HSE Air Ambulance

ambo112

Recruitment has begun for an aeromedical service in the HSE - anyone have any knowledge in where it's at and any planned launch?

There are five areas listed as a base - Sligo, Waterford, Dublin, athlone and Shannon.

Bang Bang

ambo112 wrote: »

Recruitment has begun for an aeromedical service in the HSE - anyone have any knowledge in where it's at and any planned launch?

There are five areas listed as a base - Sligo, Waterford, Dublin, athlone and Shannon.

The HSE/Air Corp Air Ambulance will be based in Athlone, the other areas are for standby purposes only, Coast Guard assist etc and will probably be for Advanced Paramedic assistance as the Coast Guard have Paramedics as part of their crew.
The application deadline has been extended for a short period so if you haven't yet applied then one would want to move quickly, that is of course if you qualify and meet the set criteria.

The best of luck to those who've applied.

flazio

Where's the advert? (I'm just a little sceptical that this is some sort of April Fool prank)

Bang Bang

flazio wrote: »

Where's the advert? (I'm just a little sceptical that this is some sort of April Fool prank)

It's not a prank. The Emergency Aeromedical Service was advertised 3 weeks ago. The Advanced Paramedic and Paramedic posts are for HSE National Ambulance Service staff only. So if you are NAS, the advertisement should have been posted in your station.

ivabiggon

Bang Bang wrote: »

It's not a prank. The Emergency Aeromedical Service was advertised 3 weeks ago. The Advanced Paramedic and Paramedic posts are for HSE National Ambulance Service staff only. So if you are NAS, the advertisement should have been posted in your station.

why would it not be open to suitably qualified personell from the DFB, why is it only HSE.
Surely the competition should be advertised nationally under competition law. After all its a national service run by the aircorp.

ambo112

ivabiggon wrote: »

why would it not be open to suitably qualified personell from the DFB, why is it only HSE.
Surely the competition should be advertised nationally under competition law. After all its a national service run by the aircorp.

It will actually be run by the HSE, they will be contracting the Air Corp to provide the staff, as far as i know. There are other service provides available aswell as the Air Corp but it will be HSE run.

sdanseo

ambo112 wrote: »

It will actually be run by the HSE, they will be contracting the Air Corp to provide the staff, as far as i know. There are other service provides available aswell as the Air Corp but it will be HSE run.

Oh fantastic. We know what an absolute shambles can occur when the HSE contracts another state body to provide a service (think D134).

You couldn't write this stuff.

gem112

The HSE didn't contract dfb to provide d134 the dfb put it on at their own expense...... The HSE already have an ambulance in swords....

ambo112

Oh fantastic. We know what an absolute shambles can occur when the HSE contracts another state body to provide a service (think D134).

You couldn't write this stuff.

The HSE don't have pilots, navigators, mechanics, technicians etc....
It was always going to be other individuals who would run the helicopter. Air Corp would be perfect in my opinion, they have the vast amount of training, skill and experience, especially when you consider landings and the terrain they may have to land on.

mr.dunkey

sdeire wrote: »

Oh fantastic. We know what an absolute shambles can occur when the HSE contracts another state body to provide a service (think D134).

You couldn't write this stuff.

Think your getting the rumours mixed up. D134 was done to death at one stage on forums.In the short end of it the DFB funded it themselves, well done.
Then the funds went dry and asked the HSE for funding.
After alot of Crap im nearly sure they're receiving the go ahead off the HSE now. My opinion is the extra ambulance is badly needed who ever ran it.

But i know what you mean the state makes stupid money wasting , example is voting machines, port tunnel etc...

Bang Bang

ivabiggon wrote: »

why would it not be open to suitably qualified personell from the DFB, why is it only HSE.
Surely the competition should be advertised nationally under competition law. After all its a national service run by the aircorp.

It's a service provided by the National Ambulance Service run by the National Ambulance Service through the National Ambulance Service Command & Control so there is no reason to open the competition to anyone else but NAS staff, competition law has nothing to do with HSE/NAS staff being deployed into NAS positions.
The Air Corp will provide the aircraft and pilots for the National Ambulance Service with a similar setup to the provision of the Garda Air Support which are crewed by Garda members and controlled by An Garda Siochana.

mr.dunkey

ivabiggon wrote: »

why would it not be open to suitably qualified personell from the DFB, why is it only HSE.
Surely the competition should be advertised nationally under competition law. After all its a national service run by the aircorp.

The service will be run by the NAS not Council/Fire service so its for NAS staff to operate, Also its national service out of the area for DFB. It wont be open to army Paramedics/ DFB etc.

The NAS are still recruiting staff since 2008 so we have plenty of medics willing to do it.

markpb

Bang Bang wrote: »

It's a service provided by the National Ambulance Service

It's a public sector job - by government policy, it must be offered on publicjobs.ie so all qualified candidates can apply. The only exception is if they're filling the roles through redistribution of staff and the overall staff numbers doesn't rise.

Bang Bang

markpb wrote: »

It's a public sector job - by government policy, it must be offered on publicjobs.ie so all qualified candidates can apply. The only exception is if they're filling the roles through redistribution of staff and the overall staff numbers doesn't rise.

The posts are internal secondments so no need to advertise anywhere else but to National Ambulance Service staff of which there are plenty who meet the criteria;)

markpb

Bang Bang wrote: »

The posts are internal secondments

That's fair enough but it's not what you suggested first time

Bang Bang

markpb wrote: »

That's fair enough but it's not what you suggested first time

The staff numbers have been rising within the National Ambulance Service recently as they advertise the competition for new paramedics every couple of years. Next week the numbers swell again when another class of recruit paramedics begin training.
The Air Ambulance along with other areas come with service and progression within the service, they are internal posts so there's no requirement to advertise them anywhere else, just the same way positions become available in stations throughout the country every month, they are filled internally.

Torpedo

Bang Bang, how will the Coast Guard Bases come into? AP based alongside CG heli crew or based off site but on standby?

kub

Torpedo wrote: »

Bang Bang, how will the Coast Guard Bases come into? AP based alongside CG heli crew or based off site but on standby?

Thats interesting, so will the NAS copter be solely for back up to ambulances or will/ can it preform rescue operations?

It may be a case so that in dual agency sites the CG crew may not get as many of those land based ambo back up calls. Will this possibly then cut down on various call out rates and question the need for the CG heli at some bases?

Bang Bang

Torpedo wrote: »

Bang Bang, how will the Coast Guard Bases come into? AP based alongside CG heli crew or based off site but on standby?

kub wrote: »

Thats interesting, so will the NAS copter be solely for back up to ambulances or will/ can it preform rescue operations?

It may be a case so that in dual agency sites the CG crew may not get as many of those land based ambo back up calls. Will this possibly then cut down on various call out rates and question the need for the CG heli at some bases?

Torpedo, the Coast Guard placements would be for Advanced Paramedic assistance as the Coast Guard have their own Paramedics. I'm not fully up on how this is going to operate.

kub, the NAS helicopter will not be performing rescue missions as in there is no winch on that aircraft and no flying out to sea, that's for the skills of the Coast Guard crews.
The NAS Incident Response Team on the other hand are trained in winching and sea rescue, most of that team are Advanced Paramedics and they can and have done on occasions flown with the Coast Guard.

ambo112

Looks like its set to fly in May
http://www.advertiser.ie/mullingar/article/51059/air-ambulance-to-be-based-at-athlones-custume-barracks

Bang Bang

ambo112 wrote: »

Looks like its set to fly in May
http://www.advertiser.ie/mullingar/article/51059/air-ambulance-to-be-based-at-athlones-custume-barracks

That's not an official HSE/Government statement, just another Deputy trying to grab the credit for something he has nothing to do with. The information given in that link is just what's known by anyone who has their ear to the ground with regard to the HSE air ambulance.
As for flying in May, no interviews have taken place as yet, there's also the stringent medicals and training to go yet so May would be very optimistic.

supermedic

Staff have been selected and are already in the second week of EAS training. They will be in Athlone next week finalising some operational issues. Could and probably will start flying the week after that.

Bang Bang

supermedic wrote: »

Staff have been selected and are already in the second week of EAS training. They will be in Athlone next week finalising some operational issues. Could and probably will start flying the week after that.

This is great news. I personally feel that it was the excellent choice of officer/s chosen and put in place to get this 'off the ground' so to speak. The best of luck to all the AP's who were successful in getting a place on this panel.

Now standby for the various ministers who'll crawl out of the woodwork claiming responsibility for this programme:mad:

ambo112

http://www.independent.ie/national-news/chopper-service-to-fly-injured-to-hospital-3110825.html


Excellent news!!! EAS to be launched next week, well done to all those involved!!!

Hopefully it will develop to have full country cover!!

antichrist

Equipment being loaded

Rawhead

Is this system similar to the Garda helicopter?

Will it be piloted by AC personnel with a NAS crew?

Is it 24hr all weather?

miju

Similiar yes AC pilot and NAS personnell as far as I know and also will not be flying at night.

savagecabbages

Piece in yesterdays news about it:

http://www.rte.ie/news/av/2012/0521/media-3293486.html#

flazio

The Helicopter could use a new lick of paint, or at the very least some Ambulance markings.

goldie fish

flazio wrote: »

The Helicopter could use a new lick of paint, or at the very least some Ambulance markings.

It#s a military helicopter. You won't be expected to meet it in traffic on the M50..

savagecabbages

Dr. Reilly seemed to imply in that piece on the news that in most cases the road ambulances would be driving with the casualty to a rendezvous point and meet the helicopter. I'm a little disappointed that the impetus isn't on getting the AP on board to the accident site to assist on scene, or that a trauma doctor isn't being carried to the accidents.

Still and all, it'll be a marked improvement over current transit times from accident site to an acute hospital in many cases over the next year, which I'm sure we all welcome.

Rawhead

goldie fish wrote: »

It#s a military helicopter. You won't be expected to meet it in traffic on the M50..

Well if it's doing it's job there could be every chance you could meet it on a motorway or in the middle of the road in Connemara, granted traffic will be slowed somewhat due to it needing to be there.

It's a big step in the right direction but it seems like a "Irish solution to an Irish problem".
Am I right in saying that there is no doctor on board?
Will the lads on the ground have the authority to call for the heli?
It looks like an upgraded role of the patient transfer system rather than a dedicated HEMS.
Surely all the research and studies prove how critical the golden hour is and how critical it is to get patients to a major trauma center within that critical window.

antichrist

The chopper will be dispatched at the request of the ground crew. Initially talk is that control rooms won't dispatch it automatically only under request of para's.

If the chopper is landing out in connemara the road will be closed. There is no need for markings on it as Gardaí, Fire and Ambulance services should be fending the area off with vehicles. If you still find yourself driving towards it all the markings and flashing lights in the world won't help.

Currently this is a trial run and there is no need for a trauma doctor. The medical crew member is an AP

Rawhead

antichrist wrote: »

The chopper will be dispatched at the request of the ground crew. Initially talk is that control rooms won't dispatch it automatically only under request of para's.

If the chopper is landing out in connemara the road will be closed. There is no need for markings on it as Gardaí, Fire and Ambulance services should be fending the area off with vehicles. If you still find yourself driving towards it all the markings and flashing lights in the world won't help.

Currently this is a trial run and there is no need for a trauma doctor. The medical crew member is an AP

Why do a trial run though, HEMS is a worldwide proven system. I'm not being completely negative about the set up it's just annoying to see the typical Irish attitude of setting things up half arsed. It's no reflection on the Paramedics or AC personnel, they will do an outstanding job i believe, but it's still an incomplete and flawed system.

stretch00

1- It's not HEMS, nor was or is it intended to be.

2- I think you may want to revisit some real evidence base regarding " Golden hour" theory.

3 - why not speak to the group who created this pilot, rather than exchanging speculations, they would be happy to share.

That is all

Rawhead

stretch00 wrote: »

1- It's not HEMS, nor was or is it intended to be.

2- I think you may want to revisit some real evidence base regarding " Golden hour" theory.

3 - why not speak to the group who created this pilot, rather than exchanging speculations, they would be happy to share.

That is all

If you were involved in a serious incident in a rural part of Ireland would you want,
A. A dedicated HEMS with a trauma doctor arriving to help
or
B. A big green flying ambulance

It's the cheap option and not the best option and to argue otherwise is asinine and ignorant.

crackcrack30

There is only so much 'anyone' can do on the side of the road .....I have met very few trauma docs on the road and would prefer to see a good AP come anyday to back me up..........
sometimes the worse or more serious the incident is... the more basic the interventions become and can revert back to basic life support or ABCs very quickly so to answer your question either would do..... you can't recreate a full blown resuss room on a hard shoulder...


I know a couple of guys on the chopper and they are leading edge & on top of their game.........best of luck to them.....

joeKel73

The helicopter has been buzzing around Galway the last couple of days...

First Aid Ireland

crackcrack30 wrote: »

There is only so much 'anyone' can do on the side of the road .....I have met very few trauma docs on the road and would prefer to see a good AP come anyday to back me up..........
sometimes the worse or more serious the incident is... the more basic the interventions become and can revert back to basic life support or ABCs very quickly so to answer your question either would do..... you can't recreate a full blown resuss room on a hard shoulder...


I know a couple of guys on the chopper and they are leading edge & on top of their game.........best of luck to them.....

The reason that the doctor on board system has worked so well in Oz and the UK (The only countries where I have experience of it) is because of the range of drugs that can be given. ABCs are basic, which is fair enough. But we used to have people choppered in with all kinds of things that needed heavy morphine use, seizures stopped, inotropes, chest drains, advanced surgical airway use etc.

It's not a competition, but it seems short sighted not to have the option of a doctor on board, when it works so well worldwide. I presume that will follow shortly.

crackcrack30

First aid this is not........you need to call in to your local ambulance station, get a tour of the base and and maybe an ambulance, ask the guys about the skillset of an irish Advanced paramedic and compare that to the uk and other modern countries .

First Aid Ireland

crackcrack30 wrote: »

First aid this is not........you need to call in to your local ambulance station, get a tour of the base and and maybe an ambulance, ask the guys about the skillset of an irish Advanced paramedic and compare that to the uk and other modern countries .

Well I'm a doctor and have AP friends and have worked in emergency and acute in several countries.

I know what the APs are up against having to call in for authorisation for various meds etc. At the end of the day, everyone has a different skillset. If you want someone who's put in 100+ central lines/chest drains or has experienced in surgical airways, then that's almost certainly going to be an anaesthetist or A+E doctor. In terms of sick kids/neomates, in a lot of countries a specific paediatric emergency physician or intensivist will be sent out if needed. For example, Australia has a whole dedicated mobile paediatric ICU team with intensivist, ICU nurse, ICU paramedic.

Like I said, it's not a competition. But it's naive to think that acute care doctors wouldn't bring anything to a lot of these situation. That's why they're used worldwide.

savagecabbages

I agree, but simply putting a doctor on board will be of limited usefulness if the chopper isn't going to be dispatched directly to the scene each time. Having the helicopter wait at a rendezvous point with doctor on board while the road ambulance paramedics stabilise the patient at the scene isn't much use...

Put simply, unless its full HEMS a doctor isn't necessary for transit missions.

First Aid Ireland

savagecabbages wrote: »

I agree, but simply putting a doctor on board will be of limited usefulness if the chopper isn't going to be dispatched directly to the scene each time. Having the helicopter wait at a rendezvous point with doctor on board while the road ambulance paramedics stabilise the patient at the scene isn't much use...

Put simply, unless its full HEMS a doctor isn't necessary for transit missions.

I mostly agree, unless a particular intervention is required urgently and there isn't time for the chopper to get to the hospital. I guess it depends on the criteria for dispatching the chopper, though.

investment

This country and the HSE sicken my hole...we need more doctors and helicopters to serve our country.

crackcrack30

How many 'practitioners' can fly at a time? is the limit weight based or on availability of seats? .........

Rawhead

crackcrack30 wrote: »

How many 'practitioners' can fly at a time? is the limit weight based or on availability of seats? .........

Now the doctors are wrong as well.

It's a flawed system that is below that of international best practice.
It's better than nothing I suppose, but why not go the whole hog and do it right from the start.

crackcrack30

Better than nothing.... has to be the understatment of the month.

Until recently we had within a 50 mile radius

- Full time AP car 24/7.
- 30 minutes down the road an oncall sysyem, whereby people were/are alerted at home ang given 20minutes to report for duty.
- Another 40 minutes down the road there was (6mts ago) a system running whereby the base was alerted and the paramedic had to sometimes drive past an RTC to collect an nurse?

So let me tell you this is a major improvement for rural Ireland.

My Advice still stands for First Aid Ireland.....

Morphine, Et tubes, lines/fluids, midaz for seizures ect are all used by AP's every day in ambulances accross the country and i'm sure with this new 'mode' of ALS more improvements will be added as deemed necessary.

I'm not even going to discuss the geographical differences between Ireland or Austrailia or the thoughts of a flying peadratiac Icu or surgical team here. lets just take it one step at a time:rolleyes:

There are Ambulances (without shiney wings & blades) providing a modern emergency service accross Ireland every day sucessfully with out trauma doctors or the plans to put them in there. In rural ireland its almost impossible to get a G.P at attent a patient in theit own home ( even with car and pilot driver provided) but that a different story/Thread

The ambulance Service and hospital Depts share training experincees and learning regularly with work placements ' lectures ect. and i'm sure this will continue & surley include the Chopper.

I agree this is not HEMS but its one 'giant leap' for the Irish Ambulance service...Combined emergency services & General public.....

nsa75

I think the undertone of 'Doctor vs AP/Paramedic' is obvious here and unnecessary.....not the only thread to suffer from this either it must be said!

The skill set of the AP in Ireland is indeed high and something the ambulance service should be particularly proud of. However, to speak of this skill set with a tone suggesting it serve as a replacement, or ''better option'', over placing a pre-hospital care physician/emergency medicine specialist/anesthetist/intensivist in the field is but to ignore a plethora of international evidence supporting physician-led pre-hospital care.

Better to cite our closest neighbours when comparing services in other countries, I suppose. Leaving London's HEMS as a world leader in pre-hospital care aside, the success of voluntary and government part-funded pre-hospital care schemes is obvious. The BASICS and MAGPAS schemes are clear examples.

Most, if not all, of such services in the UK involve clinicians working side-by-side with AP's (or UK equivalent). Each brings particular and important skills to the field. The fact that it is necessary for a Doctor to be the lead in any clinical situation should not come as a surprise to anyone, or indeed be argued against. It is not about being the hero. It is about providing the highest level of acute/critical care in the most organised and professional manner possible. Placing suitably qualified Doctors at the first contact point for serious emergencies represents the best option for continuity of care as well as maximising patient survival chances and minimising long term morbidity.

I think discussions on these threads frequently reveal an air of reluctance for AP/Para's to work side by side with medics. I have always wondered why this is the case....or indeed if it is really the case or just the opinion of a small minority. What forms the basis of this resistance to change? Any service provided in healthcare is based on best serving the patient. To argue against improving the standard and skill set of services currently provided goes against this.

There are important skills and procedures that will never be done in the pre-hospital environment by anyone other than a suitably qualified Doctor. This is not elitism, this is medicine. As the new specialties of pre-hospital care and retrieval medicine continue to advance it is a welcome inevitability that appropriately trained Doctors will be established in this role in the medium to long term future here in Ireland. This country needs it and stands to benefit greatly from it in my view.

The above mentioned new service is aimed at addressing gross inadequecies in patient transport rather than treatment. It is not a HEMS service and it is obvious that it was never intended to be at this stage. However, we can only hope that it represents the first rung of the ladder towards a full capacity HEMS service spanning country-wide. We should hold this hope for our patients, not for our egos.

crackcrack30

Good post nsa 75 and welcome, I have to admit i agree fully with most of what you say but..... im sorry if you get the impression (from me) that there is as you said yourself a 'doctor v paramedic AP' undertone.....most peoples veiws are just that opinions and i wouldn't read too deep into individual written posts but more their actions on the ground..... (or air).

I also think it go's without saying that everyone that works in the vicinity of patients from porters to consultants (should) have the best of the patient as a priority, infront of their own ego's or self importance.... the problem is that what one person thinks is best for the pt, may appear less than perfect from a different aspect, position or skillset ..........this brings me nicely back to this chopper......obviously 'The powers that be' accept/think that the chopper in its current form /proposal/staff is adequate at this point for Patient care...........for now at least.

cc30

First Aid Ireland

crackcrack30 wrote: »

Morphine, Et tubes, lines/fluids, midaz for seizures ect are all used by AP's every day in ambulances accross the country and i'm sure with this new 'mode' of ALS more improvements will be added as deemed necessary.

I'm not even going to discuss the geographical differences between Ireland or Austrailia or the thoughts of a flying peadratiac Icu or surgical team here. lets just take it one step at a time

No need to get cranky. We used to use the chopper in Oz for journeys much shorter than the type that get brought in an ambulance in Ireland. They do the same in lots of countries.

You're a little defensive. But the reality, as pointed out by NSA and by me, is that everyone has a particular skillset. Some seizures need lots of different meds to get on top of them, some patients need shed loads of opiates, some need a surgical airway or chest drains or inotropes.

I'm not sure where the argument is, to be honest.

The other thing that jumps out at me, when comparing standards internationally, is that we seem to underutilise our paramedics. I can't believe that our paramedics aren't allowed put lines in, for example. A relatively easy skill to learn, and from teaching a group of them recently, they're very knowledgeable about what needs to go through the lines once they're in! And they're keen to be allowed expand their skillset. Seems bizarre that they need to call out APs (possibly in helicopters) before an IV can be inserted.

crackcrack30

[QUOTE=
The other thing that jumps out at me, when comparing standards internationally, is that we seem to underutilise our paramedics. I can't believe that our paramedics aren't allowed put lines in, for example. A relatively easy skill to learn, and from teaching a group of them recently, they're very knowledgeable about what needs to go through the lines once they're in! And they're keen to be allowed expand their skillset. Seems bizarre that they need to call out APs (possibly in helicopters) before an IV can be inserted.[/QUOTE]

This is true.......but i cant see much demand for this from the paramedics without some recognition in pay, the new entrants at the moment are on a very basic wage.... what may happen down the road is an accross the board paramedic upskilling and then gradual disolvement of the AP programme but that could take years.....

Yes there are a wide varation in skills and most manual skills can be tought and picked up easily as has been proven with the very sucessfull graduate entry Doctor Uni course........

As NSA 75 correctly pointed out there are some procedures that will never be carried out in the field with out them being doctor led, does that leave the patients who do avail of this new sevice any worse off ? to the contrary it gets them in a timely manner with the best staff available to the most appropriate facility.....

I myself have extensive history working for a well known multinational company they had some 'analagy' about the staff being part of a batton relay race, and how the batton passed thru several hands to get to the customer, i see the emergency services in a similar light from bystander to first responder, paramedic, triage nurse all the way up and each or any of those people may provide the best or worst care that affects the pt out come. In an 'ideal world' the pt would present himself to the front desk but that can't/dosen't always happen.

I'm sure there are some budgetary constraints about having a 10/12 man doctor roster attached to a HEMS chopper but isnt that the whole fabric of the current health care setup- budgets,cutbacks and constraints which can be seen in every hospital department, be it the waiting room/ trollies/ canceled ops or ward closures & thats our lot for the forseeable future...in Ireland anyway.........