Recognition of the best performing emergency medical technicians – the GVK EMRI way

Published in Autumn 2018 Edition of Ambulance Today Magazine

As of July 2018, GVKEMRI is operating in 14 states and two Union Territories in India, with about 19,000 EMTs and ambulance drivers known as ‘Pilots’. In such a large, non-profit organisation with nearly 26,000 emergencies being responded to on a daily basis, recognizing the best performing EMTs is an essential prerequisite. 

The quality of case-handling and pre-hospital care is a special area of focus. Real-time documentation, study, research, analysis, recommendations based on real-time cases are also of prime importance. This will allow timely feedback and appreciation of Emergency Medical Technicians (EMTs) and Pilots (ambulance drivers) in the field with regards to the administration of necessary pre-hospital care measures. The Best Case selection committee at the state level are a group comprising of representatives from the medical department, operations team and HR departments. Best cases are published in a monthly periodical titled EMCARE both at the state level and national levels.

Based on the pre-determined selection criteria, two cases from each district are considered at the first stage for the best case of the month. Cases are gathered through a nomination process. Wide publicity is given to the best-case process amongst the work force at the ambulance level and supervisory level group meetings etc. EMTs and Pilots report cases to their district manager within 24 hours of case-handling. 

Best case selection criteria are as follows: 

• Case Nature – Critical / Serious/ Unique / Challenging

• Appropriate patient assessment protocol followed 

• Emergency Response Centre Physicians (ERCP) medical direction (Online Medical Direction – OLMD) obtained 

• Essential pre-hospital care provided 

• Precise (complete and correct) documentation of the case – voice log at state level Emergency Response Centre (ERC)/ Pre-hospital Care Record (PCR)/ photograph depicting the pre-hospital intervention 

• Patient alive in 48-hour follow-up • Optimal arrival time to scene 

• Optimal (justified to the judgment of the committee) on- scene time 

• Proper ongoing assessment 

The role of the Pilot (ambulance driver) is assessed for best cases, in terms of safe driving measures, required support to EMT in provision of scene safety, and appropriate photography depicting the pre-hospital care interventions with consent of the patient, without disturbing the services and facilitating anonymization (i.e. covering the eyes). 

Such cases selected from each state are published in the monthly state level EMCARE magazine. Each case will have a brief description of the emergency, a photograph taken while pre-hospital care was being rendered, a media clipping (if published) and accounts of the EMTs & Pilots in handling such a case. 

Timelines are fixed from the process of selection to publishing in the state level EMCARE magazine and a compilation of best cases from month-to-month from the districts, as well as the objectively-selected state level best case as per the selection committee. Cases from 26th of the month to the 25th of the following month will qualify for the current selection process. The monthly periodical is published on the 15th of the month. The EMCARE awards ceremony takes place on the 20th of the month. At the state level, the Chief Operating Officer (COO) or Regional Managers will preside over the EMCARE award ceremony.

The Public-Private-Partnership (PPP) Department will circulate the monthly periodical to all national, state, district-level stakeholders, visitors and key government personnel. 

At the national level, state level best cases are compiled by a single point of contact before the 25th of the month. Every aspect of the completeness and correctness of the cases are validated at the state level SPOC for best case and EMCARE magazine. Medical team members from the Emergency Medicine Learning Centre will coordinate with the national best case committee – a broad-based committee with at least seven members selected from various states of HR, Operations and Medical Teams.

All the cases which are selected at the national level are given the 108 Saviour of GVKEMRI India award at the quarterly ‘National Review Meeting’ at the main office of GVKEMRI by the Chairman of the GVK Foundation. Awardees also receive a medal, a certificate of appreciation and a cash reward for both the EMT and Pilot of the ambulance.

The rewards and recognition process by the organization is one of several sources of recognition towards ambulance staff. At the national festivals days, like Independence Day, in most of the districts best-performing EMTs and Pilots also receive special awards from the District Magistrate for their services beyond the call of duty.

Social recognitions the EMTs and Pilots get from the communities they serve are over and above the formal recognitions they obtain from the organisation. At the end of the day, EMTs work with enhanced professional zeal and passion after receiving recognition. 

To find out more about GVK EMRI visit their website at: www.emri.in

Mountbatten trained volunteers to support patients dying in hospital

Date: 13 August 2019

Families facing death and bereavement at St Mary’s Hospital now have access to specially trained volunteers from Mountbatten, who can offer dedicated time to support people during this challenging time.

The ‘end of life care companions’ have been carefully selected and given comprehensive training by experts in end of life care at Mountbatten, who are working with the Isle of Wight NHS Trust to improve support to people in hospital who are dying, as well as to their loved ones.

Liz Arnold, Director of Nursing at Mountbatten, said: “It is recognised that ensuring one-to-one, dedicated support for patients who die in hospital can be challenging in such a busy environment. By training our volunteers in areas including communication skills and bereavement support, we hope to be able to offer comfort, reassurance and a listening ear to both patients and their families. Through our volunteers, we are also able to explain more about our specialist bereavement service which is open to anyone, wherever a death may have occurred.”

Shane Moody, the trust’s Clinical Director for End of Life Care and Consultant Nurse for Critical Care and End of Life Care said “Thanks to working in partnership with Mountbatten, we are able to provide this new service within the acute hospital giving us another source of support for those at end of life and their families.   If the scheme proves successful then we aim to recruit more End of Life Care Companions.”

Families or patients who feel they would like a companion to support them during their stay at St Mary’s Hospital should speak to a member of staff on the ward, who will then contact the Integrated Palliative and End of Life Care Team (available from 8am to 8pm, Monday to Friday).

TEAM 999 SET TO HELP FIND A DONOR MATCH FOR ‘FINN THE FABULOUS’

Date: 9 August 2019

Ambulance staff from Bromsgrove Hub are joining forces with 999 colleagues later this month to help find a donor match for a little boy who urgently needs a transplant.  

Bromsgrove-based Clinical Team Mentors Abi Coombs and Ruth Hodgson and Technician Caroline Hadley have been following the story of ‘Finn the Fabulous’; a seven-year-old boy called Finn Hill from Clent who has a rare and life-threatening condition where the immune system begins to damage a person’s own tissues and organs.

His only hope of a cure is a stem cell transplant from a perfectly matched donor which has led his family to work tirelessly to raise awareness about the condition as well as hold events to get people to register to be donors by doing a simple mouth swab. 

Abi, Ruth and Caroline have now helped to organise a tri-service open day at Bromsgrove Fire and Police Station on Saturday 31stAugust, 12pm – 4pm, where people can come to sign up as a blood stem cell donor and have a swab taken in the hope of finding a perfect match for Finn.

Caroline said: “Finn’s story is one that has captured our attention and our hearts. Aged just seven, he’s been battling this condition for three years of his short life already. Organising ambulance representation at the tri-service open day is the least we could do to ensure Finn gets as much help as possible to find a stem cell match to save his life.”

If you aren’t already on the UK Stem Cell Register and are free on Saturday 31st August, please come along! Alternatively, you can visit the UK Stem Cell Register via dkms.org.uk or anthonynolan.org. To find out more about Finn the Fabulous, visit https://www.facebook.com/finnthefabulous/.

Brother and ambulance crew get Carter – just in time

Date: 29 July 2019

A Newcastle man was effectively dead for 20 minutes, but Bruce Carter is alive thanks to his brother, a passer-by and a team from the North East Ambulance Service.

Bruce, a 61 year-old self-employed plumber, suffered a cardiac arrest while out cycling around Tyneside with his brother Tristram.  The brothers were reunited with the ambulance crew so Bruce could thank them.

Tristram takes up the story of what happened on the day.

“We had cycled to North Shields and got the ferry.  He said he felt uncomfortable, with pains in his shoulders, but I put that down to the fact that he hadn’t been on a bike for quite some time.  We were going to get the Metro back.  We were pushing our bikes up a road to Chichester station.

“I was slightly ahead of him but when I looked back he was down on the ground.  I was expecting him to be dehydrated and suffering from heat exhaustion but when I got to him he was totally lifeless.  I started CPR (cardiopulmonary resuscitation).  A passer-by called Peter offered to help, so he took over while I rang for an ambulance.”

Clinical advisor Lisa Ahmed took the call from Tristram.   “It was clear he and the passer-by were doing a really good job with CPR.  They were very focussed and it was crucial that CPR was administered so quickly.”

The Monkton-based crew of paramedic Michael Hugo, student paramedic Paul Wales and emergency care assistant Emma Newton were only minutes away when they got the call to respond.

Michael said:  “Paul took over CPR and we realised he was in ventricular fibrillation which is a cardiac arrest and required a defibrillation shock so his heart could then be re-started.  After the shock CPR continued and eventually his heart went into a normal rhythm.

“We got him on to a stretcher and into the ambulance.  By the time he woke up, he was understandably very confused and didn’t know where he was.  The one thing he did say was that he didn’t want to go to a ‘red and white’ hospital!

“Effectively he had died for 20 minutes – he had stopped breathing and didn’t have a pulse.  His brother and the passer-by helped to save Mr Carter’s life – he needed CPR with the initial cardiac arrest.”

Paul said:  “Tristram and the passer-by were doing excellent compressions when we arrived.”  While for Emma, it was the most dramatic case after changing jobs a couple of months ago from being an office-based health advisor to working on an ambulance.

Mr Carter was taken to South Tyneside Hospital, and then transferred to the Sunderland Royal Hospital where he had stents inserted.

Bruce, from Thorntree Drive in Newcastle, said:  “My brother is trained in first aid and used CPR – that’s probably what saved me – meaning my brain wasn’t starved of oxygen.

“I’m very grateful to the crew.  They were fantastic, helping to treat me and reassuring me.  I just wanted to thank them personally for what they did.  At first I was making light of what happened, but after a couple of days the seriousness of what happened struck home.”

Tristram, an RAF Squadron Leader who works in air safety, added:  “The ambulance crew were wonderful, they were the ones who brought him round.”

Treating My Own Mother

Jerusalem, June 12th, 2019 – United Hatzalah volunteer EMT Noa Salant was shocked when she responded to an emergency incident to find her mother to be the patient in need of medical care.

The family was supposed to get together for some quality time and both Noa and her mother were arriving by bicycle from different locations. “As I was driving, I heard screams from up ahead of me and saw a few people standing around someone lying on the street,” said Salant sometime after the incident which occurred two weeks ago.   

When Salant arrived at the scene she saw a very familiar woman lying on the sidewalk injured-  her mother. “I immediately went into EMT mode and began triaging her. I took her pulse while simultaneously calling for an ambulance. I asked the people around her if anyone saw what happened and all they would share was that she fell.”

Noa (right) and her mother.

Salant relived the dramatic moments of the treatment. “I noticed that my mother could not move her pelvis. I began treating her for her injuries and immobilizing her so that none of the injuries would get worse. Other volunteers from United Hatzalah began arriving and they assisted me in providing treatment. When the ambulance came some ten minutes later, I joined the team on the ambulance and kept watch over my mother the entire way to the hospital. When we arrived at the emergency room we found out that she had broken her hip.”

Salant spent the next few days visiting and caring for her mother in the hospital. “The doctors told us that this is the type of injury where there is no corrective surgery and that the best medicine is to keep my mother stable and her spirits up in order to give her body time to heal. They added that the care I gave at the scene prevented the injury from getting worse. It is thanks to the training that I received from United Hatzalah that I was able to keep my cool and follow all the procedures and protocols necessary even though I was treating my own mother,” Salant concluded.  

“If it wasn’t for the London Ambulance Service, my wife and daughter, I wouldn’t be here now.” Chingford cardiac arrest survivor thanks staff who saved his life

Date: 24 July 2019

A man has been reunited with staff from London Ambulance Service who saved his life after he collapsed at home in cardiac arrest.

Andreas Kallis, 68, and his family visited Walthamstow ambulance station recently for the opportunity to meet and personally thank all those involved.

His wife Tina, 63, recalls the moment her daughter, Christina, 37, alerted her to Andreas’s collapse at their home back in February 2018: “All of a sudden my daughter came to me and said: ‘Mum, I don’t know if dads asleep or ignoring me’.”

After running into the sitting room and checking if he was breathing, they immediately dialled 999.  They spoke to Emergency Call Coordinator, Fran De Wet, working in the London Ambulance Service control room, who started directing them through cardiopulmonary resuscitation (CPR).

“Fran told us precisely how to do CPR and the rhythm as well. I did so much better than I thought and that’s because of her help.”

An ambulance was quickly dispatched and London Ambulance Service paramedic crew Esme Choonara and Amanda Gowing responded to the scene.

They managed to get a pulse and rushed Andreas into Barts Heart Centre at St Bartholomew’s Hospital, where with the help of doctors and nurses has made a full recovery.

At the emotional reunion Andreas and Tina were joined by Fran, Esme and Amanda.

Andreas said: “I must be really lucky to survive. If it wasn’t for the London Ambulance Service, my wife and daughter I wouldn’t be here now. It was wonderful to be able to thank them all personally.”

Call handler Fran said: “This is why we do the job. That feeling of knowing that something you’ve done has really helped someone and their family.”

“In over twelve years working for the Service I have taken several cardiac arrest calls. But I have only ever received three letters to tell me that those patients have returned to normal life and have walked out of hospital. So to actually meet Mr Kallis is truly amazing.

“The whole experience has been overwhelming – I promised I wouldn’t cry but I did.”

The family wants to raise awareness of the importance of the general public learning lifesaving skills such as CPR. Tina said: “I had done a bit of CPR training years ago, but you never really think that something like this is going to happen to you.

“I just feel so good that I was able to help save him.”

“We are so grateful to all of the ambulance staff and everyone at St Bartholomew’s Hospital, the nurses, the doctors and the police who also attended that day. It feels like it is the closure we needed.  To thank them and to see them in lovely surroundings not in that traumatic, horrendous way.”

Weardale community paramedic scheme starts

Date: 31 July 2019

A new community paramedic service has been set up in Weardale.

The service started this month and covers Crook, Willington and Stanhope.  It will initially operate for a 12-month trial period.  The new service is in addition to a similar scheme which currently operates in Barnard Castle.

Paramedics from the North East Ambulance Service (NEAS) are working with local GPs, district nurses and falls teams to provide improved, community-based health care and reduce the time it takes to respond to life-threatening emergencies.

The scheme is a joint venture involving NEAS, NHS Durham Dales, Easington and Sedgefield Clinical Commissioning Group (DDES CCG) and the local GP Federation of doctors.

The paramedic team will use a rapid response vehicle and be available from 8am-8pm seven days a week. They will be work solely in the Crook/Willington/Stanhope area and will respond to immediate life-threatening incidents if they are closest to the patient.

They will also help support GPs by carrying out some home visits and work with other healthcare staff to prepare and deliver care plans for patients with long-term conditions.

Phil Blance, the Clinical Operations Manager for NEAS in the Dales said:

“This new scheme will mean that our paramedics will be much closer to local communities and be able to respond more quickly to the most serious incidents.

“The scheme in Barnard Castle has shown that the number of patients taken to hospital can be significantly reduced – that’s good for patients and helps reduce the impact on the rest of the NHS.”

Stewart Findlay, chief officer of NHS DDES CCG, said: “We have been working hard to find a solution to the difficulties in providing an emergency response to our rural areas for some years now.

“For many years we have invested significant additional money in to the two Durham Dales and the service that now runs in Teesdale offers a solution that is popular with patients and GPs alike.

“It offers the best chance of a rapid response and makes best use of paramedic time which is dedicated to the Dale. It demonstrates how well the CCG has been working with NEAS, our local GPs and our local GP federation and I am delighted to see it now extended to the Weardale population.”

Brothers rewarded for their brave efforts in getting their mum emergency help

23 July 2019

Three brothers from Newcastle have been awarded bravery certificates by the North East Ambulance Service for their actions in helping to get emergency help for their mum after she collapsed at home.

Seven year old twins Charlie Duke and Dylan Duke, and their four year old brother Jayden Douglas, were at home when their mum Lisa Hefferin collapsed at the bottom of the stairs and became unresponsive.

Dylan rang 999 by using his mum’s mobile but it was Charlie that spoke with call handler Vikki Wightman, to ensure the door was unlocked for the ambulance crew to arrive and that he and his brothers stayed safe.

Vikki said, “The call came in and I was alarmed that it was a young boy ringing about his parent. All three of the boys spoke on the phone and gave a clear account as to what had happened, but it was Charlie that gave me clear details of his mum’s condition and what their address was.

“If children know the basic information of what to do during an emergency, it makes it that little bit easier for us to find out exactly what is going on.

“It was a privilege to be able to award Charlie and his brothers for their actions. They were all so brave in getting their mum the help she needed. It’s not every day we get to see the outcome of a patient and as a call handler, being able to meet the person on the other end of the phone, really puts into perspective the work that we do.”

Lisa suffers with low blood pressure and has to take iron tablets. Her blood pressure dropped so low that day that she collapsed and didn’t regain full consciousness until she was in the back of the ambulance, on her way to hospital. 

Lisa said, “It was me and the three boys in the house at the time and it was absolutely amazing what they did.  Charlie looked after his siblings and called for help for me when I needed it the most. I couldn’t believe it.

“I think every parent should learn from my story and educate their children in what to do during an emergency. I taught them what to do and they got me the help I needed.

“I’m so proud of all of my sons.”

The ambulance crew members that attended to Lisa were paramedics Craig Hurst, Victoria Landale and Daniel Price as well as rapid response paramedic Paul Jackson.

Craig has worked at NEAS for seven years and has been a qualified paramedic for two and a half years. He remembers the job well, “We got a serious life threatening call about a female in cardiac arrest at her home and that one of her children had called 999.

“When we arrived he had unlocked the door for us and we saw Lisa in a semi-conscious state. Thankfully she wasn’t in cardiac arrest. Charlie had found blankets and pillows to make his mother comfortable and stayed by her side the whole time. Whilst we were there he was looking after his brothers and gave us exceptional information about what had happened. As it turned out, she collapsed with low blood pressure.

“He continued to look after his brothers and got them ready for school whilst we were helping Lisa and kept their family dog calm. 

“I feel the efforts of this young gentleman and his brothers deserve recognition and I could not go without presenting them a bravery certificate.”

Victoria Landale has worked at NEAS for five years, first beginning as a dispatch officer in in the emergency operations centre. She said, “It’s great to meet Lisa and to see how she is getting on from what happened. It’s also closure for us to hear the outcome of patients that we have treated, which we don’t always get to hear about.

“Many schools now are implementing CPR within their curriculum and I think this case highlights the simple things that young children can do to save their parents or someone else’s life.”

Daniel Price said, “Charlie was a really grounded little boy as he kept reassuring his brothers that mummy was going to be alright. He also got them ready for school, he was really mature for his age.

“We don’t get a thank you very often but when we do it’s really nice to get one. My job is to help people and when someone recognises that, it’s really inspiring for me.”

The Trust is hosting a CPR training day called Restart a Heart Day in October, that encourages schools, organisations and communities to sign up to receive lifesaving skills in CPR.

Over 30,000 people suffer a cardiac arrest out of hospital in the UK every year.   Currently, less than one in 10 survive. The earlier a patient can receive CPR and a shock from a defibrillator, the greater their chance of survival. We know that the major difference is widespread training in CPR. Find out more and sign up to Restart a Heart Day: http://bit.ly/2L7UJFF