Saving Eyesight In The Time Of Corona

https://chat.whatsapp.com/AmbulanceTodayDirect

The Eye Clinic at Soroka Medical Center in Beer Sheva in partnership with United Hatzalah and with the assistance of the municipality of Beer Sheva and the Lions Club of Israel has begun a program that allows elderly residents of Beer Sheva to receive their Avastin treatments close to their homes. 

This unique service is being offered to residents of Beer Sheva and the surrounding area who suffer from a variety of maladies that require Avastin treatments to receive the treatment without having to physically show up at the hospital by utilizing a mobile “treatment room” inside a United Hatzalah ambulance.

The ambulance travels to the home of the patient and the procedure is done inside the ambulance by members of the eye clinic. 

The treatment is normally an in-clinic procedure for macular degeneration, diabetic retinopathy, and retinal vein occlusion.

Patients suffering from any of these illnesses are required to receive this treatment once a month.

Photo Credit: United Hatzalah. Staff from the eye clinic stand outside a United Hatzalah ambulance.

Without the treatment, patients will gradually lose their eyesight and may even go blind.

Due to complications with the Covid-19 Coronavirus, as many of the patients who require this treatment are high-risk, many patients are unable to come to the hospital clinic to receive the treatment.

Thus the need for a mobile treatment center with clinic staff that could come to the patients and provide the treatment for them at home.

This partnership is the first of its kind in Israel.

A doctor and nurse from Soroka’s eye clinic arrive at the patient’s home in one of United Hatzalah’s ambulances in a clean, safe, and sterile environment allowing the treatment for the patients to take place.

Senior Physician from the Optometry Center in Soroka Medical Center Dr. Noam Yankelevitz spoke about the special project: “On a regular basis, our eye clinic treats patients for a wide range of retinal diseases, utilising various methods, one of which is eye injections.’

“In an effort to prevent irreversible damage to the eyes of our patients who cannot come in person to the hospital during the current crisis we created this unique partnership that brings the medical clinic to the home of the patient themselves.’

“We perform the injection in the ambulance outside the patient’s home and bring this necessary service to them.”

Head of the Beer Sheva Chapter of United Hatzalah Eliah Tubul said: “In partnership with the Soroka Medical Center, we are enabling elderly patients and those with eye illnesses to continue receiving their treatments and are preventing the deterioration of their medical conditions.’

“The major challenge was maintaining the sterile environment surrounding the patient when they received the injection.’

“It is for this reason that we are using an ambulance which is thoroughly cleaned. We are making sure that it is as clean as an operating room.’

“We are very proud of this project and when the patients thank us for our help, we feel a tremendous amount of satisfaction.”

One Nurse Replaces An Entire Medical Team Stricken With Corona For a 48 Hour Shift

https://chat.whatsapp.com/AmbulanceTodayDirect

By Gilad Hadari,
United Hatzalah Volunteer

My name is Gilad Hadari, I live in a small town named Elon Moreh.

My town is nestled in the hills of Samarai, near the city of Nablus. I’m a divorcee and I have three young children whom I was supposed to spend the weekend with. After all, it was my birthday.

But my plans changed dramatically on Friday afternoon after I received a phone call just before Shabbat began from the head of the Bnei Brak Chapter Ephraim (Effy) Feldman.

Effy and I have known each other for a while as I have been volunteering with United Hatzalah for close to 12 years now.

Effy knew that I was a registered nurse and that I have experience working in a nursing home. He asked if I would be willing to come down to Bnei Brak, some 70 kilometers, (or 44 miles away) in order to take over for the medical staff of a nursing home.

The staff had all called in sick as many of them had contracted Corona or were in forced home isolation and there was no one to manage the home until more staff could be found.  

On Thursday night, the city of Bnei Brak was put on lockdown by the Israeli government due to the rampant outbreak of the Covid-19 virus that had permeated the city. The disease was taking its toll among the staff of this nursing home and throughout the city.

Officials in the Health Ministry speculated that 75,000 residents of the city have the virus and there simply aren’t enough testing kits to get to them all. So many are left untested.

The IDF and the Home Front Command took over running the city. No one was allowed in or out without their travel being deemed absolutely necessary. 

It was into this bedlam that I ventured. Effy sent an ambulance to transport me from my home to Bnei Brak. Due to it being Shabbat, and according to Jewish law, I wasn’t allowed to take any non-essential items with me.

No personal belonging, no food, just my phone as I would need that to communicate with the Social Services and Home Front Command and update them about what was happening at the home over the course of Shabbat.   

When I arrived at the home I found that I was the only medical staff at the location. The manager of the home was there, and he and I were alone.

He had no medical training and was not allowed to perform even the most basic medical tasks required by the patients.

There weren’t even any available Auxiliary staff.   

70% of the residents in this nursing home are invalids. I grabbed the files of each of the patients and went over them one at a time to familiarise myself with who needed which medication and what medical conditions to expect etc.

After running a quick inventory, I realised that we didn’t have enough masks or full protective gear for me and the manager to make it through the weekend. 

I called Social Services and the Home Front Command and told them that I needed a lot more supplies.

There was no food for me personally, and patients needed their diapers changed. Some hadn’t been changed for 12 hours.

Sometime later a nursing student from Ichilov hospital came and we worked together tirelessly until 2:00 a.m. when he said he had to leave so he could make his shift the next day at the hospital.

I was once again alone together with the manager of the home. He came with me and over the course of the night we attended to each patient’s needs, and I prepared all of the medication for each patient according to their chart.

However, I relied on the manager to tell me which patient was whom. We went person by person and made sure that everyone was comfortable and received their proper meds. 

In the morning, another nurse arrived for an eight-hour shift. We worked together and continued providing care for the patients. But then she too left.

After that, I was on my own until Sunday night working and caring for the patients non-stop. There were no other medical or auxiliary staff present.

Usually, the nursing home has a team of four nurses and numerous auxiliary staff, but all of the staff who was supposed to work over the weekend had contracted the virus or were in home isolation due to being in close proximity with someone who had.  

By Saturday morning, I had two people whom I suspected of having contracted the virus. I based my suspicions upon their displaying symptoms associated with the disease.

I contacted the chief officer of the medical station in the city and requested two ambulances be sent to take these patients to Tel HaShomer Hospital.

In the end, one person had contracted Corona, the other person didn’t. This caused the medical centre to send testing teams to test all of the residents.

I too was tested, but my test was “lost” and therefore when everyone received their results on Saturday night (thankfully everyone else was negative) I didn’t get any results at all.

After calling to inquire what my results were I had been told that my test had never made it to the lab but was lost on the way.

I continued caring for my charges over the course of the next day as well. I provided medication for those who needed it and assisted others with their basic needs as well.

Gilad preparing medication at the home for the residents

Over the course of Saturday — a day when religious Jews traditionally don’t use the phone — I received 250 phone calls from worried family members, the Home Front Command, the IDF, and Social Services from the city all wanting to know what was happening and what was needed.

Often when I told them what was needed they said that they will do their best to provide it but didn’t really follow through. I had to make do with what I had.

On Sunday night I was relieved by a skeleton team. I had been awake and working for more than 48 hours. I went home and slept for a few hours and then went shopping.

I’m trying now to get myself tested but my medical clinic told me that if I am not showing active symptoms then they won’t issue a test for me as tests are scarce throughout Israel.

The ambulance service, which is also conducting testing has told me the same thing.   

On Monday, I finally got to spend some time with my children who all asked me how my weekend was. There was no real way to explain to them what had transpired.

My children range in age from 4-6-years old. I was wondering what to tell them and the only message that came to mind after such a weekend was: “It is always important to help others whenever you get the chance.’

“Just like I save lives as an EMS first responder, I also save lives as a nurse and that is what I was doing over the weekend.”

My children all looked at me and gave me a big group hug before running off to play some more.

While it wasn’t ideal for me to miss my weekend with them, in time they will understand why I did it. That may be the most important message that I could ever teach them.

Air Ambulance KSS Enhances Partnerships: Joins Regional Covid–19 Response

https://chat.whatsapp.com/AmbulanceTodayDirect

Air Ambulance Kent Surrey Sussex (KSS) today announces that it will be extending its role at the frontline of the response to the coronavirus pandemic.

Working in partnership with the NHS and South East Coast Ambulance Service NHS Foundation Trust (SECAmb), KSS will transfer patients requiring critical care by land, with aircraft being used for the rapid delivery and recovery of the team.

KSS will continue to operate its primary service during this time. Although there has been a drop in major trauma incidents in recent weeks, linked to the reduction in road traffic, cessation of higher risk industry and a decrease in leisure activities, there is still a national commitment to maintain the Helicopter Emergency Medical Service (HEMS) to save lives.

David Welch, CEO,
Air Ambulance KSS

David Welch KSS CEO, said: “Our healthcare service is facing an unprecedented challenge, and it is vital that we work together to ensure our individual experience and expertise are brought together for the greater good. ‘

“I am completely humbled by the dedication and commitment that our crews have always shown and continue to show in these challenging times — they are a credit to KSS and to our nation who very much now need their support.’

“The transfer of patients experiencing the most serious symptoms is incredibly complex.’

“These transfers will be demanding, and the safety and wellbeing of our crews will remain a priority.’

“I have every confidence in the excellence of our team and thank them for their unwavering commitment and professionalism as we evolve with a new service to support our NHS at this critical time.’

“We are currently exploring how COVID-19 patients could be transported safely by air but this can only happen once we are assured of the safety of our crews and our patients.”

Dr Fionna Moore,
Medical Director,
SECAmb

SECAmb Medical Director Dr Fionna Moore said: “I am pleased that we have further strengthened our already well-established links with our air ambulance service.’

“This approach will benefit patients across our region as we rise to the challenges Covid-19 presents.’

“As a charity, the air ambulance service relies on the generous support of the public and I would encourage anyone who is able to, to consider donating to fund this valuable service.”

KSS recently announced its outstanding CQC rating, having been scored outstanding in all five of its inspection key lines of enquiry. 

It is the first Helicopter Emergency Medical Service to achieve this top rating in all categories.

Operating out of Redhill Aerodrome and headquartered in Rochester, KSS provides world-leading pre-hospital emergency care whenever and wherever required to save lives and to enable the best possible patient outcomes.

Covering Kent, Surrey and Sussex, KSS serves a population of 4.8 million plus those who travel through the area — making it one of the busiest services in the UK.

Its crews of pilots, doctors and paramedics fly over 2,500 missions a year, and it was the first, and only, UK Air Ambulance to operate its helicopters 24/7. 

KSS is a registered charity and of the more than £14m needed to sustain the service each year, 89% is raised by public donation and fundraising.

The charity is currently experiencing increased  costs as a result of the COVID-19 pandemic and a decrease in income following the cancellation of vital fundraising events.

To support the charity, please visit www.aakss.org.uk

Innovating Idea In Search Of Solutions To Rapidly Improve Ambulance Decontamination

https://chat.whatsapp.com/AmbulanceTodayDirect

The Welsh Ambulance Service has challenged businesses to develop a new innovation to speed up the decontamination of ambulances during the Coronavirus outbreak.

The Trust has asked businesses to come up with a solution to accelerate the cleaning of its vehicles so that crews can get back on the road and respond to other emergency calls.

It takes additional time to decontaminate an ambulance that had transported a suspected or confirmed Covid-19 patient, taking precious resources away from the frontline temporarily while the vehicle is made safe for the next patient.

More than 200 applications have been received and shortlisted after the Trust put out a call to action through the Small Business Research Initiative (SBRI).

Jonathan Turnbull-Ross,
Interim Assistant Director of Quality Governance,
WAST

Jonathan Turnbull-Ross, the Trust’s Interim Assistant Director of Quality Governance, said: “The safety of our patients and staff through the Covid-19 outbreak is paramount and we have to be on top of our infection prevention and control measures.’

“Typically, it can take an additional 30 to 45 minutes to clean an ambulance vehicle that has transported a suspected Covid-19 patient, but the process can also take upwards of several hours, depending on the level of decontamination required.’

“We have to think outside the box if we want a solution that is going to speed up this process, and release our crews back on the road quicker to respond to other calls.’

“We were delighted with the number of submissions we received, and genuinely excited by the ideas and concepts that these businesses have to offer.’

“We look forward to seeing how these will evolve through the evaluation stages, and to understand how these innovations can be further supported to roll out across Wales, which will ultimately save lives.”

The challenge is being managed by the Welsh Small Business Research Initiative (SBRI) Centre of Excellence, hosted by Betsi Cadwaladr University Health Board, with support from Welsh Government, the Defence and Security Accelerator (DASA) and Innovate UK.

Vaughan Gething, Minister for Health and Social Services, added: “I’m really pleased the Welsh Government is supporting the Welsh Ambulance Service to spearhead this UK-wide search for sanitation solutions.  

“Anything which reduces the turnaround time for our ambulance fleet will ultimately save lives because innovation is never more important than in times of crisis.

“I hope too, that we can find solutions which can be used by our other emergency services and the dedicated workers keeping our public transport on the move.”

Testing will take place at the Ministry of Defence’s Defence Science and Technology Laboratory in Porton Down, Wiltshire, in mid-April before the Trust will consider the successful solutions which may be implemented across the organisation.

Physician Response Unit Expansion Supports London’s Covid-19 Response

https://chat.whatsapp.com/AmbulanceTodayDirect

Expert teams of emergency medics are taking the Emergency Department to the patient in rapid response cars across North East London, forming a vital part of the capital’s Covid19 response.

The Physician Response Unit (PRU) is a collaboration between London’s Air Ambulance, the London Ambulance Service and Barts Health NHS Trust.

It is staffed by a senior emergency medicine doctor and an ambulance clinician, and carries advanced medication, equipment and treatments usually only found in hospital.

The service responds to 999 calls, treating patients in their homes who would otherwise have often required an ambulance transfer to hospital.

Since Monday 6 April, the PRU service is now operating with two cars and its operational hours have been extended to run from 8.30am to 11pm seven days a week.

The Covid-19 pandemic means that the NHS across the capital is responding to the biggest global health threat in a century while also ensuring that people who don’t have the virus can still access the other services they need in as safe a way as possible.

In response to this, the PRU has also established new ways of working to provide care for more patients in their own homes. These include:

  • Enabling early discharge from Emergency Departments: ED clinicians in the Royal London, Whipps Cross and Newham hospitals may discharge a patient with the aim of providing home visits from the PRU, rather than referring the patient for inpatient care
  • Saving vulnerable/ at risk patients a trip to hospital: PRU teams can be tasked to visit patients that are ‘high risk’ (for instance, cancer patients on chemotherapy that would otherwise need to come to hospital for assessment). They are able to perform an advanced assessment, do blood tests and other investigations, and administer treatments, all in the patient’s home.
  • Taking referrals from inpatient wards: The PRU has created a consultant rota so that ward teams can discharge patients that they would normally have to keep in hospital. The safety net of a review by the PRU within the actual community instead of at the hospital means that patients can now be discharged.
  • Supporting palliative care services: Palliative care teams at St Joseph’s Hospice and The Margaret Centre can liaise with the PRU for them to visit and provide community reviews or clinical consultations, when otherwise patients would need to be taken to the hospital by ambulance. These measures will free up hospital beds and reduce risks for vulnerable patients.
  • Covid Transfers: The PRU is offering assistance to the London Ambulance Service to help with transfers of unwell Covid-19 patients to the Nightingale Hospital. This undertaking will support the large-scale Nightingale project being orchestrated by NHS services across London and will offer the ambulance service additional support at a time when it is facing huge pressure from 999 and 111 calls across London.

Dr Tony Joy, Consultant in Emergency Medicine at Barts Health NHS Trust & Clinical Lead for the Physician Response Unit, said: “The Physician Response Unit is proud to be expanding our service and stepping up at this critical time.’

“By taking the Emergency Department to the patient in their home we can ensure they get the right care fast, while also reducing risk and keeping hospital beds free for those who really need them. ‘

“The launch of a second car is a huge step forward for the PRU, allowing us to cover more hours of the day, delivering safe and effective emergency care in the community at this extremely challenging time. ‘

“This is another way in which the NHS is ensuring it is still open for business and there for everyone during this pandemic, and while Londoners are responding to advice on staying at home, they should still seek NHS medical help when they need it.”

London Ambulance Service’s Chief Operating Officer, Khadir Meer added: “The expansion of the Physician Response Unit will ensure we continue to provide the best possible care for Londoners and help to reduce the unprecedented pressure on the wider healthcare system at this extremely challenging time.’

“The PRU, a collaboration between both the hospital team and ambulance clinicians — and dispatched from our 999 control rooms — helps bring clinical expertise into a person’s home, potentially saving a patient an avoidable, unnecessary trip to hospital.’

“Introducing an extra vehicle means more of our other ambulance resources will be available for critically injured patients in London.”

“This is one of a number of advances the Service has made to offer more people the right care for them closer to home, in their community, without an unnecessary trip to hospital.”

Jonathan Jenkins, Chief Executive of London’s Air Ambulance Charity emphasised the vital importance of the Physician Response Unit: “At a time when NHS staff are working round the clock it is humbling to see blue light services pulling together, and the expanded Physician Response Unit is vital in terms of bringing the Emergency Department to the patient and helping the wider system respond to the Covid-19 challenge.’

“It is down to the unwavering hard work and determination of Tony Joy, Bill Leaning, and everyone at the PRU that we are able to expand the service in this crucial way and at this crucial time, and they should be incredibly proud.”

As well as carrying state-of-the-art equipment, the PRU vehicle also has a computer with access to patients’ electronic records, allowing the team to review hospital and GP notes.

The PRU is also using an innovative new mobile app, Pando, to manage referrals and disseminate information within its clinical team.

Pando allows users to track tasks using the information-sharing platform, and the duty team can receive and communicate clinical information about patients wherever they are, enabling timely care and efficient decision-making.

In addition, mobile network operator EE have donated iPhones and an iPad to the PRU and its expanded service, covering all associated running costs, in order to ensure a smooth communications operation.

Barts Health, London’s Air Ambulance and the London Ambulance Service were the first in the UK to set up a PRU, launched in 2001.

The innovative model has since been implemented across the UK, including Wales, Oxford, Lincoln and Leicester, with other parts of the country also looking to develop similar services.

Corona Survivor Donates Plasma To Save 29-Year-Old Corona Victim In Serious Condition

https://chat.whatsapp.com/AmbulanceTodayDirect

The blood services of Magen David Adom and the Israeli Ministry of Health received an inquiry yesterday afternoon from Assuta Ashdod Hospital for delivery of plasma units (the blood component containing the corona antibody) for a 29-year-old corona patient who is in serious condition.

With the help of the Minister of Health and his assistant, a donor residing in Jerusalem who had recovered from the Corona virus was found and Magen David Adom duly brought her to MDA’s blood service center via ambulance.

The project is based upon the assumption that the blood of patients who have recovered contain antibodies in the amount that enables effective treatment of patients

With a special team waiting for her upon arrival, plasma units were transferred to the laboratories for testing prior to transfusion.

With the approval of a health ministry committee, the blood units were delivered to Assuta and were given to the patient last night .

MDA Deputy Director General of Blood Services, Prof. Eilat Shinar said: “A week ago, we started the plasma units collection project from patients who have recovered from the disease caused by the corona virus, with the aim of giving infusion to patients in moderate and severe conditions, according to a therapeutic protocol set by an experts committee.’

“The project is based upon the assumption that the blood of patients who have recovered contain antibodies in the amount that enables effective treatment of patients.’

“The professional work of the blood services team, in combination with the MDA logistical preparation and the response of the donors , enables us to promote the issue in practice with 7 donors that donated plasma already; in the last two days plasma units were provided to three different hospitals. “

MDA Director General, Eli Bin further stated: “As soon as a referral from Assuta Ashdod Hospital was received, we were quickly prepared, combining forces of MDA blood services and logistical staff.’

“With the assistance of Health Minister Litzman and his assistant, a suitable donor, a resident of Jerusalem who observes Shabbat, was found, and we immediately did everything we can, so that last night the patient got the plasma, which we all hope will help doctors in their efforts to improve his condition. “

Corona patients within Israel who have recovered are welcome to donate plasma, in a very simple procedure, after 14 days of complete recovery.

MDA Blood Services are calling upon such people who are willing to offer their support and help to come and donate.

For more information please call 03-9101101 or email hadarm@mda.org.il

Trauma Care in Africa: The Challenge of Definitive Care

https://chat.whatsapp.com/AmbulanceTodayDirect

By Michael Emmerich
Published in Ambulance Today, Issue 1, Volume 17, Global Warning & the Burning Issues At The Core Of Prehospital Trauma Care, Spring 2020

This Africa Quarterly explores Trauma Care and, as per usual, we will put the microscope on the African continent in the search for, and the challenge of, definitive care.

Traumatic injuries are a neglected epidemic in developing countries, causing more than five million deaths each year — roughly exceeding the combined deaths from HIV/ AIDS, malaria and tuberculosis.

Due to the unsafe conditions and relatively poor outcomes once someone is injured in low and middle-income countries (LMIC), we found about 90% of the global burden of injury-related mortality and disability to be concentrated within these LMIC countries.

The likelihood of death after injury is up to six-fold greater in an LMIC than in a high-income country! * See figure 1

Around the world, acutely ill and injured people die every day due to a lack of timely emergency care.

Among them are children and adults with injuries and infections, heart attacks and strokes, asthma and acute complications of pregnancy.

Many countries have no emergency access telephone number to call for an ambulance or no trained ambulance staff, or even ambulances / emergency response vehicles.

Many hospitals lack dedicated emergency units and have few providers trained in the recognition and management of emergency conditions. Deaths could be avoided if the necessary structures were in place.

“No one should die for the lack of access to emergency care, an essential part of universal health coverage. We have simple, affordable and proven interventions that save lives. This initiative will ensure that millions of people around the world have access to the timely, life-saving care they deserve.”

—WHO Director-General Dr Tedros Adhanom Ghebreyesus on the launch of the WHO Global Emergency and Trauma Care Initiative, 8th December 2018

But there are winds of change sweeping across the continent, albeit in small pockets and in key isolated areas of the treatment paradigm.

The challenges are huge but, thankfully, the Medical Profession is one of the key, and at times only, driving force behind these changes.

Challenges to trauma care include inadequate pre-hospital and in-hospital trauma care protocols, as well as staff with limited training in trauma management.

Hospitals have no dedicated trauma units, no emergency medical equipment, drugs or trained and skilled physicians / paramedics / nurses to deal with the influx of patients.

In addition to this, poor or absent basic life support training by local communities — or patients and family preferring the services offered by early alternative unconventional traditional care — further hinders definitive trauma care of the sick and injured.

Numerous strategies targeting these challenges are being implemented across the continent driven by a host of NGO’s, Training Institutions, The WHO and other service providers.

Mapping out and, most importantly, adapting mechanisms proven to be effective in developed countries, such as assessment, diagnostic and treatment algorithms (e.g. ATLS and ITLS adapted frameworks), training, prehospital systems, and overall system organization are being driven by medical practitioners across the region.

“Injury is an increasingly significant health problem throughout the world. Every day, 16 000 people die from injuries, and for every person who dies several thousand more are injured — many of them with permanent sequelae. Injury accounts for 16% of the global burden of disease. The burden of death and disability from injury is especially notable in low and middle-income countries. By far the greatest part of the total burden of injury (approximately 90%) occurs in such countries.”

— Etienne Krug, MD, MPH Director, Injuries and Violence Prevention Department WHO

Besides the rapidly rising fatalities, we must also take cognisance of the rising number of injured persons and their cost on the (Global) health burden.

Road-traffic crashes were the number one killer of young people and have accounted for nearly a third of the world injury burden. Most of the victims were young, and many had families that depended on them, who must now rely on other sources of support; in most instances, the State.

Disability after injury is 20–50 times more common than death. Most of the resultant morbidity can be alleviated by early and appropriate rehabilitation services, which many reports/studies and NGO’s list as being sadly lacking.

Rehabilitation is a critical component of the emergency treatment algorithm; without effective rehabilitation we have not maximised the initial effective emergency and surgical care.

The loss of earnings from these deceased or disabled breadwinners is significant. From 2015 to 2030 an estimated US$7.86 trillion is expected to be lost globally due to injuries and LMIC’s are projected to experience losses that are almost 50% greater than high-income countries!

According to the Economist Intelligence Unit Limited 2018, central and southern sub-Saharan Africa is estimated to lose up to 2.5% of GDP to injuries in 2030.

The cost of economic losses from road traffic injuries in LMIC’s are thought to be around the US$100 billion mark per year; the resultant economic burden of injury is higher than that for cancer, diabetes and for respiratory diseases.

The key player in a successful turnaround strategy is not the medical profession, but government. Politicians and State institutions can turn the tide.

True, there are challenges moving forward; many African nations are impoverished and shackled by their burden of external debt, mismanagement of State resources and corruption.

There are also shortages of trained medical professionals and poorly staffed academic institutions, all of which can be redressed by a willing active and engaged government.

Trauma care requires political will and focussed governmental direction on rolling out clear national policies and guidelines.

Where we have seen decreasing mortality rates in LMICs is due to governments recognising the need to roll out coordinated injury development programs, based on clear and strong epidemiologic principles raising awareness with respect to accident prevention; for example, enforcing the wearing of motorcycle helmets.

Thanks to a combination of insufficient, non-existent or poorly enforced safety laws, poor infrastructure and a lack of enforcement alongside a presence of corrupt enforcers, we have countries aiding and abetting in the deaths of over 1.3 million persons annually!

Only 28 countries, representing 449 million people (7% of the world’s population), have adequate laws that address all five risk factors (speed, drunk driving, helmets, seatbelts and child restraints).

Over a third of road traffic deaths in LMICs are among pedestrians and cyclists. However, less than 35% of these countries have policies in place to protect their road users.

Absence of a proactive government has been identified as one of the critical barriers to effective trauma management, due to its influence on all the other essential components of the emergency medical paradigm.

We must work to develop systems that are relevant to Africa and ensure that the “disease” is attacked at all levels: from prevention, to treatment, to rehabilitation.

Without political will, nothing will change; engage politicians and policy makers to ensure injuries are made a national priority and that their allowance is felt as an outrage!

An injury to one is an injury to all — make definitive trauma care a reality!

Additional Reading

Emergency Care in sub-Saharan Africa: Results of a Consensus Conference:
https://www.sciencedirect.com/science/article/ pii/S2211419X13000037
At Breaking Point: Understanding the Impact of Musculoskeletal Injuries in Low and Middle-Income Countries: https://www.eiu.com/graphics/marketing/ pdf/Injuries-in-LMICs.pdf
Guidelines for Essential Trauma Care: https://www.who.int/violence_injury_ prevention/publications/services/en/ guidelines_traumacare.pdf

NHS Professionals Launches National Campaign: Stand Up, Step Forward, Save Lives

https://chat.whatsapp.com/AmbulanceTodayDirect

NHS Professionals (NHSP) has launched a national campaign to boost and support the wider NHS in attracting more healthcare professionals back into the service.

The organisation runs the largest staff bank within the NHS and is owned by the Department for Health and Social Care.

The campaign, Stand Up, Step Forward, Save Lives, aims to raise awareness of NHS Professionals’ COVID-19 Rapid Response service, launched last week to accelerate the bank registration process and move qualified nurses, doctors and other healthcare professionals to the front line as quickly as possible.

NHS Professionals’ Chief Executive, Nicola McQueen, explains: “Stand Up, Step Forward, Save Lives is answering the clear call from the healthcare community keen to help on the frontline by providing a simple route to get there.’

Nicola McQueen,
Chief Executive Officer,
NHS Professionals

“NHS Professionals provides one of the fastest and most straightforward ways back into the service, if you’re a student nurse, retired healthcare professional or if you’re already in the system and would like to work additional shifts.”

“Our Rapid Response service has already attracted thousands of registrations of interest and applications. ‘

“I’m incredibly proud of our unbelievable team, who are working round the clock to get these fantastic, dedicated healthcare professionals back into action as quickly as possible.’

“I’d like to say thank you so much to everyone trying to register with our bank.’

“We are fully committed to ensuring that you are able to provide the patient care that you want to and at the location that suits you.”

Karen Stephens-Green is a retired nurse from Hatfield, Hertfordshire and has recently registered to the NHS Professionals bank and is now available to work at her local hospitals.

I retired from the NHS in October and said all my goodbyes. I really didn’t think I would be back so soon after 40 years working as a nurse.  We are all doing our part and even though I have a family, I think: what if it was my family member who needed a nurse – so it’s an easy choice to make. We have to be all in this together.”

Caroline Broad, a retired nurse from Deal, Kent has also registered with the bank and is now ready to start work in her local hospitals.

I can’t believe how quickly NHSP contacted me and confirmed that I am able to work. I am so happy that I am now on the system and ready. I retired three years ago and really wanted to come back and help.  I am a senior nurse willing to do anything.

NHSP welcomes professionals from any part of the healthcare system, whether NHS or private, recently retired or students. To join the NHSP bank, please visit our website nhsprofessionals.nhs.uk

An Interview From NHSP: Caroline

Caroline Broad

How long have you been nursing for? 

Caroline: I’ve been nursing for 44 years.  I decided I wanted to be a nurse when I was 4 years old. I trained at Barts in the days when we wore starched caps and aprons.

Although I’ve had quite a varied career, the main bulk has been in Theatres/ITU and the Prison Service.

Why did you decide to join NHSP via Rapid Response?

Caroline: I googled how to return to nursing, sent off an e-mail and was then advised that since I was still registered that I could join NHS Professionals via the Rapid Response link.

How did it make you feel being able to join our Rapid Response to help the NHS?

Caroline: I was really happy to be able to join your Rapid Response. It took a couple of attempts because my iPad is an old version and a bit overwhelmed at the moment. As soon as I used my lap top, the application process was very quick and easy.

Your response was amazing; considering the numbers that must be involved it was incredible that in about 24 hours I was good to go. It made me feel valued and wanted.

What does it mean to you to support the NHS and your local community?  

Caroline: I was really pleased to be able to offer my knowledge and skills. I was feeling frustrated and a bit guilty when I saw all the exhausted NHS staff on TV.

I just wanted to get back to support them, even if it was only making beds, emptying bed pans or making the overworked staff a cup of tea or coffee.

How do you feel about returning to nursing after retiring?

Caroline: I feel excited, but a bit apprehensive as well. I’ve been out of main stream nursing for so long, I haven’t worked on a ward regularly since I qualified.

I have always worked in specialist areas; however, I have the skills to help and support.

What do you enjoy most about nursing?

Caroline: I love the interaction with people. Knowing that I have made someone comfortable, eased their pain, made them smile is brilliant. This applies to patients and colleagues.

As a senior manager I worked mainly with the staff and it was my job to help and appreciate them. I find people fascinating, they are so different, their needs are so varied.

It is my job to treat people as individuals and identify their specific needs. I love nursing, I can’t imagine any other job that I would be as happy doing.

I am so fortunate. This crisis has given me the opportunity to return to a job that I’m very good at (that’s from my patients, not my over inflated ego!) and that I love.

Clearhead NHS

An Interview From NHSP: Karen

How long have you been nursing for? 

Karen: I’ve been nursing for 37 years.

Why did you decide to join NHSP via Rapid Response?

Karen: Keeping track with the daily challenges through social media, I felt I could not sit by and watch my colleagues struggling to cope with the magnitude of this pandemic. 

How did it make you feel being able to join our Rapid Response to help the NHS?

Karen: Nursing is a rewarding vocation and it pleases me I can continue to utilise my skills. 

What does it mean to you to support the NHS and your local community?  

Karen: I feel proud of being part of a workforce who are committed and unite in challenging times as we are currently. 

How do you feel about returning to nursing after retiring?

Karen: I retired at the end of October last year, so it had not been that long my skills and knowledge are still fresh in my mind I feel confident in returning to support my colleagues. 

What do you enjoy most about nursing?

Karen: Teamwork. We all strive for the same goal to care for our patients with compassion and dignity.

Plea For Public To Stop Calling 999 For Covid-19 Tests & Check-Ups

https://chat.whatsapp.com/AmbulanceTodayDirect

The Welsh Ambulance Service is appealing to the public not to call 999 for a Coronavirus test.

Some patients have been demanding that paramedics perform an on-the-spot test to rule out the virus, according to feedback from crews.

UK ambulance crews do not, and never have, carried tests for Coronavirus.

The Trust also reports that people have been calling 999 under an emergency pretext but on arrival crews are being asked to give a ‘check-up.’

In a video appeal shared on social media, Lee Brooks, the Trust’s Director of Operations, said: “Our people are working incredibly hard to provide you with the best possible care in these exceptionally challenging circumstances.’

“Our crews cannot perform swabbing or testing for Coronavirus, so please don’t call us for this reason.’

“Please also don’t call us for a ‘check-up’ if you have symptoms of Coronavirus.’

“Our emergency ambulance service exists to help people whose lives are in immediate danger, and not to give precautionary check-ups.’

“If you are self-isolating at home then you do not need to be tested, and you do not need to call 111 to tell us you’re self-isolating. ‘

“You should only call 111 if your symptoms worsen considerably or you cannot manage your symptoms at home.’

“We do understand that you’re concerned and frightened, but using us unnecessarily is taking our precious resources away from patients who really need our help.”

The official advice from Public Health Wales says that testing for coronavirus is not needed if you’re staying at home.

Only those in hospital are being routinely tested for Coronavirus.

Testing is also accessible to healthcare workers to allow them to return to work on the frontline quicker if it is a negative result.

The Trust’s plea is on the back of a similar appeal last week, which was for the public’s honesty when calling 111 or 999 for help after it become apparent that some people were withholding information about their illness for fear of not being sent an ambulance.

It means crews have been attending some incidents without the necessary protective equipment, exposing them to potential harm.

If you have symptoms of Covid-19 — that is a new, continuous cough or a high temperature — you can take the Covid-19 symptom checker at www.111.wales.nhs.uk/covid19  

You can also use this resource to access a self-isolation note for your employer.

NHS Staff Survey Stats Show Worrying Level of Violence Towards Ambulance Personnel

https://chat.whatsapp.com/AmbulanceTodayDirect

By Colm Porter, National Ambulance Officer, UNISON.
Published in Ambulance Today, Issue 1, Volume 17, Global Warning & The Burning Issues At the Heart Of Prehospital Trauma Care, Spring 2020

The recent publication of the NHS Staff Survey painted a stark picture of the kind of environment that ambulance staff are currently working in, but it also provides much food for thought as to how we may be able to approach subtler contributing factors to violence against ambulance staff.

As part of the annual NHS Staff Survey which gathers views and experiences from staff regarding their overall wellbeing within the NHS, the feedback of almost 25,000 NHS ambulance personnel was dutifully recorded.

From this data it was found that within the last 12 months 52.8% of staff in patient-facing roles experienced musculoskeletal problems as a result of work; 52.2% of ambulance staff have felt unwell as a result of work-related stress; and 60.8% have experienced bullying, harassment or abuse from patients and service users.

Of vital importance is the statistic that 52% of ambulance staff with frequent face-to-face contact with patients and the public have experienced violence within the last year.

This is significantly higher than the 34% cited by Matt Hancock in his letter to staff on staff violence and significantly higher than the national average in the NHS of 21%.

Assaults can have a catastrophic effect on staff, not only from the physical impact of the injury, but also the long-term effect of the psychological impact. Unsurprisingly, people get traumatised, and it can take many months to recover.

It’s not just physical violence — the verbal abuse inflicted on call takers, dispatchers and other staff working in contact centres is often unseen and under reported.

This can have similar effects on staff as a physical assault and should be viewed as equally unacceptable The pressure ambulance services are under cannot be ignored as a key factor of violence against staff.

Previous research by UNISON on violence against staff in the wider NHS found that NHS trusts struggling to meet their performance targets were likely to have much higher increases in violence against staff and that NHS trusts struggling with huge financial deficits also witnessed a big rise in the number of reported attacks on staff.

It’s no coincidence that in trusts where pressure seems most extreme — where there are huge financial deficits or serious struggles to meet waiting time targets — there have been the steepest rise in the number of attacks.

Staff shortages, increased workloads and longer waiting times can all lead to growing frustration and more potentially volatile situations.

There have indeed been some very positive steps taken to address this serious issue.

The Assaults on Emergency Workers (Offences) Act 2018 came into force in November 2018 and was a very welcome development, while the recent joint agreement, which involves NHS England and Improvement and other stakeholders, has underpinned the provisions in the 2018 Act and sets out the standards which victims of these crimes can expect.

The commitment to violence reduction a laid out by the NHS Long Term/10 Year Plan, published in January 2019, is also undoubtedly a step in the right direction.

Furthermore, the piloting of body worn cameras in the ambulance services has also had a positive impact.

The work done by NEAS in this area, and particularly their commitment to involving staff and trade unions in the project, is definitely an approach UNISON would like to see replicated across all services introducing body worn cameras.

However, the introduction of new technology and legislation is not an instant solution to the problem and can never be fully effective in efforts to reduce violence and aggression against staff without a fundamental change in how our services are funded from a political level in the face of such clear links between burdens caused by financial deficit and abuse of staff.

Additionally, we can’t help but bemoan that as of April 2017 NHS Protect, the national organisation that was responsible for setting the violence reduction strategy in England, no longer exists.

NHS Protect had wide-ranging responsibilities which played a key role in the fight against violence, from setting the violence and aggression standards contained in the standard NHS Contract to producing annual violence and aggression data.

In their absence ambulance trusts have been left with the difficult task of managing the violence and aggression risk but without the leadership and strategic oversight that comes from a national body.

The safety of ambulance staff needs to be paramount in the NHS and it can never be acceptable to feel that regular assaults or abuse are simply ‘part of the job’.

This needs to be heard loud and clear from NHS staff and, whilst the NHS Staff goes some way to showing this within its data, uniting the voices of NHS staff across the UK to ensure that this data is acknowledged by those with the power to make positive changes is a role that UNISON takes pride in.

As these cases continue to rise it would appear to be more vital than ever that you ensure your voice is heard in this.