Ambulance TXA equipment review
Need for review into whether frontline ambulances should carry specific life-saving medications like intramuscular tranexamic acid (TXA).
Source spread
Where this theme appears
This theme appears across 3 independent accountability sources, so the source mix matters as much as the headline total.
9 inquiry recs
4 PFD reports
1 LGO/SPSO decision
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Source-grouped records are useful for tracing where a concern came from. Large sections show the 50 strongest matches for that source; counts still show the full theme total.
Inquiry recommendations(9)
MAI-118 — Review intramuscular TXA on frontline ambulances
Recommendation: 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.
Gov response: The Home Secretary made a written statement to Parliament on 3 November 2022 following publication of Volume 2, acknowledging the findings on emergency response failures and stating the government would work with emergency services to …
Accepted
MAI-116 — Consider freeze-dried plasma for HART operatives
Recommendation: 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 …
Gov response: The Home Secretary made a written statement to Parliament on 3 November 2022 following publication of Volume 2, acknowledging the findings on emergency response failures and stating the government would work with emergency services to …
Accepted
MAI-114 — Review optimal stretcher types for mass casualties
Recommendation: 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 …
Gov response: The Home Secretary made a written statement to Parliament on 3 November 2022 following publication of Volume 2, acknowledging the findings on emergency response failures and stating the government would work with emergency services to …
Accepted
MAI-113 — Public Access Trauma kits equipment requirements
Recommendation: 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.
Gov response: The Home Secretary made a written statement to Parliament on 3 November 2022 following publication of Volume 2, acknowledging the findings on emergency response failures and stating the government would work with emergency services to …
Accepted
MAI-109 — Review stretchers on Mass Casualty Equipment Vehicles
Recommendation: 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.
Gov response: The Home Secretary made a written statement to Parliament on 3 November 2022 following publication of Volume 2, acknowledging the findings on emergency response failures and stating the government would work with emergency services to …
Accepted
MAI-105 — Consider SMART Triage Tags in paramedic bags
Recommendation: 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.
Gov response: The Home Secretary made a written statement to Parliament on 3 November 2022 following publication of Volume 2, acknowledging the findings on emergency response failures and stating the government would work with emergency services to …
Accepted
MAI-101 — Review analgesia regulatory regime for paramedics
Recommendation: 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 …
Gov response: The Home Secretary made a written statement to Parliament on 3 November 2022 following publication of Volume 2, acknowledging the findings on emergency response failures and stating the government would work with emergency services to …
Accepted
MAI-91 — Review analgesia deployment for firearms officers
Recommendation: 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.
Gov response: The Security Industry Authority (SIA) published a formal statement on 17 June 2021 in response to Volume 1 of the Manchester Arena Inquiry. The SIA committed to collaborating with the private security industry, law enforcement, …
Accepted
MAI-49 — Review analgesia rollout to HART operatives
Recommendation: 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 …
Gov response: The Security Industry Authority (SIA) published a formal statement on 17 June 2021 in response to Volume 1 of the Manchester Arena Inquiry. The SIA committed to collaborating with the private security industry, law enforcement, …
Accepted
Prevention of Future Deaths reports(4)
Susan Smalley
Concerns: Concerns include insufficient ambulance resources, unclear guidance on hospital destinations for patients, and inadequate processes for expediting urgent inter-hospital transfers.
Overdue
Fern Foster
Concerns: Ambulance triage for suspected poisoning is too slow for timely intervention, and paramedics do not carry crucial antidotes for on-scene administration, potentially preventing deaths.
Response (NARU): NARU will review evidence from a West Midlands Ambulance Service trial and a proposed Yorkshire Ambulance Service project at the forthcoming NARU Clinical Subgroup in September, with the aim of …
Response (NHS England): NHS England describes the role of the Emergency Call Prioritisation Advisory Group (ECPAG) in managing ambulance service prioritisation, referencing the NHS Pathways product and its alignment with clinical standards. They …
Response (AACE): AACE and NASMeD will await the outcome of the NARU clinical subgroup meeting regarding toxicological incidents and the potential role of methylene blue and look to support and improve clinical …
Overdue
Joel Colk
Concerns: NHS Pathways' overdose categorization system fails to differentiate severity, leading to delayed responses. Ambulances also lack the necessary antidote for certain ingestions, causing critical treatment delays.
Response (NHS England): NHS England explains that the NHS Pathways system is a triage tool, and adjustments would be made if national guidance changes. They note that carrying specific medications like Methylene Blue …
Response (SECAmb): SECAmb expresses condolences and explains their protocols, but disputes the need for changes regarding overdose categorization and the provision of specific medications like methylene blue, citing clinical feasibility and national …
Responded
Wayne Austin
Concerns: Difficulties locating the appropriate cardiac arrest guidance on the JRCALC app, the inability of paramedics to comply with respiratory arrest guidelines, and insufficient Naloxone supplies in ambulances were identified as concerns.
Response (West Midlands Ambulance Service): West Midlands Ambulance Service disputes the practicality and clinical effectiveness of the JRCALC cardiac arrest Naloxone guideline, stating they cannot customise the JRCALC app. Their Medical Director has raised these …
Response (Association of Ambulance Chief Executives on behalf of the Joint Royal Colleges Ambulance Liaison Committee): JRCALC's committee has approved the removal of naloxone use during cardiac arrest and is standardising drug monographs. These changes will be reviewed by the national ambulance service medical directors group …
Responded