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Ambulances & Programming

Public Access


Public-access lifesaving equipment is not a new idea: life rings by lakes and rivers are a very common sight, as are (to a lesser extent) things like throw lines and public SOS telephones. That said, awareness of and access to public-access defibrillators is still relatively new in comparison, and it’s really only the last few years that we’ve seen any kind of rise in awareness and availability. Even newer than that are other types of public-access lifesaving kits that we’re only just starting to see: things like trauma kits, first aid kits, etc.

Start Them Early

I’ve had some kind of first aid qualification since I was about 8 years old. The first one was a shiny “Junior First Aider” certificate that we got after a lightweight one-day first aid course. The school had clearly spent about 5 minutes on it — but it didn’t matter; it gave all the 8 year olds something to be proud of. The course itself was spot on, including all the essentials: keep yourself safe first, call 999, how to put a bandage on, how to do CPR. (We’ll ignore the fact that 8-year-olds aren’t strong enough to do CPR — having the awareness is super important.)

That got upgraded to a full British Red Cross first aid qualification 3 years later. From there, I’ve kept it up either through school, through the Scouts, then through the Red Cross again when I needed the certificate for my job, and from there into the ambulance service where first aid is my job.

First aid is one of those things that I think should be part of a good early curriculum. It can start off super simple: what’s 999, and how do you call it if someone is in trouble? A 999 operator can talk anyone through first aid from there — even young children, and there are plenty of documented cases of this happening. Introducing the idea of CPR early is important, too: while young children aren’t strong enough to actually perform good CPR on an adult, knowing what and why builds awareness and (hopefully!) reduces panicking if the worst does happen.

What’s a Defibrillator?

I hear this far too much. Defibrillators (aka defibs, AEDs) are life-saving, and I’ve seen (well, heard) them save lives. In most big cities (in the UK, at least), you’re unlikely to be more than about 500 metres away from one — less, in city centres.

While there has been increased awareness recently and more and more places are fitting AEDs, there’s still a long way to go. The most common response to being asked if there is a defibrillator is available is “I don’t know”, shortly followed by “What’s that?”. After that comes “Maybe, but I don’t know where” and “It’s in a locked box, what’s the code?”

“I don’t know” is… disappointing, but understandable. If you’re being asked about a defibrillator, it’s already a stressful situation; many people haven’t had time to think, and even if they do know where one might be, it’s slipped the mind under the pressure.

“What’s that?” is what I’d love to see changed. Sure, there have been campaigns to make folks aware of AEDs, what they do, how they’re used, etc. The problem is that the nature of these campaigns often mean they reach a lot of younger or middle-aged people, whereas the people who are most likely to need that knowledge are elderly folks. Teach your grandma about AEDs!

“I don’t know where” is already a solved problem, fortunately. The majority of ambulance services have a map of every defibrillator in their area — if you don’t know where the defibrillator is, I can tell you! Buuuut… “It’s in a locked box”? Now we have a problem. Locked AED boxes are managed by whoever installed them — the ambulance service may well not have the code for it.

Make the Save

We’re just starting to see other types of lifesaving kits appearing for public use. In London, the epidemic of knife violence has spawned at least one non-profit organisation that’s installing “Stop the Bleed” kits — in other words, major trauma kits containing tourniquets, bandages, and other bleeding-control materials. The Scottish ambulance service has recently started a pilot of a take-home naloxone program, where at-risk drug users or those close to them are given kits containing naloxone (aka Narcan — a drug to reverse narcotic overdoses).

I would love to see more of this sort of thing. Public awareness and training in how to help someone in an emergency situation, and access to the equipment to make that happen, are some of the biggest factors in improving outcomes for patients, and ultimately saving lives.

first-aid public-access
Written on March 22, 2021