Altruism: this is why we are here.
The concern for the welfare for others: this is why we are here.
The belief that we can and will be better, that we can push harder, that we will save lives. The idea that a loved one will spend another birthday another holiday, another day, with those that they love. We, often at great risk to ourselves, dedicate our practice, our lives and our hearts to this cause; that we might be the light in someone’s darkest hour.
The late Dr. John Hinds told each of his severely injured trauma patients, “I will not leave you.” What he was promising them was not simply companionship, a hand to hold or an experienced paramedic, he was promising them his own, personal, clinical skill and excellence as a trauma physician, who would remain with them in their time of need and transfer to definitive trauma care. It is with that approach in mind that Dr Hinds advocated for the development of a robust trauma system in Northern Ireland to include a helicopter staffed by a crew who could deliver similar skills and excellence. His belief was that the standard of trauma care the people of Northern Ireland deserved was only the highest.
There is growing concern, after remarks made by the Minister of Health, Mrs. Michelle O’Neill MLA, that the physician led staffing model originally proposed and publicly supported, will not be the initial staffing model.
The global Helicopter Emergency Medical Service (HEMS) community, has a wealth of experience in the delivery of advanced critical care and they know what works and what doesn’t. Dr John Hinds knew this too 1 and he worked with that community to advise and inform the way forward for a gold standard service based on the physician-paramedic staffing model. The leaders and clinicians from the best HEMS services around the world work together in research, best practice and knowledge sharing in this way. This community works together sharing best practice, knowledge and research to improve patient care and they were prime instigators with Dr Hinds in lobbying for the establishment of HEMS in Northern Ireland.
In an open letter to Mrs. O’Neill, more than 25 of the most respected HEMS/EM clinicians from around the world wrote in support of the need for a physician-paramedic staffing model:
“Recently, the UK National Institute for Health and Care Excellence (NICE), published benchmark guidelines. The life and limb-saving prehospital interventions listed in this guideline cannot be provided in Northern Ireland outside of a physician-staffed model. Examples include, but are not limited to: prehospital blood transfusion to a bleeding patient, safe general anaesthetic in severe head injury and advanced trauma resuscitation including surgical interventions.
We fear the Service will not be capable of providing the best life-saving care possible to the people of Northern Ireland from the outset if a doctor is not on board the helicopter. Placing a combative, agitated, head injured or bleeding patient in a helicopter without a general anaesthetic is unsafe, both to the patient and the crew.
There are excellent paramedics in Northern Ireland who can be trained to work at the highest level in a doctor/paramedic team. This team will be more than the sum of their parts, but rather a multiple of those parts.”
The model proposed by the Minister of Health, would not be able to deliver what John and experts in prehospital care envisaged and this would be unfair to the people of Northern Ireland. Irish HEMS trained physicians and paramedics are in place and ready to serve together. The international HEMS community is prepared to support the paramedic-physician model and the world is watching. We sincerely hope that the Minister of Health hears the expert testimony of HEMS leaders and does not allow anything less than a physician-paramedic model. This excellence in trauma care is what Dr Hinds promised his patients and wanted for his community. This world-class HEMS program is what the citizens of Northern Ireland deserve.
Dr Hinds is sadly no longer with us. His words to his patients are his legacy; “I will not leave you.”
Please tweet, email and share this as widely as you can. If you have friends and family in Northern Ireland get them to read and share locally. Do what you can to give the people of Northern Ireland the trauma and critical care service they deserve.
We are delighted to announce that the Northern Ireland Health minister has announced a physician based model for PHEM in Northern Ireland. I wonder if they read the blog 😉
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