, up from 21% in the previous year. The GMB said NDAs were seen as a "method of silencing rather than resolving" and called on the trust to discuss more meaningful ways of dealing with problems. Read full story Source: BBC News, 10 February 2020- Posted
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Content ArticleWhile there is growing awareness of the risk of harm in ambulatory health care, most patient safety efforts have focused on the inpatient setting. The Comprehensive Unit-based Safety Program (CUSP) has been an integral part of highly successful safety efforts in inpatient settings. In 2014 CUSP was implemented in an academic primary care practice. As part of CUSP implementation, staff and clinicians underwent training on the science of safety and completed a two-question safety assessment survey to identify safety concerns in the practice. The concerns identified by team members were used to select two initial safety priorities. The impact of CUSP on safety climate and teamwork was assessed through a pre-post comparison of results on the validated Safety Attitudes Questionnaire. CUSP is a promising tool to improve safety climate and to identify and address safety concerns within ambulatory health care.
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News ArticleHeart attack, stroke and burns victims are among the seriously ill and injured patients waiting over an hour for an ambulance to arrive in England and Wales, a BBC investigation shows. The delays for these 999 calls - meant to be reached in 18 minutes on average - put lives at risk, experts say. The problems affect one in 16 "emergency" cases in England - with significant delays reported in Wales. NHS bosses blamed rising demand and delays handing over patients at A&E. Rachel Power, Chief Executive of the Patients Association, said patients were being "let down badly at their moment of greatest need" and getting a quick response could be "a matter of life or death". She said the delays were "undoubtedly" related to the sustained underfunding of the NHS. Read full story Source: BBC News, 29 January 2020
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Content ArticleThis US-focused article looks at the evolution of the ambulance service and the methods used to try to ensure that supply meets demand.
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News Article
Coroner raps trust for not realising woman was in ‘imminent danger’
Patient Safety Learning posted a news article in News
A coroner has criticised an ambulance trust after it took nearly four hours to reach a woman who had taken an overdose. Taking the unusual step of publishing a prevention of future deaths report before an inquest had concluded, coroner for Gateshead and South Tyneside Terence Carney said “the real and imminent danger of [the deceased Maureen Wharton’s] admitted actions does not appear to have been appreciated and readily reacted to in a meaningful way”. Ms Wharton called North East Ambulance Service Trust to say she was dying of cancer and had taken prescribed drugs, including an opioid-based medication and sleeping pills. She threatened to take more and later called back, appearing drowsier. North East Ambulance Service graded the 61-year-old’s call as “category three”, which meant she should have received a response within two hours. It took three hours and 45 minutes for the ambulance service to access her flat, by which time she was already dead. Mr Carney pointed out no attempts had been made to identify family or other support for her, or to contact other agencies which could have responded. The inquest into her death is expected to conclude later this year. In a statement, NEAS said it has already made changes to safeguard patients in mental health cases, including implementing greater oversight in its control rooms, improving call transfers to crisis teams, mapping available local mental health services, introducing more staff training, and telling patients in a crisis but not at risk of physical harm about other, more appropriate, services. Read full story (paywalled) Source: HSJ, 14 January 2020 -
News Article
Shante Turay-Thomas: Human error factor in allergy death
Patient Safety Learning posted a news article in News
A teenager with a severe nut allergy died in part because of human error, a coroner has ruled. Shante Turay-Thomas, 18, had a severe reaction to eating a hazelnut. The inquest heard a series of failures meant that an ambulance took more than 40 minutes to arrive at her home in Wood Green, north London. Her mother Emma Turay, who said she felt "badly let down" by the NHS, wants an "allergy tsar" to be appointed to help prevent similar deaths. The inquest heard call staff for the NHS's 111 non-emergency number failed to appreciate the teenager's worsening condition was typical of a severe allergic reaction to nuts. A telephone recording of the 111 call, made by her mother, at 23:01 BST on Friday 14 September 2018, revealed how the 18-year-old could be heard in the background struggling to breathe. "My chest hurts, my throat is closing and I feel like I'm going to pass out," she said before asking her mother to check how long the ambulance would be, then adding: "I'm going to die." The inquest heard Ms Turay-Thomas had tried to use her auto-injector adrenaline pen, however it later emerged she had only injected a 300 microgram dose, rather than the 1,000 micrograms needed to stabilise her condition. It also emerged she was unaware of the need to use two shots for the most serious allergic reactions and had not received medical training after changing her medication delivery system from the EpiPen to a new Emerade device. The inquest at St Pancras Coroner's Court was told an ambulance that was on its way to the patient had been rerouted because the call was incorrectly categorised as requiring only a category two response, rather than the more serious category one. Read full story Source: BBC News, 13 January 2020 -
Content ArticleIn January 2016, a high-profile local inquest examined the death of Jasmine Lapsley, a six year old child who sadly died after choking on a grape. One of Bangors post-ACCS Clinical Fellows (not involved with the case) attended the inquest with the intention of sharing any learning points at a CPD Day for Emergency Medical Service (EMS) colleagues we were due to hold six weeks later. Upon releasing the CPD Day programme, organisers realised some EMS colleagues were profoundly uncomfortable about this talk, stating concerns such as 'talking publicly about lessons learned might upset the bereaved family'. They decided to ask all delegates at the CPD day what they thought of the inclusion of this item on the conference programme before and after the talk. This poster shows the results.
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News Article
Two patients die after hospitals ignore key safety warning
Patient Safety Learning posted a news article in News
Two patients have died as a result of NHS hospitals failing to heed warnings about the use of super-absorbent gel granules, which patients mistakenly eat thinking they are sweets or salt packets. A national patient safety alert has been issued by NHS bosses to all hospitals, ambulance trusts and care homes instructing them to stop using the granules unless in exceptional circumstances. An earlier alert in 2017 warned the granules, which are used to prevent liquid being spilled, had caused the death of one patient who choked to death after eating a sachet left in an empty urine bottle in their room. The 2017 alert warned hospitals there had been a total of 15 similar incidents over a six-year period between 2011 and 2017. The latest warning from NHS England says most hospitals concentrated on “raising awareness” rather than stopping the use of gel granules. Read alert Read full story Source: The Independent, 4 December 2019 -
Content ArticleSuperabsorbent polymer gel granules are used to reduce spillage onto bedding and clothing when patients use urine bottles or vomit bowls, or when staff move fluid-filled containers (eg washbowls or bedpans). If the gel granules are put in the mouth, they expand on contact with saliva risking airway obstruction. This National Patient Safety Alert requires any organisation still using these products to protect patients by introducing strict restrictions on their use.
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News Article
Patients given wrong air in oxygen mix-up at hospital
Patient Safety Learning posted a news article in News
A hospital has made changes after two patients were accidentally given medical air instead of oxygen. The two incidents, which took place at the Norfolk and Norwich University Hospital (NNUH), were classed as "never events" meaning they were serious but preventable. They happened to patients in November who were being handed over to the hospital by the East of England Ambulance Service. The patients should have been given oxygen but were given medical air instead which only contains 20pc oxygen. The ambulance service said in a message to staff: "Severe harm or death can occur, if medical air is accidentally administered to patients instead of oxygen. As per NNUH's request, with immediate effect, when handing over at the NNUH, all medical equipment and oxygen should be swapped only by an emergency department doctor or registered nurse." Read full story Source: Eastern Daily Press, 2 December 2019 -
Content ArticleTransport of patients from the intensive care unit (ICU) to another area of the hospital can pose serious risks if the patient has not been assessed prior to transport. The Department of Critical Care Medicine, Calgary Health Region, experienced two adverse events during transport. A subgroup of the Department's Patient Safety and Adverse Events team developed an ICU patient transport decision scorecard. This tool was tested through Plan-Do-Study-Act cycles and further revised using human factors principles. Staff, especially novice nurses, found the tool extremely useful in determining patient preparedness for transport.
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- Transfer of care
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Content Article"It’s time to halt, take a break, and redraw the relationship between patient care and self-care. Self-care isn’t an optional luxury. It must sit at the heart of what we do, to ensure our teams can continue to rise to the challenges of working in the 21st century NHS, to give our patients the best of both ourselves, and the organisation so many of us are proud to be a part of."
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Content ArticleInformation for the Public pre-hospital emergency medicine (PHEM) feedback is a collaboration between the Princess Alexandra Hospital and the services who bring patients to them (ambulances and air ambulance teams) and provide pre-hospital care to those patients.
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Content ArticleIn this lecture from the PHEM (Pre Hospital Emergency Medicine) Feedback Showcase, Gordon Patterson (Patient Representative for Resuscitation Council UK and Patient Representative for PHEM Feedback) describes his experiences as a patient who experienced an out of hospital cardiac arrest 15 years ago. With him is Jonathan Dermott, the paramedic who was called to rescue him and provide resuscitative care, and who since has benefited from following up the case. He describes the life-changing consequences of his care both as a clinician and educator.
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Content Article
PHEM Feedback Showcase Lecture 1
Claire Cox posted an article in Motivating staff
This is the opening lecture of the 2019 PHEM (PreHospital Emergency Medicine) Feedback Showcase event. It opens with an address from Ms Jacqueline Kelly, Dean of the School of Health and Social Work at the University of Hertfordshire. It then gives an explanation of what PHEM Feedback is and how it came to exist. -
Content ArticleEmergency service workers describe how being on the front line affects their mental health, how they cope with the traumas they see and their advice for colleagues on how to stay mentally fit. Wellbeing staff from the first responder agencies also provide information about the help and support programmes available, including peer support.
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Content Article
Matthew's Story
Claire Cox posted an article in Handover
Matthew’s story provides a compelling case for improving ambulance handover times, and for changing the behaviours and cultures that contribute to unnecessary waits for patients. -
Content ArticleThis guideline from the National Institute for Health and Care Excellence (NICE) covers preventing and controlling healthcare-associated infections in children, young people and adults in primary and community care settings. It provides a blueprint for the infection prevention and control precautions that should be applied by everyone involved in delivering NHS care and treatment.
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Content ArticleThe South Western Ambulance Service (SWASFT) launched a new electronic patient care record (ePCR) with Weston Area Health NHS Trust – an electronic solution designed by paramedics for paramedics. They discuss the background to the project and how the ePCR was designed.
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Content ArticleA framework to support ambulance trusts in England to learn from deaths in their care.
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Content ArticleResuscitation in the pre-hospital setting is very challenging. To give the best possible care, teamwork needs to be optimal. Tom Evens, an emergency physician with Londons Air Ambulance and former coach of the Olympic UK rowing team, shows us how performance psychology will help you in providing critical care at the roadside. Presented at the ResusNL Conference 2019.