An AED or automated external defibrillator is a medical device designed and recommended for use by almost anyone without any previous training, although familiarisation does help.

Its function is to deliver a powerful electric shock to the heart of somebody who has collapsed. It is the only treatment for somebody in this condition and speed is of the essence. No doubt you’ve seen a similar defibrillator being used many times on television programmes. It can save a life.

To date, the British government and others have purchased and installed around 10000 or more AED’s across the country with the aim of getting a defibrillator to a victim within 3 minutes. Around 60,000 people a year die from sudden cardiac death, often with no previous history and no warning. You will find them already installed in airports, railway stations, police cars, homes, shops and pubs factories and offices.

I started to sell defibrillators exactly 30 years almost to the day, in those days customers were sceptical of the technology and the prices were around £2700

Ambulance staff body-cams ‘to tackle paramedic attacks’

Paramedics could start wearing body cameras in the south east of England as part of efforts to tackle a 46% rise in assaults on them.
South East Coast Ambulance Service (Secamb) trust data showed attacks rose yearly from 98 in 2011-12 to 184 in 2015-16, including a jump from 126 in 2014-15 to 184 last year.
Secamb said several ambulance services were looking at using “body-cams”.
Unison has called for a government-led task force to tackle the problem.
Secamb security manager Adam Graham said current measures included CCTV, risk assessments and conflict resolution training.
He added: “One thing that’s being looked at nationally is additional devices and additional training – so for the devices, body-cams, such as the police have, [are] being considered.”
The ambulance service, which released its figures under a Freedom of Information Act request, can also take sanctions ranging from warnings to prosecutions over violence and aggression, he said.
In 2015-16, Secamb submitted 44 sanctions.

Paramedic Gemma Fitzgerald was assaulted while trying to help a lady who was collapsed in the street.
“When we got there, she was lying in the road and we knew that she was quite agitated, screaming and shouting at passers-by,” said Ms Fitzgerald.
“She became really verbally abusive, so we backed off and made sure the road was safe with the ambulance and called police.
“But whilst we were waiting for them, she actually started to attack a friend. She also started to hurt herself.
“As we stepped in, she sort of caught my eye, and that was it. I became the target of her aggression.
“[She was] very verbally abusive, lashing out, and actually managed to – I was kneeling down next to her – kick up and kick me in the face, knocking me off my feet.
“The police arrived and pretty much arrested her straight away. I went to hospital and found I had a broken jaw.”

When several services met last year for a presentation by Kent Police on body-cams, one of the features was the quality of evidence, Mr Graham added.
West Midlands Ambulance Service is also looking at body-cams – a spokesman said the trust was looking at costs but “nowhere near piloting it”.

But Bea Adi, from Unison, said: “It’s not just about things like CCTV, it’s about educating people to let them know the impact that these incidents have on people who are working to protect them.

“Unison itself is calling for the government to set up a special task force that looks at ways of keeping people safer in their roles.”
NHS Protect said it undertook research into assaults in the ambulance sector, including aggravating factors such as likelihood of injury, times incidents were most prevalent and the demographics of the perpetrator.

It said it was working to provide guidance for the future and the protection of NHS staff.
In a sample of 2,479 incidents between 2010 to 2015, NHS Protect found 1,184 had one or more aggravating factors and of those 22.1% were attributed to illegal drugs and 72.2% to alcohol.

Yorkshire Ambulance Service will be part of a new Northern Ambulance Alliance

Yorkshire Ambulance Service is to team up with two other trusts to form a new Northern Ambulance Alliance.
North East, North West and Yorkshire Ambulance Service Trusts say the collaboration will help to improve the efficiency of ambulance services in the North of England.
Joint procurement exercises and major changes to IT systems will take place, and specialist expertise will be shared across the region.
The trusts emphasised that the alliance is not a ‘merger’ of the organisations, but “the creation of a body that will facilitate greater collaboration and realise benefits individual Trusts are unlikely to be able to achieve on their own.”
Rod Barnes, Chief Executive of Yorkshire Ambulance Service described it as a ‘great opportunity’ that will be ‘for the benefit of patients.’
“This is a great opportunity to explore how we can deliver the improvements expected from the ambulance service within existing resources and for the benefit of patients.
This might mean the procurement of a single agreed vehicle specification for all three services, identifying savings through the standardisation of maintenance and equipment contracts, which is something that has proved elusive at a national level.”

Dr Glyn Phillips and Professor John Ashton were both at the FA Cup semi-final as Liverpool FC fans

Professor John Ashton and Dr Glyn Phillips who both gave evidence at the Hillsborough inquests
When Lord Justice Taylor published his interim report on the Hillsborough disaster in 1989 he exonerated the emergency services.

He dismissed the opinions of two Merseyside doctors who had been at the match as fans – the only two Taylor inquiry witnesses to criticise the South Yorkshire Metropolitan Ambulance Service (SYMAS) response on the day.

More than 25 years later those two doctors – Dr Glyn Phillips and Professor John Ashton – gave evidence to the new inquests into the 96 deaths, where the ambulance service admitted delays in their actions on the day.

The inquests found that SYMAS made errors which “caused or contributed” to the loss of lives in the disaster, after the crush in the had begun to develop.

They concluded: “SYMAS officers at the scene failed to ascertain the nature of the problem at Leppings Lane. The failure to recognise and call a Major Incident led to delays in responses to the emergency.”

Yesterday’s findings led to the current head of Yorkshire ambulance service , Rod Barnes, issuing an apology and admitting that lives could have been saved at Hillsborough if its response had been different.

Criminal charges could now follow
The ECHO spoke to both Dr Phillips and Professor Ashton bout how it felt to hear their evidence validated more than two decades on.

DR GLYN PHILLIPS

Dr Glyn Phillips, a GP originally from Huyton but living in Scotland at the time, was in pen three of the Leppings Lane terrace with his younger brother and two friends for the FA Cup semi-final on April 15, 1989.

After managing to climb into a side pen, he jumped up through a gate onto the pitch, cutting his head in the process.

Once on the field, Dr Phillips successfully resuscitated 18-year-old fan Gary Currie – who was believed to be in cardiac arrest but went on to survive.

Dr Phillips, who is still in touch with Gary and his family today, said: “Gary was incredibly lucky to be found on the pitch very quickly by somebody who knew CPR and somebody who knew you had to keep it going for a decent length of time.

“In that sense he was he was so fortunate and I just feel saddened that many more of the the other victims weren’t as fortunate, in terms of the time it took to get out of the crush.”

He added: “My experience with Gary has provided perhaps the exemplar of what could have happened if some of the others had been treated like that.

“Importantly, it totally undermined and disproved the 3.15pm cut off time used in the original inquests.

“If that’s my contribution to the families’ case then I’m glad I have been able to make it.”

In the months after the disaster, he gave evidence to the Taylor inquiry but said barrister Michael Kallipetis, representing South Yorkshire Ambulance Service, attempted to discredit him.

He said: “I was just disgusted by the whole process.

“I thought we were there to find out what happened to the poor, innocent people who died.”

Dr Phillips told the Taylor Inquiry an oxygen cylinder he was handed was empty, but in Lord Justice Taylor’s interim report the judge said St John Ambulance divisional superintendent Peter Wells had described taking the oxygen cylinder to Mr Phillips and said it was full and working.

But the new inquests were shown footage of Dr Phillips being handed the cylinder by a police officer, not Mr Wells.

Lord Justice Taylor wrote: “In my view, Dr Phillips may have been mistaken as to the cylinder of which he complains being empty.

“He agreed he was under great pressure, in an awkward situation; his head was injured and he became very angry at what he regarded then as wholly the fault of the police.”

Lord Justice Taylor also disagreed with Dr Phillips’ view that there should have been defibrillators at the ground.

Dr Phillips said: “I felt let down by the process and reading Lord Justice Taylor’s report but by then we had had all these allegations about fans and what did we expect?”

The retired GP said he felt a “joyless vindication” following the evidence which came out at the inquests.

He said: “I was not only at the match but I was in pen three with my friends and my brother so I knew how bad it was – we didn’t imagine it was that bad, it was that bad.”

He said he had expected to be called to the original inquests, which started in 1990.

He said: “I expected to be called because I think it was the proper thing to happen and I also expected John Ashton to be called.

“Paradoxically, I had the feeling neither of us would be called.

“Clearly we were persona non grata with regard to the various authorities in Sheffield.

“I discovered relatively recently that the coroner was specifically asked by Doreen and Les Jones, who wrote to him asking whether we could appear.

“He replied and had clearly made his decision not to call us.

“I think that was a serious error of judgment on his part.

“It was frustrating but nowhere near as upsetting and frustrating as it must have been for the families.”

He added: “I cannot fathom why he didn’t call us, other than he specifically did not want to hear our evidence, in which case the first inquests were coloured and flawed before they even started.”

PROFESSOR JOHN ASHTON

Professor John Ashton, now President of the Faculty of Public Health, was a lecturer in public health in 1989, as well as a Liverpool fan.

He was sitting in the West Stand, above the terraces where the fatal crush happened, with his two sons and nephew and went to the inner concourse after a call for doctors in the stadium,

Prof Ashton, who worked to establish a triage system in the area behind the stand, gave a number of radio and television interviews after the disaster in which he criticised the emergency response.

He went on to give evidence to the Taylor Inquiry, but said his experience there made him apprehensive about appearing at the inquests in Birchwood Park, Warrington.

He said: “At the Taylor Inquiry I was given no briefing, no coaching, no mentoring and I didn’t know what to expect.

“I felt like I went into the lion’s den.”

He added: “I naively walked in thinking that I knew what I saw and what I did and I would turn up and tell them the story, but they tried to rubbish it.”

He said he was also criticised for his media interviews.

He said: “They tried to make out I was a publicity seeker and it was all about ego.

“I was doing what I felt was my responsibility – to tell the truth.”

In his interim report Lord Justice Taylor said: “The only attack on SYMAS came from two Liverpool doctors.

“One claimed that ambulances did not arrive swiftly or with sufficient equipment and that there was a lack of triage. He was proved to be wrong in all three respects.

“Unfortunately he had seen fit to go on television on 15 April when he said more lives could have been saved if staff and equipment had arrived earlier.”

Prof Ashton said: “I had to live with that for 23 years, the idea that I’m not reliable, that I’m making things up and I’m an attention seeker.

“That was the draft of the report and in a sense it blemished my character as a doctor.”

He added: “People ask me if it affected my career and I have thought about that quite a lot.

“I’ve had a good career and a very satisfying career but I was never considered for the job of chief medical officer of England – I wasn’t even longlisted for it.

“I think my card was marked nationally in that sense because I was regarded as a loose cannon and unreliable.”

After the Taylor Inquiry, Prof Ashton had expected to be called to appear at the original inquests.

He said: “I was surprised that I wasn’t called but by that time I was very bruised by my experience at the Taylor Inquiry.

“I can’t remember now the circumstances when I found out I wouldn’t be called to the inquests but it was because of the perverse decision not to take evidence after 3.15pm.”

After that, he said, said he rarely spoke about the disaster.

He said: “Everyone deals with this kind of thing themselves and personally, once the immediate aftermath was over – it took over my life for three or four weeks – after that I didn’t really talk about it.”

He added: “It has been very emotional to go through it all again and I hope that, for so many people involved with this, the end of the inquests can allow them to begin to get on with their lives.”

He added: “In any large scale disaster you make sense of it through the story of one person and for me that person was Philip Hammond.

“He was 14 and he was the same age as my son, Nick.

“They went to school together and were in the same football team.

“To see my own son at the stage in his life he is now does make me think about Philip.”

Following the panel report and the new inquests, Prof Ashton said he felt vindicated.

He said: “But I’ve always said that this is not about me, it has always been about the families.

“It’s a question of how the families can get some comfort and the beginnings of peace of mind.”

Troubled East Midlands Ambulance Service (EMAS) is struggling financially and has some of the worst response times in England.
It is thought the trust’s non-executive directors want to merge with West Midlands Ambulance Service.
Both trusts said discussions on a “range of options” had taken place but talks were at an early stage.
If the merger goes ahead, the new service would cover a population of 10.4m people and cover 11,500 sq miles.

EMAS recently applied for a loan after ending the year £12m in debt, and chief executive Sue Noyes stood down last month. Its response times to the highest-priority emergency calls in 2014-15 were well below national targets.
It is understood EMAS first approached the West Midlands trust – which had some of the best response times in the country – for help around six weeks ago.
The BBC understands that although the non-executive directors at EMAS believe a merger is the right option, there is resistance from the trust’s other management.
In a letter to staff, chairwoman Pauline Tagg said she had been talking to WMAS about the potential for chief executive Dr Anthony Marsh, to provide support.
“This option, and others, is still being explored and discussions have not yet come to a conclusion,” she said.
It is understood Mr Marsh, who previously took on a part-time role as head of the East of England Ambulance Service, was interviewed by EMAS.
However, sources told the BBC Dr Marsh, who was heavily criticised over his salary in the dual roles, was concerned he would face similar attacks if he stepped in to oversee the East Midlands Trust.
In a statement, West Midlands Ambulance Service confirmed it had been approached “to explore how we might assist” and “a range of options” had been discussed but nothing yet agreed.

Dr Anthony Marsh is the chief executive of West Midlands Ambulance Service
Dr Iestyn Williams, senior lecturer in health policy and management at the Health Services Management Centre in Birmingham, said that large mergers are complex and often do not provide the anticipated benefits.
“It can cost millions of pounds and run into years.
“The productivity and efficiency can be affected and it can be years before the benefits materialise.”
How the services compare:
West Midlands Ambulance Service
Serves population of 5.6m
Area: More than 5,000 sq miles covering Shropshire, Herefordshire, Worcestershire, Staffordshire, Warwickshire, Coventry, Birmingham and Black Country
Number of calls a day: 3,000
Number of staff: 4,000
East Midlands Ambulance Service
Serves population of: 4.8m
Area: 6,425 square miles covering Derbyshire, Leicestershire and Rutland, Lincolnshire, Northamptonshire and Nottinghamshire
Number of calls a day: 2,000
Number of staff: 2,700

The chairman of the scandal-hit South East Coast Ambulance Service (Secamb) Tony Thorne has resigned,
Last October it emerged the trust had delayed sending help for certain calls to allow extra time for patient assessments.
The reasons for Mr Thorne’s resignation are not known.
It is also understood chief executive Paul Sutton will take a leave of absence from the trust.
Mr Thorne’s resignation from Secamb, which has been under pressure for months, follows a crisis meeting of bosses at the trust.

Image caption
Secamb gave itself an extra 10 minutes to deal with some potentially life-threatening calls
Last October it emerged Secamb, which covers Kent, Surrey, Sussex and North East Hampshire, delayed sending help for certain 111 calls, transferring them instead to the 999 system as part of a pilot project.
It did this to re-assess what type of advice or treatment patients needed and whether an ambulance was really required.
The trust defended the project but acknowledged the “serious findings” of a report into the practice.
At the time, health regulator Monitor said the trust had not fully considered patient safety. It said the project was “poorly handled” and there were “reasonable grounds to suspect that the trust is in breach of its licence.”
It added a condition to Secamb’s licence so that if insufficient progress was made the leadership team could be changed.
How call handling was changed
Secamb provides NHS 111 services across the region and responds to 999 calls.
Some 111 calls were transferred to the 999 system to give Secamb more time for more urgent calls.
The calls affected were in the second most serious category – Category A Red 2 – which covers conditions like strokes or fits but which are less critical than where people are non responsive.
Under NHS rules, calls designated as life-threatening are supposed to receive an ambulance response within eight minutes.
The trust allowed itself an extra 10 minutes to deal with some calls by “re-triaging” patients in the 999 system.

ISLANDERS on Mull have claimed an ‘accident is waiting to happen’ after claiming a review has left them with a lack of ambulance cover.

A heated meeting between community representatives and the Scottish Ambulance Service is to take place tonight after the area and Iona was left with one ambulance.

Campaigners claim that one emergency vehicle is inadequate to cover the 240 mile of mainly single track roads on the islands which attract about 250,000 visitors a year.

The Scottish Ambulance Service has caused consternation by claiming there is no need for it to provide a second vehicle.

Billy McClymont, Chairman of Mull Community Council, and fellow islanders Fiona Brown and Colin Morgan, said: “As the community representatives through this whole process we are completely disillusioned and feel that the communities of Mull and Iona have been completely let down.”

Argyll MSP Michael Russell said: “Like the community I completely reject the proposal now coming from the SAS. “I am also very concerned that after eighteen months those who run the service are still trying to impose a solution to suit their organisation but which local experience shows is the wrong one and moreover one that was not chosen by the options process which took place last year.

“I have gone back to the Cabinet Secretary to tell her that SAS is still attempting to ride roughshod over the community and that must stop and I am now also tabling a motion in the Scottish Parliament to make that point.” Mr Russell said he believed these meetings confirmed the ‘unelected boards’ of the SAS and NHS Highland were “out of touch” with the strength of feeling in the community.

Local residents had not asked for a second ambulance but had favoured a review option for a paramedic and fast response vehicle to be brought in as a back-up.

However, the ambulance service favours an option which wouldn’t cost it anything, using an NHS Highland doctor, based at Craignure, as its 999 call back-up.

Mull Community Councillor Fiona Brown said: “It’s an accident waiting to happen, a high risk strategy, will it take someone to die before things change?”

“How can the NHS 24 doctor leave on a 999 call if there is an ambulance coming in with another 999 call?

“Ninety per cent of our roads are single track and the locum doctors don’t know the roads.

“They say there has only been one incident in the last three years when two 999 calls have come in at the same time but we know there have been other instances when another ambulance was needed.”

She said that recently an elderly man was told the ambulance was too busy dealing with an incident elsewhere after he struck his head.

A SAS spokesman said it was committed to meeting community needs and added: “A thorough and robust options appraisal was undertaken by the Mull and Iona Health Care Review Group and we have engaged extensively with the community throughout that process.

“Along with other NHS colleagues from the Health Care Review Group, we are meeting with communities in Mull on March 7 to continue to engage and explain proposals, which are based on detailed analysis of demand patterns, volumes and the potential impact of skills atrophy.

“Recent work has resulted in an upgrade to paramedic cover, the establishment of Community First Responder Groups and provision for two 24/7 landing sites for air ambulance helicopters, which support local ambulance teams whenever required.”

AMBULANCES in Wiltshire are failing to reach a third of critically ill emergency patients on time.

Figures from South West Ambulance Service Trust (SWAST) show response times in Wiltshire are among the worst in the region.

Of the 12 areas covered by SWAST, only South Gloucestershire was worse at reaching Red 1 calls, such as heart attacks, within eight minutes.

In 2014/15, ambulances in Wiltshire only reached two thirds (66 per cent) of such cases within this target.

Although this was up from just 59 per cent the year before, it was still “very disappointing” according to the trust’s own assessment. It aims to reach three quarters of patients within the eight minutes.

The average for the region was much higher, at just under 75 per cent.

Meanwhile, Dorset ambulances hit their Red 1 targets 84 per cent of the time.

For Red 2 calls, like strokes, Wiltshire was the worst performing area in the region for the second year running, reaching only 62 per cent within eight minutes. The average for the region was 71 per cent.

And for Red 19 calls (when patients need a fully equipped ambulance rather than an ambulance car) Wiltshire was again the worst performing area in the SWAST region, and the only one below 90 per cent.
In these cases, ambulances must arrive at 95 per cent of cases within 19 minutes.

Paul Birkett-Wendes, head of operations for SWAST’s northern zone (covering Wiltshire, Gloucestershire and Bristol) said the eight-minute targets were far more challenging in rural areas than in urban ones.

And he said response times were just one aspect of the service SWAST delivered, with a huge focus on “clinical outcomes” and the way paramedics treat people at the scene.

Mr Birkett-Wendes said SWAST was the best in the country at treating people at home, less than half its patients are taken to accident and emergency departments.

“It’s much better for patients and much better for the health system,” he said.

“If you are taking everyone to A&E it would cause quite significant problems.”

And he said the targets were strict – “If you are late by one second, you fail. We normally find it’s within about nine minutes or so.”

More demand for ambulances – particularly from the NHS 111 phone line – is “almost outstripping our ability to keep up,” he said.

SWAST has not cut frontline ambulances and has hired more staff, despite a national paramedic shortage.

And it is tackling the response-times problem by increasing the role of community first responders and working more closely with the fire service.

“We are striving to improve on those response times. It is one aspect of what we do, and we are very proud of our clinical record with patients,” said Mr Birkett-Wendes. “It is absolutely one of our prime focus areas.”

Despite these efforts, the response times have worsened in Wiltshire over the past year.