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: Accepted in full
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: Accepted in full
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: Accepted in full
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: Accepted in full
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: Accepted in full
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: Accepted in full
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: Accepted in full
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: Accepted in full
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: Accepted in full
Accepted
Prevention of Future Deaths reports(4)
Susan Smalley
Concerns: 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.
Overdue
Fern Foster
Concerns: 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.
Response (NHS England): • NHS England issued updated communications in November 2023, instructing that Category 3 ambulance responses for overdose cases receive further clinical assessment within a set timeframe or be automatically upgraded. … (AI summary)
Response (NARU): • The NARU Clinical Subgroup is scheduled to meet in September 2024 to discuss the management of toxicological incidents and the potential role of methylene blue within HART practice. • … (AI summary)
Response (AACE): • The organisation stated it would not recommend the routine carrying of methylene blue antidote by all ambulances or its inclusion in JRCALC guidance, citing a lack of evidence. • … (AI summary)
Overdue
Joel Colk
Concerns: 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.
Response (NHS England): • NHS England published an operational procedure in April 2021, requiring further clinical intervention within 30 minutes for declared overdoses and recommending TOXBASE® use. • NHS Pathways introduced a new … (AI summary)
Response (SECAmb): • SECAmb has procedures in place for overdose calls, which include clinical intervention within 30 minutes or automatic upgrade within 40 minutes, and the use of TOXBASE® for risk assessment. … (AI summary)
Responded
Wayne Austin
Concerns: 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.
Response (West Midlands Ambulance Service): • The Trust noted that the format and navigation of the JRCALC PLUS App are determined by JRCALC and Class Publishing. • The Trust recognised that the Naloxone Hydrochloride dosing … (AI summary)
Response (Association of Ambulance Chief Executives on behalf of the Joint Royal Colleges Ambulance Liaison Committee): • The JRCALC committee approved changes to the naloxone monograph and removed the use of naloxone during cardiac arrest. • The organisation contacted the UK National Poisons Information Service to … (AI summary)
Responded