THE Welsh Ambulance Service has introduced a new telephone consultation tool to help clinicians arrange the most appropriate care for 999 callers.
The service says the Emergency Communication Nurse System (ECNS) software supports control room clinicians to determine the best course of action for patients who call 999 through its evidenced based approach.
Welsh Ambulance Service say ECNS is part of a comprehensive re-organisation of its control centres to help meet the increasing patient demand, changing healthcare environment and resource availability.
The system replaces a paper-based triage product and introduces digital features enabling clinicians to share patient information to their GP or another healthcare provider, making the process slicker.
But most importantly they say, the system is an evolving product.
The team behind the implementation are pressing on to introduce even greater functionalities to support both patient and clinician, with video functionality being an exciting future addition.
Dr Mike Brady (Consultant Paramedic) says: “Demand on our ambulance service is increasing year-on-year, so this is about thinking smarter about what we can do with the resources we have to keep up with the fast-changing picture.
“The mix of combining people, process, and technology were the game changers, as well as the benefits of improved resource allocation.
“It means that patients are getting the right care, in the right place at the right time, and it also means we can protect our precious resources for those who need us most.
“We also try not to overwhelm the wider health economy if we can clinically care for patients at source and provide them the most appropriate care remotely and closer to home.”
(Lead image: Welsh Ambulance Service)
Calls to use ambulance services wisely this Jubilee Bank Holiday weekend
The Welsh Ambulance Service is urging the public to use its services wisely over the four-day Bank Holiday weekend.
The Trust is also reminding people to collect any medication they require and stock up on first aid supplies to treat minor injuries at home as it prepares for a busy weekend.
The NHS 111 Wales symptom checkers should be the first port of call for health advice, the service say.
Jubilee party-goers should also drink responsibly and treat emergency workers with respect.
Judith Bryce, Assistant Director of Operations (National Operations and Support), said: “We’re delighted to be celebrating Her Majesty the Queen’s Platinum Jubilee, and want people to have a safe and enjoyable celebration.
“We always see an uplift in demand as people take advantage of the long weekend, and this weekend is expected to be no different.
“More people are out and about socialising with family and friends, and this can lead to more people becoming ill or suffering injuries and requiring medical attention.
“While there are plans in place to deal with the increase in demand, we only have a limited number of crews and vehicles available which means that we need to prioritise those sickest patients first.
“It also means that people not facing a serious or life-threatening emergency could wait longer for a response or be asked to seek alternatives to an ambulance response.”
Hundreds of events are happening up and down the country to mark the Queen’s Platinum Jubilee, the 70th anniversary of the accession of Queen Elizabeth II in 1952.
The Trust is gearing up by putting extra resources in place on the road and in control rooms so that it can support as many patients as possible.
“We’re also working with partners on a number of multi-agency initiatives to mitigate demand, including alcohol treatment centres in Cardiff and Swansea to offset the number of people needing to attend the Emergency Department presenting with alcohol intoxication,” said Judith.
“Community First Responders will assist us not only by responding to calls in their local area, but by providing administrative support to colleagues in the Trust’s control rooms.
“We’re working hard behind the scenes to get us into the best place possible, but the public has a role to play too.
“Your GP surgery may be closed and your usual pharmacy may be closed or have altered opening hours, so check with them in plenty of time so you’re aware of any changes.
“Please also ensure you have all the medicines you need before the Bank Holiday, be it everyday medication like paracetamol or cough remedies, or getting your prescription filled.
“If you need advice about medication or prescriptions during any out-of-hours period, a pharmacist should be your first port of call.
“If your usual pharmacy is closed, search for an open pharmacy near you on the NHS 111 Wales website.
“The NHS 111 Wales website should also be the first place you visit for health advice and information if you’re ill or injured and unsure what to do.
“Help us protect our precious resources for those who need us most.”
Ambulance service issue Bank Holiday plea as emergency worker assaults continue to rise
Emergency workers in Wales are reminding the public to treat them with respect in the face of a continued rise in assaults.
The monthly average of emergency worker assaults has increased from 203 in 2019, to 226 in 2020, to 237 in 2021, representing a year-on-year increase of 4.9 per cent.
More than 1,440 assaults were committed in the six-month period 01 July 2021 to 31 December 2021, new figures have revealed.
The top five most common types of assault were kicking, spitting, verbal abuse, punching and shoving.
Among the victims is Joanna Paskell, a paramedic in Barry, Vale of Glamorgan, who was assaulted last May by a patient at Cardiff’s University Hospital of Wales.
Joanna, an ambulance worker of 25 years, was subsequently left with panic attacks.
The mother-of-four recalls: “It was while we were trying to move the patient from the trolley to a bed that she lashed out and punched me straight in the chest.
“I was stunned as it was completely out of the blue, and there had been no indication that she was going to get aggressive.
“Although shaken, I thought nothing of it at the time, just taking painkillers for the pain.
“It was only as I was getting ready for my next shift that realisation dawned, and I actually had a panic attack.
“I subsequently had to take time off work.
“It took a lot for me to come back, and even now, I’m very cautious around patients.”
Meanwhile, Andy Davies, a paramedic in Llangefni, Anglesey, was left with a dislocated shoulder when he was assaulted by a patient last June.
Andy recalls: “The patient was becoming verbally aggressive to the point where we actually called for police back-up.
“As I tried to assess him, he threw me to the floor, partially dislocating my left shoulder.
“I had to have six weeks of physiotherapy afterwards to help me recover from the injury.
“I’m ex-military police so I’m quite good at compartmentalising these things, but it doesn’t mean to say we should accept it.”
Ahead of the extended Bank Holiday weekend, when assaults will typically spike, emergency workers are appealing to the public to treat them with respect.
Jason Killens, Chief Executive of the Welsh Ambulance Service, said: “The last couple of years have been a fraught time for all of us, but that’s no excuse to assault an emergency worker, who are people, just like you and I.
“With a Bank Holiday weekend comes lots of people enjoying the revelry, and with alcohol consumption usually comes an increase in assaults.
“There were 80 verbal attacks alone on our ambulance control room staff in the second half of last year.
“We know it’s distressing when you’re waiting for help, but abusing our call handlers is not the answer – if anything, it could potentially delay help.
“On the road meanwhile, crews might have no choice but to leave a scene if their safety is compromised, and that’s not helpful for anyone, especially the patient.
“The debt of gratitude we owe to our emergency workers has never been greater, so please treat them with respect.”
In the six-month reporting period, almost half of emergency worker assaults took place in South East Wales; Cardiff, Rhondda Cynon Taf and Bridgend were the most prolific local authority areas.
For 2021 as a whole, Denbighshire in North Wales had the highest rate of emergency worker assaults at 1.24 per 1,000 population.
Offenders aged 26-35 account for the highest portion of offending (21.9 per cent), and alcohol intoxication continues to apply to a third of incidents.
Twenty three incidents involved the use or threat of use of a weapon, eight of which caused injury to the victim.
Assaults on police account for more than two thirds of the total number; there were an average 165 victims each month in 2021, up from 152 in 2020.
Pam Kelly, Chief Constable at Gwent Police, said: “Every day, our officers are working to protect and serve local residents and businesses.
“Being a victim of hate crime or being assaulted on duty is not acceptable for members of our own community as they go about their job.
“We already ask a lot of our officers and staff in the course of their working day as they often deal with situations most of us hope never to encounter.
“Working where the threat of verbal or physical assault is an increasing possibility makes the role even more challenging.
“We work hard to support any officer who has faced this situation and we will take firm action against those individuals who cause them harm.”
Carl Foulkes, Chief Constable at North Wales Police, added: “Every single day our officers, staff and volunteers are often dealing with very difficult and challenging situations, putting themselves in harm’s way to uphold the law and protect the public.
“They must be able to carry out their duties as safely as possible.
“Being assaulted is not and should never be regarded as ‘part of the job’.
“Assault is a traumatic offence that causes great distress to anyone, and it is no different when the victim is an emergency worker.
“It is wholly unacceptable for them to be threatened, attacked, verbally abused or spat at – and those responsible should face the full force of the law.
“Assaults stay with the victims for the rest of their careers, and none of my officers and staff should have to go to work serving the public and be afraid of being assaulted.
“With the busy summer season almost upon us, please respect and protect our emergency workers.”
May 2021 saw the highest volume of emergency worker assaults with 294, rising as Covid-19 restrictions were eased across Wales.
More than 100 instances are known to be Covid-19-related, for example, where an assault occurred during police attendance for a breach of regulations.
Under the Assault on Emergency Workers (Offences) Act, the definition of an emergency worker includes police, fire and ambulance staff, as well as prison staff and NHS workers.
Judith Paget, Chief Executive of NHS Wales, said: “Emergency workers provide life-saving and life-changing care every day in often difficult circumstances and deserve to be treated with respect.
“Any form of attack on emergency workers is completely unacceptable and can have a significant impact on someone’s mental health and wellbeing.
“During the pandemic emergency workers worked tirelessly on the frontline to keep Wales safe and now they deserve to feel safe and appreciated for the great work they do.
“We must all work together to reduce their risk of being exposed to violence.”
(Lead image: Wales Ambulance Service)
Premature baby doing well thanks to emergency crews and hospital staff
A young Swansea couple whose son was born prematurely at around 30 weeks have been reunited with some of the emergency crews who helped safeguard the child and swiftly get them the care they needed.
Since the birth of their son Hunter in November, Jenna Cullen and partner Jack Harris, both 28, experienced several traumatic months with Hunter spending time in a specialist neonatal care unit at Singleton Hospital, Swansea.
At birth, Hunter weighed just 700g, but now safely back home together in Swansea and with Hunter weighing a fantastic 9lbs, the proud parents have reached out to tell their story and highlight the work of the Welsh Ambulance Service and the Emergency Medical Retrieval and Transfer team who attended them.
Jenna, who works for the DVLA, said: “Everything was fairly normal until around 20 weeks when I lost a lot of water, and after a scan they put me on weekly monitoring.
“At my 25+3 week scan, I was told the water had increased and that things were fairly normal.
“A week after that, I started suffering back pains but put this down to Hunter lying on my back.
“It eased by the following day but came back with a vengeance the next night, so we popped to the hospital who said I was not in labour and I may have slept awkwardly and we went back home.
“Six hours later, Hunter was born.”
Due to the early arrival, Hunter had not yet turned as most full-term babies would so was born feet-first which can carry extra dangers.
Jenna said: “I didn’t know what contractions felt like but I was in a lot of pain and by the time Jack had phoned 999 Hunter was almost here.
“I wrapped him in a towel and cleared his airways and got a little cry.
“I just kept him wrapped up warm and checked on him but he was quiet.
“I thought he was dead.”
It was then that Senior Paramedic for the Welsh Ambulance Service, Dai Bowen from nearby Cwmbwrla Ambulance Station, arrived and began emergency care on Hunter.
“Dai was amazing,” said Jenna.
“He came in and straight away began giving oxygen and he cut the cord for us also.
“I helped with the oxygen as Dai placed equipment upon hunter to monitor him.
“Without Dai and the other crew members, I don’t think my son would be here now.
“They definitely saved his life.”
Dai, 46, also from Swansea, had only minutes earlier begun his shift.
He said: “I’d booked on at six and checked my vehicle when I got my first job or ‘detail’ as we call it around 20 past down in Port Tennant.
“Control told me a young mother had given birth to a very premature baby.
“I was on my own in the rapid response vehicle so requested support and back-up as I knew we’d need an ambulance to get the baby to hospital.”
The control room were able to release an ambulance from nearby Merthyr to assist Dai due to the dangerous nature of such a young child being born.
Dai said: “I was greeted at the door by dad who was obviously very distressed, but with my 20 years in the ambulance service I was able to talk to him quickly and calmly and get him to show me to his partner.
“Jenna was so calm, bless her, and already had the baby in her arms – I thought the baby may have been stillborn.
“I quickly checked she was alright and then began to look at the little man.
“He was so premature and was very susceptible to losing heat and picking up infections.
“But then, I saw his little chest move and he took a breath on his own.
“That was it, action stations.”
Dai took the baby and made a resuscitation area in the couple’s lounge where he began working on Hunter and connecting him up to the monitoring equipment.
He said: “Hunter was making minimal effort, but we are lucky as we have great paediatric equipment and on this job it all worked really well.
“He was still very cold despite the warming mattresses we had on him and I just continued to keep him warm and monitor his levels.”
A Welsh Ambulance crew of Robert Shannon and David Griffiths soon arrived to support Dai.
The Wales Air Ambulance charity’s road division known as the Emergency Medical Retrieval and Transfer Service (EMRTS), also attended the scene from their base at Dafen to help deliver the critical care and advice that was so valuable to Hunter, providing things such as heat pads to keep his body temperature up during transfer to hospital.
On duty for EMRTS that day were Dr Jon Baily, Critical Care Practitioner Dewi Thomas and Helicopter Transfer Practitioner Jez James.
Jo Yeoman, Wales Air Ambulance Patient Liaison Nurse, said: “Our crew arrived with specialist neonatal equipment and made a rapid assessment while keeping baby Hunter warm.
“Premature babies are at high risk of a declining body temperature so they placed him in a special wrapping specifically designed to keep premature babies warm, covered him with a heated blanket and put a hat on his head to prevent heat-loss.
“They then attached him to some neonatal monitoring to assess his vital signs and contacted the Specialist Neonatologist at Singleton Hospital to arrange for direct admission to the specialist unit rather than going through Accident and Emergency.
“We are delighted that Hunter is doing so well.”
Call handler Emma Beynon picked up Jack’s 999 call at the Clinical Contact Centre in Carmarthen.
She said: “I’d been working a night shift and it was the last call before I was due to finish.
“It was quite traumatic as the baby was so premature.
“At the start of the call I thought it wasn’t going to be very good news.”
Emma, 36, from Narbeth and herself a mum of three girls, said: “I was supported by my manager Emma Colvin as it was only my second birth call – the first had come earlier that week.
“We were giving birthing advice and I remember the caller shouting that the baby was out and it was only the size of his hand.
“We didn’t think the baby was going to be born so soon but it happened really quickly on the call.
“But most importantly the baby was breathing.
“The crew got there very quickly which was the saviour I think.
“It’s remained a call that has stuck in my mind and I’m so happy to find out that baby Hunter is doing really well along with mum.”
The couple were able to spend a lot of time together at the hospital with Hunter thanks to a change in visiting restrictions.
Of the care Hunter received at Singleton’s intensive care unit and their special care nursery, Jenna said: “They were absolutely brilliant and nothing was too much.
“The staff and the consultant there were all so good.
“We’re lucky to have such good facilities here.”
(Lead image: Wales Ambulance Service Trust)
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