Edesix Body Worn Cameras To Protect Ambulance Staff

Edesix, a leading supplier of Body Worn Camera (BWC) solutions, are having their VideoBadge VB-300 cameras trialled by South Western Ambulance Service NHS Foundation Trust (SWASFT) to better protect their ambulance crews against violence and aggression.

Crews in Exeter, Plymouth and Bristol are wearing the cameras during the three-month trial which began in October. The use of cameras is intended to deter abuse and obtain evidence of offences against the ambulance crews. If the trial is successful, the cameras could be rolled out across the Trust.

There were 1,285 recorded incidents of violent or aggressive behaviour towards SWASFT staff between August 2018 and August 2019, which is an increase of 24% compared to the previous year.

Ken Wenman, Chief Executive of SWASFT, said: “Like all our emergency services colleagues, our crews and control staff work in extremely difficult circumstances. They are often under threat of attack or abuse, and staff members are assaulted every day. That is totally unacceptable.

“We want to take every possible measure to ensure our employees are safe at work. Using body worn video cameras will discourage people from abusing and assaulting our staff. They will also enable us to provide evidence of abuse or assaults when they do happen so the police can bring more prosecutions against people who assault our staff.”

Edesix’s BWC solutions are designed to deter abuse, protect workers and record evidential-quality footage for review or to secure prosecutions. This all-encompassing solution, which includes the VideoBadge and VideoTag cameras, and VideoManager software, is proven in industries from retail to policing, prison and emergency services.

For further information please contact us at sales@edesix.com or give us a call on 0131 510 0232

British Red Cross calls for change in law to improve response when UK emergencies or disasters strike

The British Red Cross is calling for the law to be updated to give individuals and communities more say in how they are treated and the support they get in an emergency.

Currently emergency services, government bodies and councils, who together are responsible for planning for emergencies, aren’t legally bound to involve voluntary and community groups.

As a result, local knowledge about needs, vulnerabilities and sensitivities may not always be known or taken into consideration.

In its latest report, People Power in Emergencies, the charity looks at how far local resilience forums, which lead local council emergency planning, factor in the knowledge, skills and capacities of the voluntary and community sector.

Emergency response volunteer providing hot drinks for the community from British Red Cross Emergency vehicle in Fishlake near Doncaster.

It reveals that collaboration is variable, meaning responses to emergencies tend to focus chiefly on “command and control” mechanisms, which of course are important.

At the same time, this can mean missed opportunities to mobilise people power encouraging communities to build their resilience and support their recovery from within.

The report highlights the very different needs of individuals and how those needs can best be met.

One of the report’s key recommendations is for an urgent review of the 2004 Civil Contingencies Act.

The British Red Cross is calling on whoever wins the election to update the act to enshrine in law the role of the voluntary and community sector in emergencies. 

Other recommendations in the report include:

·         A “people at the heart of planning” checklist for local resilience forums, produced by the British Red Cross, and championed by the recently formed voluntary and community sector Emergencies Partnership

·         A further amendment to the Civil Contingencies Act, Regulations and Guidance to require local resilience forums, in partnership with the voluntary and community sector, to plan what the report calls a more ‘person-centred’ approach to preparing for and dealing with disasters and emergencies.

British Red Cross volunteers were out in force providing support to many communities after widespread flooding swept across northern England. Thousands of people were forced from their homes across Yorkshire and the East Midlands due to flooding in November 2019. Within hours of floods occurring, emergency response volunteers were deployed to hard-hit communities across parts of Derbyshire, Lincolnshire, Nottinghamshire, Humberside/East Riding, and South Yorkshire, after parts of the country were inundated with a month’s rainfall in just 24 hours. In the days following the flooding, volunteers were checking on vulnerable people in the community, manning rest centres for evacuees and distributing much-need donations. The British Red Cross also released £50,000 from its Disaster Fund to help people who have been most affected by the flooding.

Previous research by the British Red Cross has shown how involving grassroots organisations in responding to emergencies ensures people and communities feel listened to and more empowered and in the face of disaster.

As every individual will react differently, it is unrealistic to ask councils and emergency services to adopt a ‘one size fits all’ approach.

The British Red Cross is calling on local authorities and the voluntary and community sector to work with it on the report’s recommendations, and to see the law amended urgently.

British Red Cross CEO Mike Adamson said: ‘Our own response to the recent floods across Yorkshire and the Midlands has shown the value we bring, whether supporting fire and rescue to distribute sandbags, or welcoming people who’ve been flooded out of their home into rest centres. 

“This is about showing how we complement the work of our partners.

“It’s also about giving a voice to those affected by emergencies and highlighting local challenges, sensitivities and opportunities to help people survive and recover better. 

“It’s people and communities who know best what their needs are and how they want them addressed.

“They are the experts in who may be seriously ill, have a disability or mobility issue, or face difficulties because of language barriers, poverty, immigration status or anything else.

“By listening harder and tapping into that resource, people will have the best possible chance of survival and recovery.

“By updating the law so that statutory agencies work more with communities and the voluntary sector, people’s immediate needs will be met more easily, in the most appropriate way.”

Dr Andy Johnston, Chief Operating Officer of the Local Government Information Unit (LGIU), and Convenor of the Local Government Flood Forum, has welcomed the report: “It is very timely, given the recent emergency response to flooding in the North of England and the Midlands. 

“Emergencies in the UK are evolving, with climate change and threats of terrorism, and are very complex, affecting both communities and councils.

“I am therefore pleased to see the recommendation for reviewing the legislation to better guide the local agencies in their planning for emergencies.

“In my roles as part of the LGIU and Convenor of the Local Government Flood Forum, I very much look forward to working more closely with both councils and the voluntary and community sector to take forward these insights and recommendations to ensure community insight is key to local government emergency planning.”

Women Exceed Men in Ultra-Endurance

World Extreme Medicine Conference provides platform for Female Doctors rowing Atlantic to prove a point

It is an exciting time for women in sport, in particular women are increasingly meeting or exceeding male performances in ultra-endurance events.  The World Extreme Medicine Conference 23-25 November 2019 in Edinburgh is providing a platform for the “Emergensea Girls” to announce their research project and talk about their plans for taking on the world’s toughest rowing race – the Talisker Whisky Atlantic Rowing Challenge 2020.

A&E doctors at the Royal Devon and Exeter NHS Foundation Trust and Extreme Medicine MSc Fellows at Exeter University Medical School, Rosie Alterman and Charlie Fleury are going to use the challenge to carry out some preliminary research that they hope will support the theory that women are better than men at ultra endurance events.

The girls will be rowing across the Atlantic from La Gomera in the Canaries to Antigua in a 24ft boat. In addition to conducting research on themselves and simply staying alive they are aiming to smash the current women’s pairs record, and reach Antigua in under 50 days. All proceeds from their venture will be going to Devon Air Ambulance Trust.

Charlie Fleury and Rosie Alterman

Prof. Mark Hannaford, Co-Founder of the MSc Extreme Medicine programme at Exeter and Founder of World Extreme Medicine and Conference said

“I’m delighted to see real research advances being made as a result of the establishment of the MSc in Extreme Medicine at the University of Exeter Medical School in a partnership with World Extreme Medicine.   

This area of medicine has been poorly researched in the past, especially in the area of female psychological response to extremes, and I’m delighted that progress in this area is being made by two exceptional Clinical Fellows enrolled on the course partners with the Royal Devon & Exeter Hospital in Devon.”

There are numerous hypotheses as to why women are increasingly outperforming men ranging from evolutionary roots as child-bearers through to the composition of female muscles. 

During the race Charlie and Rosie will be conducting original research into women and endurance sports as part of their MSc in Extreme Medicine. They will be using data collected from the rowers participating in the Atlantic crossing events in 2019 and 2020 – looking for trends from this year which they can input into the research planned for next year. They will be examining body composition and muscle fatigue pre and post the rows and during the crossings there are two questionnaires that the rowers will complete each day which will profile mood states and provide the rating of perceived effort ( a common method used in sports to measure the individual’s perceived exertion at a point in time).

Charlie, who recently had major surgery on her pelvis, said

“Rosie and I have shared many challenges in the past – ranging from hiking in snake-infested Costa Rica to camping in -20°C in Norway, to surviving a Friday night shift in Exeter’s Emergency Department. What we lack in rowing experience, we more than make up for in determination! 

In addition to long-distance triathlons and running marathons Rosie volunteers with the RNLI – so is well aware of the unpredictability of the sea and the respect crossing an ocean demands. 

We will be training with James Parkes, strength and conditioning coach at Exeter Chiefs Premiership rugby team, and have a variety of other supporters to help us prepare physically and mentally for the challenge for which we are immensely grateful”

The duo will be running a rowing competition at the World Extreme Medicine conference in Edinburgh and are also planning a 24 hour row in their hospital foyer next March in aid of Devon Air Ambulance.

From the Africa Desk of Ambulance Today: A Case Presentation of Electrical Alternans in the Field

https://chat.whatsapp.com/AfricaDeskFeedback

By Michael Emmerich
Published in Ambulance Today, Issue 1, Volume 16, Around the World in 80 Questions, Global Clinical EMS Special, Autumn 2019

For this Africa quarterly, I will be discussing a cardiac patient encountered on a remote site in Africa and the unique challenges faced by the paramedic and his support team.

Patient Presentation: A patient presents at a remote site in the Southern DRC around 07:15 on a Saturday morning, with the patient’s chief complaint being shortness of breath (SOB) and swollen legs. The patient is brought into the emergency room and the consultation process commences. On first examination the findings are as follows:

Observations/Vital Signs on Initial Assessment

  • Heart Rate: 108 – Regular
  • Blood Pressure: 158/91
  • Temperature: 36.8
  • Pupils: PEARL
  • Oxygen Saturation: 75% on an FiO2 of room air
  • Respiratory Rate: 32 bpm
  • Respiratory Effort: Rapid and labored
  • Skin Colour & Appearance: Flushed and warm
  • Blood Sugar: 7.1 mmol/li
  • Malaria Rapid Diagnostic Test: TDR –

Physical Examination

  • Head & Neck: NAD
  • Chest: Cardiac Auscultation detects Miåtral Regurgitation – Lungs clear Abdomen Distend, Pitted Oedema on all Quads – No Ascites
  • Pelvis: NAD
  • Upper Limbs: Oedema in fingers and wrists – no pitting
  • Lower Limbs: Pitted Oedema up to the knees
  • Back: NAD
  • ECG – 12 lead: Electrical alternans and Atrial hypertrophy
  • Other: Pulsus Paradoxus noted in both radial pulses

Preliminary Diagnosis

  • Date/Time: Acute Pericardial Effusion
  • Date/Time: Differential Diagnosis of Mitral Regurgitation

The ECG findings of electrical alternans are usually associated with pericardial effusion (with the potential to lead to pericardial tamponade) and is due to the periodic wobbling of the heart in the pericardium. The significance of the pulsus paradoxus adds strength to this initial diagnosis. Without access to an ultrasound or X-ray, a definitive diagnosis could not be made and based upon the entire patient presentation, including excessive weight, short neck and history of two malaria positive tests over the past 7 months, a decision is made to evacuate the patient off-site to a cardiac ICU unit in Johannesburg, South Africa. In further consultation with the top cover support Dr, palliative care, maintaining oxygen saturation by means of supplemental oxygen (done via nasal prongs at 3 to 4li/min to maintain Sat’s of 90 to 93%) and the insertion of a TKVO IV line is agreed upon.

Initial 12 Lead ECG Done at Mine Clinic

If this patient was in an urban setting or even a rural setting with rapid access to a Cardiac ICU, a definitive diagnosis and ACLS treatment could be initiated forthwith in a controlled multi-team clinical setting.

The Challenges Faced by the Team

Plans are put in place to begin evacuating the patient, the nearest landing strip only has daylight landing rating, so the patient would need to be there before 16:00 to facilitate the fixed wing evacuation. Before this can happen, multiple processes need to be initiated: approval gained from the insurers, an evacuation company needs to be appointed to do the flight, landing clearances must be granted by the DRC aviation authorities and the patient needs to be taken there by road—a 2-hour road trip in a 4X4 ambulance on a muddy, wet and potholed gravel road. In this instance, for a variety of reasons, landing clearances are taking longer than usual so a decision is made to charter a light aircraft—the Cessna Caravan (non-pressurised)—and to move the patient from the landing strip to the nearest largest town with night landing capability (so clearances can be obtained for that evening and because it has a good hospital nearby where the paramedic can keep the patient stable).

It must be noted that once the paramedic leaves the work site, he is working alone with the patient, with only the equipment he chooses to take for the road transfer, the chartered flight and the hospital stay. They eventually arrive at the neighbouring large city in the DRC and move the patient from the airport to the nominated holding hospital, where the paramedic settles the patient in—managing, monitoring, and continuing to co-ordinate the evacuation with various flight and insurance desks. Due to ongoing political instability in the region, the airport with night landing capability is shut down for the evening and the paramedic must sit it out until sunrise with his patient.

At sunrise the whole process starts all over again, to get clearances and wait for the fixed wing ICU jet from South Africa.

The Patient on (Ongoing) Re-Examination

Throughout the night the paramedic kept watch, monitoring and keeping the patient attached to the various monitors he dragged with him from the work site. Upon early morning re-examination a few new flags have popped up: abdominal cellulitis, a raised fever (37.8 C) and a positive malaria test result. They are also able to do a chest X-ray and notice a widened mediastinum and the presence of early pulmonary oedema developing in the base of the lungs. A third 12 lead ECG is done to see if there is developing ischemia or signs of an infarct – none are present. The fever is managed with IV parfalgan (paracetamol) while oral antibiotics and coartem are started for the infection and malaria. The paramedic discusses the ongoing care with his top cover Dr life line, and a Dr in the hospital. The diagnosis does now appear to be definitive – that of pericardial effusion.

Chest X-Ray of the EA Patient

The Flight Evacuation

Finally landing clearances are obtained (which is another story in itself) and a landing ETA is finalised, for around 17:00 on the Sunday afternoon. The patient is loaded into an ambulance with the paramedic and all his medical gear and is moved to the airport. As the plane is on final approach, the heavens open and it starts raining. After a detailed, comprehensive and wet handover, the patient is loaded onto the jet and they depart for the awaiting Cardiac ICU team in Johannesburg, South Africa.

En Route in the Cesena Caravan, Fixed Wing Evacuation

Case Close Out

12 Lead ECG the following day, taken at a local hospital

34 hours have now elapsed since the patient was initially seen by the paramedic back at the work site. Throughout this time the medic has been by his patient’s side, giving comfort, reassurance and medical care as needed. Finally, sleep is possible but getting out of the wet and dirty work clothes, followed by a hot shower and a decent meal, must happen.

The patient arrived in Johannesburg and was admitted into care at around 23:00 on the Sunday evening – almost 40 hours since the original provisional diagnosis was made. Treating and moving the sick and injured in Africa presents one with unique challenges not normally encountered in the developed world, or discussed at most cardiac symposiums. Welcome to the life of the remote and austere paramedic in Africa.

Tell Michael what you think about this article through WhatsApp via the following link:

https://chat.whatsapp.com/Africa Desk Feedback

Equally, if you have any news items you would like us to run either in our magazine or digitally then please email the editor via: joseph@ambulancetoday.co.uk

TAKING MENTAL HEALTH CARE TO THE NEXT LEVEL

Supporting patients living with mental health problems and/or dementia, North West Ambulance Service (NWAS) has officially launched its new Mental Health and Dementia Strategic Plan (2019 – 2022). 

Put in place as part of the trust’s aim is to be the best ambulance service in the country by delivering the right care, at the right time, in the right place; every time; the plan supersedes NWAS’ previous Mental Health Improvement Plan (2017–2022).  It details 17 recommendations, including a range of actions for each of these recommendations, which collectively aim to shape and transform mental health and dementia care within the trust over the next three years.  

The plan is reflective of the relevant mental health and dementia related aspirations detailed within the Five Year Forward Plan for Mental Health (2016), the NHS Long Term Plan (2019) and the Prime Ministers Challenge for Dementia (2015).

The recommendations and associated actions are based on extensive scoping and appraisal of care provision between January and July 2019 including feedback from staff, patients and partners within mental health across the North West region.

One example of the 17 recommendations is to review and learn from the mental health triage car pilots currently taking place within the Merseyside and Lancashire areas, and agree a trust wide plan for the future.   

The current pilot operating in Lancashire is called Psynergy and was launched last December in Blackpool, Fylde and Wyre, and involves a paramedic, a senior mental health nurse from Lancashire Care and a police officer coming together as a crew in a vehicle to jointly respond to people experiencing a mental health crisis.  The aim is to provide appropriate triage, offer the right care and advice, improve patient experience and avoid unnecessary hospital admissions.

The pilot has already proven to improve outcomes for appropriate patients, and results in better use of ambulance resources and multi-agency working, ultimately leading to financial benefit to the wider NHS.    

In year one of this particular recommendation, the trust will undertake a detailed and comprehensive review of the two pilots and work collaboratively with partners and commissioners to secure funding streams to widen this excellent service. 

Gill Drummond, Mental Health and Dementia Lead for NWAS said: “The work regarding mental health and dementia care already being undertaken by the trust is fantastic, but there is so much more we can do to.  The number of related 999 calls is increasing significantly, which is why one of the trust’s key priority areas is to improve care in this area, and why we have developed a plan to take this forward.”

To read more about the other 16 recommendations, the full plan is available to download here.

Dementia patients of the Welsh Ambulance Service to benefit from dementia cannula sleeves

THE Welsh Ambulance Service has received its first dementia cannula sleeves, devised and made by volunteers at Handmade for Dementia. The sleeves have proven to keep dementia patients calm and stop them from pulling needles out of their arms during treatment.

Ambulance staff on both emergency and non-emergency services will be using them when they are out on the road treating patients. It is the first time that the Trust will be using such objects to care for our patients.

During the mid to late stages of dementia, a person can become very anxious and fidgety. Having a cannula sleeve knitted with different wools, with different textures and ‘twiddle’ detail, has proven to make a difference in keeping patients calm.

Each sleeve is knitted following a copyrighted pattern and are individually risk-assessed before being donated to NHS Trusts across the UK.

Alison Johnstone, Dementia Manager at the Welsh Ambulance Service said: “Donations of such innovative items enable us to support our patients and provide person centred-care to people living with dementia.

Alison Johnstone, Dementia Manager at the Welsh Ambulance Service said: “Donations of such innovative items enable us to support our patients and provide person centred-care to people living with dementia.

“We cannot thank Handmade for Dementia enough for providing us with their dementia cannula sleeves as these will improve the experiences of people living with dementia at times of anxiety.

“As we’ve learned, it’s not necessarily the facts of the experience a person with dementia will retain, but the emotion, and these will go a long way to improving the emotional experience of using our service.”

Sharon (Wallace) Holdstock founded Handmade for Dementia in 2016 and started by recruiting a knitter to make ‘twiddle mits’ before moving on to devising and making dementia cannula sleeves following the suggestion of retired District Nurse, Eileen Copeland.

The group, which today has more than 5,000 members has knitted close to 8,000 cannula sleeves since January 2018.

Sharon Holdstock, founder of Handmade for Dementia said: “I am thrilled that our dementia cannula sleeves are making such a difference to people affected by dementia across the UK, saving the NHS thousands of pounds.

“After having sent thousands of sleeves to hospitals, now collaborating with the Welsh Ambulance Service is really exciting for us.  We hope that that result of our work will prove to be just as efficient on the road as it is in hospitals.”

Everyone can join Handmade for Dementia as long as they can knit. To do so, they must first join the group’s Facebook Page. If you would like to do so, head to – https://www.facebook.com/groups/HandmadeForDementia/

The Welsh Ambulance Service hopes to develop its partnership with Handmade for Dementia in the months and years to come.

The i-view™ Video Laryngoscope from Intersurgical: The Key Considerations

By David Chapman,
Airway Group Product Manager,
Intersurgical Ltd.
Published in Ambulance Today, Issue 3, Volume 13, Ahead of the Curve, Education and Technology Special, Autumn 2019

Video laryngoscopy represents one of the most significant advances in airway management in recent years. With the increased emphasis placed on ensuring the first attempt at intubation is the best attempt, the role of video laryngoscopy in airway management seems secure, at least for the foreseeable future1.

Video laryngoscopes utilise the latest video and camera technology to provide an optimal (indirect) view of the larynx during the process to insert an endotracheal tube in to the patient’s trachea. There are many video laryngoscopes available, but the i-viewTM from Intersurgical is the first single use adult video laryngoscope with a Macintosh type blade. i-viewTM provides the option of video laryngoscopy, wherever and whenever the clinician may need to intubate, whether in a pre-hospital setting on a patient with a difficult airway or in the emergency room on a patient with respiratory failure. Where availability of a video laryngoscope may be limited due to the cost implications of purchasing reusable devices for multiple sites, i-viewTM provides a cost-effective solution, by combining all the advantages of a fully integrated video laryngoscope in a single use, disposable product. As i-viewTM incorporates a Macintosh blade, it can be used for direct as well as video laryngoscopy, making it ideal for use in the emergency sector, where there may be a greater potential for the airway to become soiled with blood or other fluids, obscuring the view on the screen. In such circumstances, the operator can immediately switch from indirect to direct laryngoscopy.

As with all medical devices, whether single use or reusable, deciding on the most appropriate video laryngoscope to use is not straightforward, and consideration may need to be given to a number of factors. These may include evaluation of financial, environmental and infection control related issues, as well as the clinical requirements, evidence and preferences. It is important to recognise this assessment may change according to where, when and how often the device is to be used.

The i-viewTM

Financial

Whilst a single use video laryngoscope may not initially appear to be the optimal choice from a financial perspective, in circumstances where multiple units are required, but it may not be used frequently, it may prove to be the most economic option. This might include use by a Helicopter Emergency Medical Service (HEMS) or by a paramedic on an ambulance.

Infection Control

In their safety guideline booklet (2008), ‘Infection Control in Anaesthesia 2’, The Association of Anaesthetists of Great Britain and Ireland (AAGBI)2, confirmed that, in relation to standard laryngoscopes, ‘Current practices for decontamination and disinfection between patients are frequently ineffective, leaving residual contamination that has been implicated as a source of cross-infection.’ They went on to note that, ‘Blades are also regularly contaminated with blood, indicating penetration of mucous membranes, which places these items into a high-risk category.’ They concluded that the use of single use blades was ‘to be encouraged’.

Laryngoscope handles may also become contaminated. The AAGBI’s recommendation in relation to laryngoscope handles is that they should be, ‘washed/disinfected and, if suitable, sterilised by SSDs after every use.’

There is no reason to believe the same considerations and arguments that apply to standard laryngoscope blades & handles regarding infection control, would not also apply to video laryngoscopes, since all laryngoscopes, whether direct or indirect, incorporate some form of blade and handle.

In the EMS sector, where it can be particularly difficult to determine the potential cross-infection risk prior to treatment, a single use video laryngoscope offers an ideal solution.

I understand new infection prevention and control guidelines from the AAGBI are in the final draft stage, and after comments from members have been reviewed, a final version is to be presented to the Associations Board for approval.

Environmental

Environmental considerations are more complex and less easily assessed. Whilst it is appropriate for healthcare professionals, as well as anyone else with environmental concerns, to consider the implications of using single use devices in relation to product disposal, any assessment of the environmental impact of any medical device, whether single use or reusable, needs to consider a number of factors. This should include disposal of single use devices, and reprocessing or decontamination of reusable devices, in the context of a complete Life Cycle Assessment (LCA). The considerations of an LCA may vary depending on the type of product being assessed, the range and type of information and data available and the objective of the assessment. However, typically, an LCA will usually consider the following areas:

  • Raw material acquisition
  • Processing & manufacturing
  • Distribution & transportation
  • Use, reuse and maintenance
  • Recycling
  • Waste management

Assessing just one element of an LCA, such as waste management, may result in misleading conclusions as to the overall environmental impact of a device. A decision also needs to be taken as to what impact factors are to be assessed and how much weight is to be given to each. Is the focus primarily on climate change and water use, or is there an interest in assessing other or additional factors, such as, ecotoxicity, eutrophication, ozone depletion or urban and natural land transformation?

A number of LCA’s have been conducted for anaesthetic and airway devices. Their conclusions vary, and the complexity of any such assessment means the LCA usually needs to be considered as hospital or organisation specific; any variation in reprocessing practices, such as the volume of water used during manual washing, the electricity consumption of different types of washer/disinfection unit, or the type of packaging material used for repacking after reprocessing, will all have an effect on the overall environmental impact. Decisions also need to be taken as to what to include and exclude. For example, should energy recovery from waste incineration or the environmental impact of Personal Protective Equipment (PPE) used by healthcare workers involved in reprocessing be included?

The i-viewTM in use

Of course, all products have an impact on the environment, but it is important to ensure the environmental assessment is considered alongside other key factors, such as infection control considerations and the clinical benefits offered by the device.

For example, the weight given to the clinical benefit of having a single use video laryngoscope available in a life-threatening road-side emergency, perhaps when this might be the only viable VL option economically, might be quite different than the assessment made for regular routine use in the operating theatre.

In an interesting paper published in the British Journal of Anaesthesia, entitled, ‘A national survey of video laryngoscopy in the United Kingdom’, Cook & Kelly3 reported on the results of an electronic survey sent to all UK National Health Service Hospitals. With regard to availability of video laryngoscopy (VL) by clinical area, 91% of operating theatres reported availability of VL. In contrast, only 55% of Obstetric departments, 54% of Intensive Care Units and 35% of Emergency departments reported availability of VL. The authors noted that, ‘The distribution of availability is notable because the incidence of difficult or failed intubation increases in those places where video laryngoscopy is less available; in order, main theatres, obstetric, ICU, and the ED.’

It is not known why VL was less available in these areas, but it is possible that with less frequent use than in the OR, the financial implications of purchasing a reusable VL may have been a factor. If so, availability of a single use device might provide a more economically viable option due to its lower unit cost, which as discussed earlier, may be more economic when use is infrequent.

In summary, the i-viewTM video laryngoscope from Intersurgical is the first single use adult video laryngoscope with a Macintosh type blade. It provides the option of video laryngoscopy, wherever and whenever the clinician may need to intubate. This makes VL a viable option in places where the higher initial costs of purchasing a reusable device may previously have been prohibitive. With the new focus in airway management of ensuring the first attempt at intubation is the best attempt, i-viewTM may have a contribution to make to support this objective. Whilst it may not be suitable in all situations, such as when a hyper-angulated blade is required, it may be ideal in situations where use is infrequent, standard blade geometry is preferable and the nature of use makes it a more viable option economically.

Image taken at the ATACC Course in May 2019

Deciding on the most appropriate video laryngoscope to purchase and use is not straightforward, and in addition to the clinical requirements and preferences, consideration may need to be given to a number of other factors, including financial, environmental and infection control related issues. It is important to recognise this assessment may change according to where, when and how often the device is to be used.

Make a direct enquiry about Intersurgical’s i-viewTM here

References:
1. Cook TM & Kelly FE. Seeing is believing: getting the best out of videolaryngoscopy. British Journal of Anaesthesia 117 (S1): i9–i13 (2016)
2. Infection Control in Anaesthesia 2. Association of Anaesthetists of Great Britain & Ireland. 2008
3. Cook TE & Kelly FE. A national survey of videolaryngoscopy in the United Kingdom. British Journal of Anaesthesia, 118 (4): 593–600 (2017)

Paramedic Paul Runs UK Best At 24-Hour World Championship

A South Western Ambulance Service NHS Foundation Trust (SWASFT) senior paramedic has become one of the top ultra-runners in the world.

Paul Maskell, 41, competed at the 24 Hour World Championships in France, and managed to run an incredible 156 miles (251km).

He was the first British man in 15th place, after running as far as he could against hundreds of other athletes.

The SWASFT Operations Officer regularly runs 11 miles between home in St Austell and work in Bodmin in between 12-hour shifts.

He was selected in a team of six UK men for the race on October 26-27 after running 154 miles (248km) at another 24-hour event in London.

Paul said: “I loved doing the race. To be able to compete in a world championship was such an amazing experience, and it was a real honour to represent Great Britain. Putting on the vest was such a proud moment.

“There were highs and lows during the 24 hours. It’s a case of enjoying the highs, and battling through the lows by remembering family and friends and having the willpower to keep going. We were running in 27 degree heat during the daytime. I was also encouraged by the team atmosphere in what is usually an individual event.”

He was cheered-on by a group of 10 school friends who travelled to France for the event.  

Paul said: “They flew out and surprised me. I saw them all standing beside the track wearing specially-made t-shifts. They stayed for the whole 24 hours which was a huge boost to me and the other athletes. It was quite emotional at the finish line.

“I lost a toe nail during the race and had sore feet afterwards. Apart from that I felt great!”

Paul, who has worked for the ambulance service for almost 20 years, said: “I’ve never had any serious injuries, and have never had to take a sick day off work.

“Although I love my job, when I returned to work for a night shift there was definitely a feeling of ‘back to reality’.

“Since the race I’ve already done a 10km event in Newquay raising money for Cornwall Air Ambulance.”

“I’m going to keep on running and hope to get re-selected next year.”

The Great British team finished 4th overall and narrowly missed out on a bronze medal.

Since 2012 Paul has competed in multiple long distance and ultra-distance runs, including the London Marathon and 100-mile events.

He has won several ultra-runs in recent years, including the Arc of Attrition along the coast path from Coverack in South East Cornwall.

Jo James, who works with Paul, said: “The race was an extraordinary physical and mental challenge.

“We’ve been so excited by Paul’s journey and have been supporting him all the way. His selection was an achievement in itself. But for him to finish among the top endurance athletes in the world was phenomenal.”

Daughter’s Rescue Leads A Father To Become An EMT

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Jerusalem, November 7th, 2019 – Two years ago, Hila Zohar, aged 17 at the time, fell off of the roof of her home in Or Yehuda after she suffered a seizure. The fall, more than 8 meters, caused a serious head injury, massive bleeding and complete loss of consciousness. United Hatzalah volunteer EMT Avi Yosefov, who lives in the same neighborhood, received the emergency alert, rushed over to the scene and arrived in less than a minute. Yosefov treated her for her injuries and his near-immediate response and treatment saved her life. 

Hilah’s father, Yaakov Zohar, witnessed the terrible incident and saw how fast Avi arrived and treated his daughter. At that very moment, Yaakov decided that he too would become a volunteer EMT. On Tuesday night, Yaakov, together with 15 other new EMTs graduated their training course and became United Hatzalah volunteers. 

“I recall very clearly how Avi arrived with incredible speed and fought hard to save my daughter’s life,” recounted Yaakov. “Hila was brought to Tel HaShomer Hospital and was in the intensive care unit for two weeks. After that, she underwent months of arduous rehabilitation. When she had recovered enough and was finally out of danger, I slowly began to understand what exactly had happened and the desire to become a part of United Hatzalah awoke inside me.” 

From right to left: Yaakov Zohar, Hila Zohar and Avi Yosefov at the graduation on Tuesday 
Photo Credit: Oren Cohen

Yaakov, an electrician by profession, underwent the admissions process to participate in a training course and two days ago, came full circle by graduating the course with honors. He will now join the team of volunteers serving the area of Bika’at Ono under the guidance of Yuval Shlafman, United Hatzalah’s Chapter Head of the region. Shlafman, upon presenting Yaakov with the award of excellence in the course said: “I believe that Yaakov’s personal story will push him to become an excellent EMT with a high level of motivation that will help him continually assist others in their times of need.”

Avi Yosefov attended the graduation in order to honor Yaakov’s accomplishment and recall the traumatic incident that brought them together. “We are neighbors and live right down the street from one another. However, until the incident with Hila, we did not know each other very well, just enough to say hello when passing in the street. When the incident occurred, I was at home. When I saw the address of the call I knew that it was my neighbor. I raced outside, ran down the street, and in just a few seconds I was treating Hila. After everything calmed down, we stayed in touch and about a year-and-a-half ago, Yaakov told me that he too wanted to volunteer for the organization. Watching him graduate today with honors brought me a lot of joy.” 

Hila is now 19-years-old and healthy. “First of all, I want to thank United Hatzalah and Avi, for without them, I wouldn’t be alive today. I am also very proud of my father who has decided to volunteer and become a part of the organization so that he can now save others just as I was saved.”

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Brave Crash Victim Raises £6K For Ambulance Charity

A courageous mum whose husband died in a motorway crash has presented a cheque to the South Western Ambulance Charity after raising thousands of pounds in his memory.

Ceri and Rod Walsh, from Cheddar in Somerset, were involved in a multi-vehicle collision on the M5 near Taunton in September 2018.

Ceri sustained serious injuries in the crash, and doctors feared she would not be able to walk again.

But a year later Ceri defied expectations to complete a 10km run with their children Thomas, 14, and Carys, 11, and many other family members and friends.

Ceri handed-over the cheque for £6,387.75 to South Western Ambulance Service NHS Foundation Trust (SWASFT) staff on behalf of the charity at Taunton Ambulance Station on Tuesday 5 November.

She said she was “blown away” by the amount raised.

Ceri said: “I’ve been through a rollercoaster of emotions during the past year. But once I realised I was going to survive, I wanted to do something for the people who responded to the incident.

“The ambulance service deals with incidents that no human being would want to witness. They work professionally to maintain life at the worst possible time. Without the ambulance service my two wonderful children would be living without their mum.”

Two of Ceri’s colleagues also raised more than £2,500 from a skydive in March.

Zoe Later, head of South Western Ambulance Charity, said: “We are so grateful to Ceri, her family, friends and colleagues for their incredible fundraising for the South Western Ambulance Charity.

“Alongside the generous donations, I’ve been honoured to read some of the heart-warming messages from Ceri’s supporters on her fundraising page.

“To raise a total of almost £9,000 for the charity is a fantastic legacy to her husband, Rod, and a real testament to how loved Ceri and her family are. They are such an inspiration to us all.”

The family described Rod as a “gentle fun-loving family man” who was “loved dearly”. They praised his “laughter, love of life, kindness and loyalty”.

Rod was a committed member of the parish church in Cheddar, and had been an NHS worker for almost 40 years.

Ceri has worked as a NHS nurse for more than 30 years.

South Western Ambulance Charity uses gifted monies to benefit those in our communities who use our service, and to improve the welfare of SWASFT staff and volunteers.

At Ceri’s request, the funds she raised will be used specifically to support the staff of ambulance stations in Somerset.

Zoe added: “Every donation to the South Western Ambulance Service Charity makes such a difference, and stories like this one show the impact that SWASFT and the NHS has on our communities.”

If you would like to raise money for South Western Ambulance Charity, please email charity@swast.nhs.uk or call 0300 369 0108.

To donate to the charity, please click on this link: http://www.swambulancecharity.org/donate