Ambulance TXA equipment review

The Department of Health and Social Care, the Faculty of Pre-Hospital Care, the College of Paramedics and the National Ambulance Resilience Unit should undertake a review into whether frontline ambulances should carry intramuscular tranexamic acid or TXA.

The Department of Health and Social Care and the National Ambulance Resilience Unit should review whether stretchers should be carried on National Capability Mass Casualty Equipment Vehicles.

If the decision is that the regulatory regime should be altered in this way, the National Ambulance Resilience Unit should consider urgently whether the use of such analgesia should be rolled out to all Hazardous Area Response Team and other specialist operatives, as part of their basic equipment, and to paramedics more generally.

Mrs C complained that the Scottish Ambulance Service (the service) did not have the appropriate equipment or vehicle to take her late husband (Mr C) to hospital for a scan. Mr C was terminally ill with cancer and had widespread pain which severely restricted his mobility. Mrs C was also dissatisfied that the service did not apologise or...

The ambulance triage process for suspected ingestion incidents does not allow sufficient time for critical interventions. Additionally, there is no regional or national protocol for ambulance services to carry and administer specific antidote medication on-scene.

The Department of Health and Social Care should undertake a review, with input from other bodies as the Department considers appropriate, in order to identify the type of stretcher that is of the greatest utility in the event of a mass casualty incident. The product of that research should be rolled out to all of those with responsibility...

The Department of Health and Social Care and the Medicines and Healthcare products Regulatory Agency (MHRA) should consider urgently whether the regulatory regime should be altered to enable analgesia, such as fentanyl lozenges or sufentanil sublingual tablets, to be given by paramedics to injured persons.

The Department of Health and Social Care should take steps to ensure that Public Access Trauma kits contain the equipment that is necessary to enable first responder interventions to be undertaken.

The NHS Pathways system for overdose calls does not adequately differentiate between types or severity of ingestion, which impacts response urgency. Additionally, ambulances lack a specific antidote, Methylene Blue, delaying crucial treatment often beyond the point of effectiveness.

The Department of Health and Social Care and the National Ambulance Resilience Unit should consider whether the Basic Life Support and Advanced Life Support bags used by paramedics should contain SMART Triage Tags or an equivalent.

The coroner raised concerns regarding the sufficiency of ambulance resources in Gloucestershire, the clarity for clinicians, patients, and paramedics on appropriate hospital allocation, and the expedition of urgent emergency transfers between hospitals.

The Department of Health and Social Care, the Faculty of Pre-Hospital Care, the College of Paramedics and the National Ambulance Resilience Unit should consider whether all Hazardous Area Response Team operatives should be deployed with freeze-dried plasma and trained in its use.

The College of Policing and Counter Terrorism Policing Headquarters should review whether firearms officers should be deployed with analgesia and trained in its use, as part of providing Care Under Fire.

Difficulties locating the appropriate tab for cardiac arrest on the JRCALC app, paramedics' inability to follow guidelines due to competing tasks, and insufficient Naloxone vials on ambulances were identified.