As always, the thoughts on this blog are my own, and have nothing to do with my employer, the London Ambulance Service. I do not represent them in any official capacity and the views here are how I see things and I may have incorrect information. Also while I’ve read the report, my sinuses are blocked and my head feels like it’s going to explode.
The report on the 7/7 bombings makes interesting reading and despite what some of the media may have you believe it is not ‘slamming’ the response of the emergency services. (I could mention all the ways in which ‘The Sun’ report is inaccurate, but I can’t be bothered wasting my breath).
Personally I agree with a lot of what it suggests. In the whole I think that it is a reasonably balanced report and that a lot of the changes it suggests are reasonable ones.
However there are a few points that I believe are misinformed.
The people making up the review take on the role of ‘informed layperson’ – looking at the backgrounds of the people involved in the review, one is a barrister specialising in employment law, one has a degree in economics, one is a solicitor, one a business trainer and one has a BA in politics and economics (and incidentally studied where I trained to be a teacher).
My concerns about the report is that I believe none of them have any experience in emergency situations. It is very easy to look back and criticise the actions on the day – but the ‘fog of war’ is a very serious obstacle. Much like you, dear reader, perhaps had little idea of what ambulance work was like until you read this blog – I think that some of the reports recommendations show a lack of understanding of what a major incident is really like.
The main finding and recommendation of the report is that the communication network was inadequate, and that more should be done to improve communication between staff on the ground and Gold Control, who’s job it is to coordinate our response. Eighteen years after the Kings Cross fire and the emergency services still needed to rely on ‘runners’ for communication as the radios we have don’t work underground. With this I recommendation I agree completely, our communication needs to be upgraded – unfortunately, from what I hear the TETRA airwave system that we will be getting in the start of 2008 is not going to solve many problems. It simply isn’t as good a system as people would have you believe. (But this is a topic for another post).
There are some recommendations which are a little strange, such as allowing medical staff who are untrained in pre-hospital care to start setting up field hospitals and the like. While medical knowledge is incredibly useful, it’s also very useful to not have people who may be unaware of all the dangers on scene wandering around explosion sites in nothing more than theatre scrubs.
I understand the urge to help, I would have done the same when I was working in A&E and I don’t want you to think that I’m degrading the work that these volunteers did on the day – but the risk of creating more casualties is just too high.
One thing that the report does is to record the accounts of members of the public caught up in the explosions – unfortunately the report does not mention that in such times of trauma the brain can easily become mistaken with what is happening. Perception of time can become altered – two minutes can easily feel like ten. Also there can be a misperception of what the first ambulance on scene does – on arrival the driver should stay in the ambulance and provide communication with Control, while the attendant makes a survey of the scene in order to report on what additional resources are needed. The first ambulance on scene does not treat any patients until the scene management is taken over by an officer. Add in that the first person needs to be sure that the track current is off, and then needs to walk fifteen minutes to get to the train – spend a couple of minutes assessing what has happened and then walk another fifteen minutes to get back to the ambulance, and it is unsurprising that a lot of the injured felt that the ambulances took a long time to arrive.
While the evidence from the public should be gathered, I think that by publishing emotive eyewitness reports on what they believed happened is a poor idea. In some places the report reads more like a disaster movie rather than a report on how to better improve our response.
Some mention is made of the lack of equipment, unfortunately in the first response to a major incident you are going to get ambulances, and not the ‘bigfoot’ support vehicles – we can only carry a limited amount of equipment in an ambulance, and to be honest it’s not unusual to only need to use an oxygen mask or two in the course of a normal twelve hour shift – so while we are equipped to deal with a patient or two, we simply do not have enough room in our ambulances to stock for major incidents.
As I said at the start – the report makes a number of excellent points, and at no time does it criticise the actions of those ‘on the ground’ who did an excellent job under difficult circumstances.
I know that the LAS has already made improvements, such as reinstating the ‘obsolete’ paging technology for it’s managers – something that came in extremely useful two weeks later with the failed second attacks. I do have the LAS’ news release concerning this report sitting on my computer, I just need to OK to post it here…