Cardiac Arrest: Would you know what to do?

Would you know what to do if someone suffered a Cardiac Arrest in front of you? The answer is simply to phone 999 and start CPR until help arrives. Early CPR and early defibrillation greatly increase the chances of survival for anyone who suffers cardiac arrest.

Restart a Heart Day is an annual event where the general public are encouraged to learn this vital life saving skill. We know that many people have doubts about starting it and are fearful of giving it a go – in fact a recent survey showed that 33% of adults in NI would not try CPR if someone collapsed with Cardiac Arrest in front of them. We also know that if nothing is done, the patient will die. In fact for every minute that goes by the chances of survival decrease by 10%.

We are asking you to give learning CPR a go. You will never know when you might need to use it. Most Cardiac Arrests happen in the home – not in a public place. So it could be your parent, brother, sister, son or daughter who might need you to leave all those fears and doubts behind and do something.

The video below tells the story of how one Co Antrim man, who had previously been fit and healthy, suffered a Cardiac Arrest at home. He survived. But what played a key part in his survival was the fact that CPR and defibrillation were started immediately by a local man who had taken time to learn these life-saving skills and cares enough about his local community to volunteer to be on call for the Ambulance Service as a Community First Responder. He saved a life and what better feeling could there be than that?

NIAS Launch 12 Week Consultation on New Clinical Response Model

As part of the wider HSC Transformation Programme set out in the “Health and Wellbeing 2026: Delivering Together” strategy, the Northern Ireland Ambulance Service today launches a consultation on proposals for changing how we deliver our services. The proposed changes are the most radical development in ambulance provision over the past 20 years.

In recent years the demand for ambulance services has significantly exceeded our capacity to respond. The number of ambulance responses dispatched to calls has increased by 50% over the last five years. This has resulted in many people having to wait longer for ambulances than we would wish, with response times increasing year on year, and falling well below the Ministerial targets.

Our proposals seek to introduce changes that will ensure that those with the most serious life-threatening conditions get the most immediate and appropriate response. We are also proposing to introduce improved call handling procedures for those calls which are less serious, ensuring that they receive a response appropriate to their needs.

NIAS Emergency Ambulance and RRVMichael Bloomfield, NIAS Chief Executive, launching the consultation document said:

“The increase in demand for ambulance services seen in recent years and the resulting increase in waiting times highlights that the current model is not sustainable.

Consistent with the direction of travel outlined in “Health and Wellbeing 2026: Delivering Together”, NIAS has been introducing a range of transformations over the past few years which are improving the quality of care we provide to patients and reduces the number of patients needing to be taken to hospital Emergency Departments.

However, it is now time to reform our clinical response model which has been in place for over 40 years. At present, NIAS categorises over 30% of all calls we receive as immediately life threatening, requiring an 8 minute response. Evidence from elsewhere and the experience of our own clinical staff indicates that a much smaller proportion of calls require this speed of response.

By more accurately identifying the most clinically urgent calls, we will more consistently be able to respond to those calls within the appropriate time. For other calls our proposal will mean that we send the most appropriate type of response first time”

NIAS would welcome responses from all stakeholders to the consultation document which can be accessed by clicking here.

 

Icon of NIAS CRM Consultation September 2018 NIAS CRM Consultation September 2018: (2.9 MiB)

Northern Ireland Paramedics get formal recognition as Allied Health Professionals (AHP)

Northern Ireland Paramedics get formal recognition as Allied Health Professionals (AHP)

Paramedics have been formally recognised as members of the Allied Health Professional (AHP) group by the Department of Health (DoH).

The move follows recent discussions with the Department of Health Permanent Secretary Richard Pengelly, DoH officials and the NI Ambulance Service (NIAS).

Richard Pengelly welcomed the change.  “Formal recognition of paramedics in Northern Ireland is essential to professionalise the profession so paramedics know just how much they are valued as members of the Health Service.

“This recognition will align paramedics with other AHP colleagues and their peers in the rest of the UK, and recognise the contribution paramedics currently make as inter-professional clinicians working across urgent, emergency, primary and community care provision here.

“This change is also in line with the values within the new DoH Workforce Strategy.  It is important that paramedics feel supported in their challenging roles and this move will assist in that.

“Over recent years paramedics have taken responsibility for greater clinical decision making and are providing an increasing range of interventions as part of the wider transformational agenda. This is being underpinned by the move to Higher education for paramedic practice. By including paramedics as AHPs will enable them to expand their networks within the wider group of other AHP professions.”

Michael Bloomfield, Chief Executive of Northern Ireland Ambulance Service, also welcomed the recognition of paramedics as Allied Health Professionals. He said: “Paramedics are, day and daily, the first contact that many patients have with the Health Service and often at times when they are most anxious and vulnerable, including requiring  the highest levels of clinical intervention due to trauma or medical emergencies. Paramedics are increasingly bringing the initial treatment to the patient at the scene of the emergency.

“This recognition is testament to the increasing role of paramedicine in the provision of health and social care within Northern Ireland. Paramedic Education has been evolving, and will continue to evolve, as part of the transformation agenda ensuring that those who have need of our service can be confident that their clinical care is delivered by individuals and teams operating to the highest professional standards.

“I congratulate all paramedics on having attained this recognition, which brings them into line with colleagues across the UK, and would like to thank everyone involved in bringing about this AHP recognition.”

The Allied Health Professions (AHP) currently consists of 12 distinct and unique disciplines. These professionals provide key services and add critical value across primary and secondary prevention, diagnostics, treatment and care.

Hazel Winning, the AHP lead in DoH who has worked with NIAS to deliver this recognition, said: “The professional recognition decision would bring opportunities across the health service and has the potential to influence patient pathways and make huge differences to patients’ lives.  It can help make use of skills to develop a more flexible workforce and provide more responsive services to service users.”

Northern Ireland Paramedics get formal recognition as Allied Health Professionals (AHP)

Take a bow, Dominic Mackle and Nick Hawryliw, winners of outstanding Bravery Award in the Glens and Causeway area.

Dominic and Nick with their awardWe are delighted that two of our staff walked away with the “Outstanding Bravery” award in the Causeway Coast and Glens People of the year Awards 2018.
 
On Bank Holiday Monday on 19 March, Paramedic Dominic Mackle and Emergency Medical Technician Nick Hawryliw, based in Ballycastle Ambulance Station, were tasked to attend an incident involving a 22 year old male who had fallen 60 feet onto the cliffs whilst abseiling off Torr Head close to Murlough Bay.
 
The Outstanding Bravery AwardThey were unable to bring the ambulance as close to the incident as they would have liked and commenced their rescue operation by having to trek, carrying their heavy equipment, across wet, muddy and rocky terrain to reach the top of the cliff. Knowing that the patient’s injuries were potentially life threatening after falling such a distance, they decided that they had to get to him as soon as possible to carry out an effective assessment and so they started down the cliff.
 
As they got closer they began to realise how precariously the patient was positioned and knew they had taken the right decision to climb down. An initial assessment revealed that he had sustained chest injuries during the fall and was finding it extremely difficult to breathe.
 
Working as a team, Nick quickly protected the patient’s neck and spine allowing Dominic to carry out paramedic interventions to treat a bi-lateral pneumothorax. This treatment involves inserting needles into the patient’s chest and is difficult to perform in a stable clinical environment but is much more complicated in the situation where they found themselves – at the bottom of a cliff in poor weather conditions. Their ability to perform this life-saving technique under such conditions was nothing short of extraordinary.
 
Dominic and Nick with their awardDominic and Nick continued to treat and reassure the patient that everything was going to be ok while waiting for the Coastguard to arrive. On their watch, he was getting out of there safe!
 
Working together, the coastguard and the ambulance crew soon had the patient on board the helicopter. Dominic was also hoisted into the helicopter and continued his treatment until their arrival at the RVH in Belfast.
 
Their actions on this day speak of them as not only consummate professionals but of them as human beings who care deeply for others who find themselves in hopeless and dangerous situations. They could have, in their risk assessment, decided to stay at the top of the cliff and wait for assistance from the Coastguard. But they sensed immediate danger and they decided they had to do something more.
 
Dominic and Nick with their awardTheir decision to scale down the cliff face was the major factor in this young man’s survival. Their treatment further ensured it. Their arrival and presence would undoubtedly have brought a feeling of hope to him in his hour of need and their staying with him until he reached the Royal would have made him realise that he was always going to have someone at his side who were totally invested in ensuring that he was going to come to no further harm.
 
Congratulations to Dominic and Nick. You are now officially heroes and we are so proud of you.

NIAS & AANI Spring Review Report of HEMS

Northern Ireland Ambulance Service and Air Ambulance Northern Ireland Charity release joint Spring Review report of THE HELICOPTER EMERGENCY MEDICAL SERVICE (HEMS)

  • HEMS has responded to 297 calls since July 2017 
  • 80.7% of incidents reached within 20 minutes 
  • HEMS available for 97.2% of operational hours versus UK best practice of 91% 
  • The charity Air Ambulance NI has raised in excess of £1 million to support HEMS within 22 months

Today the Northern Ireland Ambulance Service (NIAS) and the charity Air Ambulance Northern Ireland (AANI), have jointly issued a Spring Review Report of the Helicopter Emergency Medical Service, revealing positive progress in meeting the objective to deliver a doctor/ paramedic service as a partnership.

The report reviews the performance of the service against agreed objectives, service quality standards and targets benchmarked against the Association of Air Ambulances (AAA) framework for a High Performing Air Ambulance Service.

The primary role of HEMS, which went live at the end of July 2017, is to deliver advanced pre-hospital care, benefitting those whose lives are at risk following serious trauma by bringing highly specialised medical care directly to the patient at the scene.

Up until the end of March 2018, the air ambulance has responded to 297 calls – approximately 1-2 cases per day. Most of the responses to incidents are by air in the helicopter but the HEMS team also has a rapid response car for times when the helicopter is not able to fly due to weather conditions etc., or the incident is in close proximity to their base.

The report reveals that 80.7% of incidents were reached by the air ambulance within 20 minutes. The service responds to severely ill or injured patients and operates a daylight service from 7am -7pm, seven days per week from its base in Lisburn. It aims to reach any part of Northern Ireland in approximately thirty minutes.

Overall the helicopter has been available for 97.2% of its operational hours, exceeding UK best practice across other UK services whereby air operations should be available for 91% of the operational hours.

Commenting on the report, NIAS Chief Executive, Michael Bloomfield, said:

“NIAS has been working together with our charity partner, Air Ambulance NI, to deliver this doctor/paramedic helicopter emergency medical service.  We welcome the opportunity to publish this first report detailing the excellent progress the service has made in the first nine months since it was established. This is thanks to the dedicated team of doctors and paramedics providing the medical service and the charity staff who continue to work on supporting the service through their fundraising efforts and engagement of hundreds of volunteers in the background to provide the helicopters and pilots.  Together we will continue to ensure that this vital service delivers the highest quality in patient care for those in the pre-hospital emergency environment and we are excited and proud to be part of such an important service which is saving lives”.

Air Ambulance NI needs to raise £2million each year to maintain this service so funding and public donations are crucial. As a new charity, AANI set out an ambitious objective to raise £1million in the first 22 months to match grant funding. Public support has meant that this target has been reached more quickly than expected, although there is still a long way to go to ensure the £1m is doubled to £2m and that it can be achieved annually and consistently.

Based on the fundraising performance in year 1, the charity is confident that, with continued and further support from the public, it will raise enough funds by year 3 to fully fund year 4 costs for the first time.

Ian Crowe, Chairman, for the charity, comments on the performance:

“As Air Ambulance NI approaches its first year of operational service for the citizens and visitors of Northern Ireland I would like to take this opportunity to thank our operational partners NIAS especially our Doctors and Paramedics for their professional commitment not only during their duty shift but for the support and promotion of the charity through this time. Our aviation providers Babcock MCS have maintained a high level of aircraft availability and working closely with them this level of consistency will be improved. The AANI charity team are looking forward to increasing the awareness for the Charity in the coming months and years with public engagement and community events growing every week. AANI is establishing itself as a charity worthy of support and one of the easiest ways to do this is by becoming a member of Club AANI at www.airambulanceni.org

The full report is available to view and download here: http://www.airambulanceni.org/wp-content/uploads/2018/06/NIAS-AANI-Spring-review-March-2018.pdf

NIAS Equality Forum

NIAS Equality Forum

Equality and inclusivity were centre-stage today when the Trust’s new voluntary Women’s Forum and LGBT Forum met under the NIAS Equality Forum.

The Women’s Forum and LGBT Forum are NIAS-initiatives to help implement the Trust’s Equality Action Plan 2018-23.

Colleagues got together in NIAS headquarters to start developing discussions which, in due course, will roll out across the Trust.

Anyone wishing to get involved can get more information from participating colleagues, or else send an email request through the NIAS Equality Forum to: Martina.Black@nias.hscni.net

Assaults on Ambulance Staff Continue

There are over 400 assaults on staff from the Northern Ireland Ambulance Service (NIAS) each year – more than one a day.

NIAS has a zero tolerance policy in relation to these assaults. Our staff should not be subject to such behaviour, especially while they are providing care to patients. The vast majority of these incidents are not reported in the media, but that does not make them any less concerning. All assaults on ambulance staff are totally unacceptable and result in a reduction in cover to respond to calls from people who depend on our service.

This past weekend saw a number of particularly serious assaults on our staff. On 19 and 20 May three instances occurred, two of which involved staff requiring hospital attention. In one of these, a member of our frontline staff who has given over 40 years service to the community sustained injuries to his head, arms and body when attacked outside a hospital emergency department. His assailant was restrained by hospital security staff until the PSNI arrived. This is now an ongoing investigation.

However it is not only our frontline staff who are abused. On Friday night, two EMDs and a Duty Control Manager experienced serious and unacceptable verbal abuse over three phone calls. Further action may be taken in these cases.

NIAS continues to work with Trade Unions and staff to ensure the appropriate levels of post incident care are provided to our staff who are victims of such abuse.

Commenting on these incidents, NIAS Chief Executive, Michael Bloomfield, said:

“I am deeply concerned about the frequency and level of ongoing abuse and assaults towards our highly committed and professional staff. A survey published last week by the Department of Health in which almost 7000 patients commented on their experience from arriving at hospital until they left, showed that 98% of patients said that ambulance staff behaved in a polite and courteous manner, and the same number (98%) said ambulance staff showed them care and compassion. The vast majority of patients value our staff for the excellent work they do, however regrettably a small number do not show them the same level of courtesy. This is unacceptable and NIAS believe that anyone found guilty of attacks on our staff should face the full rigour of the law.

I wish our staff who were injured in these incidents a full and speedy recovery.

Ambulance staff work in a very challenging environment, and respond with professionalism to every call they are sent to, providing a high level of care to people at some of their most distressing and vulnerable times. Unfortunately when incidents such as these occur, the level of ambulance cover is reduced and patients who need our service may wait longer, sometimes for life threatening treatment. I therefore call on the public’s support and that of public representatives in helping us bring these assaults to an end.”

NIAS welcomes EU investment of €1.1 million in Community Paramedic Services

Northern Ireland, Republic of Ireland and Scotland to benefit from Community Paramedic services to enable care to be provided closer to a patient’s home 

This week has seen the formal launch of the €1.1 million EU INTERREG VA funded cross border Community Paramedic Project. Tony O’ Brien, Director General of the Republic of Ireland’s Health Service Executive (HSE), was joined by representatives from the Northern Ireland Ambulance Service, the Scottish Ambulance Service and the HSE’s National Ambulance Service at the launch in Dublin.

This new collaboration between the three national ambulance services has been warmly welcomed and has resulted in the establishment of Community Paramedic services in Northern Ireland and the Republic of Ireland. Community Paramedics associated with this project are undergoing specialised training accredited by Glasgow Caledonian University. The project has recently commenced and is enabling Community Paramedics to provide safe and effective care to patients in their own homes and communities and is already reducing unnecessary ambulance transports to emergency departments.

Pictured (from left to right) are: Bridget Clarke and Louise Potts, Cross Border CAWT Acute Project; Brian McNeill, Director of Operations, NI Ambulance Service; Bernie McCrory, Chief Officer, CAWT cross border health; Martin Dunne, Director, National Ambulance Service (Rep of Ireland); Wendy Quinn, Head of Service, Scottish Ambulance Service; Sean Murphy, General Manager, Letterkenny University Hospital and Michael Rooney, HSE.

The Co-operation and Working Together (CAWT) Health and Social Care Partnership in collaboration with the Scottish Ambulance Service, the Northern Ireland Ambulance Service and the National Ambulance Service in the Republic of Ireland developed the Community Paramedic Project bid for EU INTERREG VA funding which was successful in securing €1.1 million for an 18 month period.

The Project will target specific patient populations in remote and rural areas / border areas of the three regions. The four pilot localities which have been identified for this scheme include Castlederg, Co Tyrone in Northern Ireland; Buncrana, Co. Donegal and Clones, Co. Monaghan in the border region of the Republic of Ireland; and the Argyle & Bute region in SW Scotland.

In addition to providing Community Paramedic training to eligible individuals, the EU funding is being used to invest in new rapid response vehicles for the pilot areas in the three ambulance regions. These vehicles are fitted out specifically to provide care to patients in their homes or their community. This means that, within the pilot areas, more patients can be treated at home instead of having to be transported by ambulance to hospital emergency departments.

Commenting on this initiative, Michael Bloomfield, Chief Executive of the Northern Ireland Ambulance Service said: “At a time when Health and Social Care is experiencing unprecedented demand which manifests itself in extreme pressure in Emergency Departments, the Northern Ireland Ambulance Service is delighted to be participating in this initiative enabling Paramedics to work closely with other healthcare professionals within rural and border area communities. The greatest benefits will be felt by patients themselves who will receive the appropriate assessment and treatment in their homes, if admission to hospital is not the deemed appropriate. NIAS welcomes the introduction of this enhanced Paramedic role as it offers an excellent opportunity for career progression for staff.”

Community Paramedics participants from the Northern Ireland Ambulance Service, the Scottish Ambulance Service and the Republic of Ireland’s National Ambulance Service who are undergoing specialist training as part of the €1.1 million EU INTERREG VA funded CAWT cross border Community Paramedic Project. In the vehicle (left to right): Mark Sheerin, Community Paramedic, Buncrana Primary Care Centre and Damian Muldoon, Community Paramedic, Castlederg Primary Care Centre. Standing at the front (left to right): Anne McDermott, Community Paramedic, Buncrana Primary Care Centre; Brendan Finan, Community Paramedic, Clones GP Practice and Declan Smith, Community Paramedic, Clones GP Practice. Standing at the back (left to right): Caroline French, Community Paramedic, Castlederg Primary Care Centre and Scott Ramsey, Community Paramedic, Scottish Ambulance Service.

Speaking at the launch event in Dublin, Tony O’Brien, Director General of the HSE welcomed this new initiative, which allows Paramedics to broaden the routine healthcare services they provide and will help to improve rural urgent medical services. He said: “Emergency Care pressures are a constant challenge for all health systems in Europe. This innovative project, enabled by EU funding and collaboration with other member states, is a good example of how we can ensure patients receive the right care in the right place while also easing some of the pressures on our Hospital Emergency Departments.  I have no doubt that it will be successful and that we will be rolling it out across Ireland as a key part of our Urgent and Emergency Care system in the coming years.”

Welcoming the project Gina McIntyre, CEO of the Special EU Programmes Body said: “The EU’s INTERREG VA Programme provides funding to organisations that can implement joint cross-border solutions to issues that affect citizens living in the border region. This project, involving ambulance services working together, will enhance the health and social care of citizens living in more rural and isolated areas and will enable the transition from tra

ditional institution-based service provision to a more community-based approach.”

The launch was attended by project participants and stakeholders from all three regions.

Match-funding for the project has been provided by both Departments of Health in Ireland and Northern Ireland and by the Scottish Government.

NI Ambulance Service (NIAS) Community Paramedics at the launch of the €1.1 million EU INTERREG VA funded CAWT cross border Community Paramedic Project involving the Northern Ireland Ambulance Service, Scottish Ambulance Service and the Republic of Ireland’s National Ambulance Service. Pictured are Damian Muldoon and Caroline French, Community Paramedics from Castlederg Primary Care Centre, Co. Tyrone.
NI Ambulance Service (NIAS) representatives at the launch of the €1.1 million EU INTERREG VA funded CAWT cross border Community Paramedic Project involving the Northern Ireland Ambulance Service, Scottish Ambulance Service and the Republic of Ireland’s National Ambulance Service. Pictured (from left to right): Caroline French, Community Paramedic, Castlederg Primary Care Centre, Co.Tyrone; Brian McNeill, Director of Operations, NIAS; Laura Coulter, Area Manager, Altnagelvin Ambulance Station, NIAS; Frank Orr, Assistant Director, NIAS and Damian Muldoon, Community Paramedic, Castlederg Primary Care Centre, Co.Tyrone.

Crew Assaulted by Patient on 999 Call

The Northern Ireland Ambulance Service responded to a medical emergency in Larne on the evening of Tuesday 28 November 2017.

On arrival, the crew were confronted by a patient who proceeded to kick a crew member.

Following this assault, the crew continued to transport the patient to hospital for further treatment. En route to the hospital, the patient continuously behaved in an aggressive manner, including verbal and physical assaults on staff and attempting to damage lifesaving equipment.

PSNI were called and arrived at the scene to arrest the patient for assault, attempted criminal damage and disorderly behaviour.

This was the crew’s first call of the night, and they continued to work the remainder of their shift despite this violent incident. In contrast, the last call of their shift was to a 4 month old baby who had to be rushed to hospital. If this crew had been unable to carry on with their shift due to the earlier assault, it may have delayed the baby receiving help and getting to hospital for further treatment.

Attacks on our crews continue at a rate of more than 8 a week. This situation is totally unacceptable. We have previously talked about the impact that these attacks have on the communities we serve in terms of crews being stood down mid-shift. We have talked about the potential for the loss of life as a result of reduced cover following these assaults. While this potential still exists we are even more concerned about the impact of such assaults on the health and well-being of our staff.

These assaults are not something which our crews are able to forget about within minutes. We have evidence to show how the impact can be felt years later and the event relived at any moment in time.

NIAS will continue to call for the full rigour of the law to be applied in instances where evidence against an assailant is clear and indisputable. We are heartened at some of the recent sentences that have been passed and hope that those who find themselves before the court on such charges will face the real prospect of custodial sentences.