West Midlands Ambulance Service
NHS Trust
Action Taken
AI-generated response summary
• Staff were instructed to remove the WISER App from work mobile devices, with its use restricted to trained Tactical Incident Commanders, National Inter-Agency Liaison Officers, and Hazardous Area Response Team leaders. • Guidance on Individual Chemical Exposure incidents was produced for officers, distinguishing between individual ingestion and chemical spills. • The Trust is reviewing the feasibility of Hazardous Area Response Team paramedics carrying and administering methylene blue and has raised this issue nationally with the National Ambulance Resilience Unit clinical sub-group.
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Dear Mr McGovern
Re: Regulation 28 Report to Prevent Future Deaths - Ashley Walker (Deceased)
Thank you for your email dated 4 February 2020 attaching your Regulation 28 Report.
Please see our response to your concerns below:
Concern 1 It is apparent that a communication error confused the ingestion of sodium nitrate with a spillage of sodium nitrate.
Response Following this incident we have instructed all of our staff to remove the WISER (Wireless Informaton System for Emergency Responders) App from all work mobile phones and tablets. The App will now only be used following training by Tactical Incident Commandars (TICs), the National Inter-Agency Liaison Officer (NILO) and team leaders in our Hazardous Area Response Team (HART). This is to ensure the risk of harm to both our patients and staff is reduced and to mitigate confusion at scene, as crews on scene will only be able to access advice from trained officers.
As a Trust we have also produced further guidance in relation to Individual Chemical Exposure (ICE) incidents which highlight the clinical management differences between individual ingestion and chemical spills for all of our Officers.
Concern 2 Sodium nitrate toxicity is a recognised method of suicide and I heard evidence from a WMAS staff member that there is an effective antidote (methylene blue) but this was not available on the ambulance.
Response We are currently reviewing whether it would be feasible for our Hazardous Area Response Team (HART) paramedics to carry and administer methylene blue along with other medications to clinically manage cases where there has been chemical ingestion of sodium nitrate. The Lead Paramedic for the Trust has raised this nationally with the National Ambulance Resilience Unit (NARU) clinical sub-group, with a view to making this standard practice nationally.
Can I please take this opportunity to pass on my sincere condolences to the family of Mr Walker.
I hope this response provides you with the appropriate level of assurance that as a Trust we have dealt with the concerns highlighted within your report.
If you require any further assistance, please do not hesitate contact me.
Re: Regulation 28 Report to Prevent Future Deaths - Ashley Walker (Deceased)
Thank you for your email dated 4 February 2020 attaching your Regulation 28 Report.
Please see our response to your concerns below:
Concern 1 It is apparent that a communication error confused the ingestion of sodium nitrate with a spillage of sodium nitrate.
Response Following this incident we have instructed all of our staff to remove the WISER (Wireless Informaton System for Emergency Responders) App from all work mobile phones and tablets. The App will now only be used following training by Tactical Incident Commandars (TICs), the National Inter-Agency Liaison Officer (NILO) and team leaders in our Hazardous Area Response Team (HART). This is to ensure the risk of harm to both our patients and staff is reduced and to mitigate confusion at scene, as crews on scene will only be able to access advice from trained officers.
As a Trust we have also produced further guidance in relation to Individual Chemical Exposure (ICE) incidents which highlight the clinical management differences between individual ingestion and chemical spills for all of our Officers.
Concern 2 Sodium nitrate toxicity is a recognised method of suicide and I heard evidence from a WMAS staff member that there is an effective antidote (methylene blue) but this was not available on the ambulance.
Response We are currently reviewing whether it would be feasible for our Hazardous Area Response Team (HART) paramedics to carry and administer methylene blue along with other medications to clinically manage cases where there has been chemical ingestion of sodium nitrate. The Lead Paramedic for the Trust has raised this nationally with the National Ambulance Resilience Unit (NARU) clinical sub-group, with a view to making this standard practice nationally.
Can I please take this opportunity to pass on my sincere condolences to the family of Mr Walker.
I hope this response provides you with the appropriate level of assurance that as a Trust we have dealt with the concerns highlighted within your report.
If you require any further assistance, please do not hesitate contact me.