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Monday, 17 January, 2000, 18:59 GMT
Ambulance services 'falling short'

Paramedic Paramedic care can save lives

Ambulance services are failing to provide the best possible standard of care to patients, a top administrator has admitted.

Barry Johns, vice president of the Ambulances Services Association, tells BBC television's Panorama programme on Monday that not all ambulance services "use best practice at the moment".

Panorama reveals how treatments available for trauma patients vary widely depending on where their accident takes place.

Some ambulance services do not train their paramedics in vital lifesaving techniques or allow them to administer certain drugs that are standard practice in other services.

Each of the UK's 36 ambulance trusts has its own treatment instructions laid down by committees of doctors known as protocols, but a survey carried out by Panorama reveals there are wide discrepancies among the trusts.

In some ambulance trusts life saving drugs and procedures that are standard elsewhere are not being used.

Heart drug

The drug Frusemide can save the life of a patient suffering from heart failure.

Last year Warwickshire paramedics gave Frusemide to 140 patients.

Panorama's survey reveals only five of the 40 ambulance trusts give this drug across the country.

When Derbyshire, Leicestershire and Nottinghamshire merged to form East Midlands Ambulance Service last April, one of them - Nottinghamshire - had been using the drug.

But after the merger, it was not extended to the other areas, while in Nottinghamshire it was actually restricted.

In an interview for Panorama Mike Handy, East Midlands ambulance chief executive says that he can authorise the use of the drug in Derbyshire and Leicestershire although he cannot in Nottinghamshire because that decision is the responsibility of the ambulance trust's medical committee.

When asked what is the logic of this situation he tells Panorama: "I'm sorry. I'm not going any further with that."

Panorama also reveals problems with the standards of paramedic care in the UK.

In one tragic case an ambulance was called out to a woman sprawled out on a street. The paramedic decided she was drunk, gave her a slap to bring her round and sent her home in a police car.

In fact, the woman had been attacked, and two men are awaiting trial for her alleged murder. She died from head injuries a few hours later.

Patrick and Kelly Delaney Patrick and Kelly Delaney were devastated by their mother's death
Her children Kelly and Patrick Delaney are devastated.

"She's gone through that attack, and then the people who've come to save her call her a drunk, slander and negligence - how can we ever live with that?" said Patrick.

A recent study of serious trauma patients treated by paramedics showed that one in ten of those treated might possibly have lived and almost in 20 probably could have done.

The study was carried out by Professor John Nicholl, of Sheffield University, the author of several reports on ambulance care.

The study he carried out assessed whether being treated by paramedics improved patients' chances of surviving serious injury.

He assembled a panel of experts, who looked at 179 cases where paramedics treated people who had died from their injuries.

They tried to assess whether these deaths were avoidable.

They thought 17 of these patients lives possibly could have been saved, and eight of them had probably avoidable deaths.

Mr Johns said: "Trauma cases themselves represent less than 10% of the demand that is placed upon emergency ambulance services.

"The incidences are tragic, they are certainly regrettable but it is important that we learn from them.

"But then to suggest that those few isolated incidents undermine the quality of the training delivered in this country, I think is perhaps an insult to the service."

The standard classroom training for paramedics lasts only six weeks - much less than nurses.

After a short period attached to a hospital, paramedics then go out on the road - on probation - but are required to administer vital treatments which a doctor would only be allowed to give after several years.

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See also:
10 Sep 99 |  Health
Ambulance workers 'traumatised by job'
16 Jan 99 |  Health
Paramedics could solve NHS staff crisis
17 Jan 00 |  Health
Ambulance 'delayed over 1.20 toll'
05 Nov 99 |  Health
Ambulance staff demand body armour

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