Voluntary services in the thick of it

May 2, 2008 on 11:20 pm | In First aid | |

I’m a regular reader of The Paramedic’s Diary and couldn’t help but notice the new poll question - Should the voluntary services support the ambulance service on frontline duties?

This likely comes from a recent diary post of his and I felt compelled to write just a bit about it.

Firstly, I’m commenting on this as it would be under usual circumstances - in the event of a major incident (London bombings, etc) then things are obviously different. I’m also basing this mainly on experience in St Andrew’s. I’ll be the first to admit St John’s are quite different on a number of aspects although I’ve tried to come at it from a combined VAS point of view.

The problem with this is how the definition of “support” is taken. If it means relying on a VAS crew attending any type of 999 call then I’d have to say no. Whilst training for some of the St John’s advanced courses (say Emergency Transport Attendant) is undoubtedly tough it is still nowhere near the level required for technicians and paramedics. A VAS crew turning up at a large RTC would, I feel, be quite overwhelmed and wouldn’t have the experience to help them.

Taking another situation, lets say a complication in late pregnancy, would possibly be worse still. Not only is there the medical condition to deal with but there is also a highly emotional situation that a number of professionals would probably not like to be in.

Further, what if there were complications in relation to the actions of the VAS crew? Insurance exists, yes, but to what level? What about regulation? A registered paramedic could face being struck off in a serious situation, but what would happen to a voluntary member? Would communication be effective enough to impose levels of discipline?

These may seem a bit far-fetched, but are foreseeable problems.

On the other hand if we take the situation where a patient is assessed by a technician/paramedic and that professional requests and is confident allowing the care to pass to the voluntary crew then that really is a different matter. Transporting a stable patient doesn’t carry quite the same risk as attending an unknown.

But in the event of a cardiac arrest when even basic lifesaving skills can help, this doesn’t really apply. I might even go as far to pick a VAS crew over a number of GPs I’ve met, basic lifesaving having long since left them.

I guess my point then is that VAS crews might have a use, particularly in busy or definite emergencies. The problems will start when they become preferential to qualified professions which, in today’s cost-effective health service, seems all too likely.

I often comment on St Andrew’s rather slow expansion capacity but if we ever get to the point of covering 999 calls I’d want to be damn sure we covered all the bases.

I’d be interested to hear other views on this and I’ll happily admit I’m not totally knowledgeable about the current policies.