PROPOSAL FOR DRUG RE-INTRODUCTION
| Published: 29th January 2007 10:09 |
A proposal is to go to the Staffordshire Trust Board that would see the re-introduction of certain drugs for use by volunteer Community First Responders (CFRs).
Staffordshire Ambulance Service (SAS) withdrew seven of thirteen drugs in use with the volunteer CFR schemes in October 2006. It followed concerns that were raised by SAS staff at the Partnership Board and related to the governance framework surrounding the administration of the drugs.
Working closely with the CFR groups, a comprehensive review of the situation has been completed by Staffordshire Ambulance Service and the new Joint Director of Clinical Performance, Dr Matthew Wyse, in co-operation with the Strategic Health Authority.
A report by Dr Wyse will go to the Staffordshire Ambulance Service Trust Board on Friday 26th January with a recommendation that GTN, Salbutamol and Entonox be re-introduced to the CFR volunteers in a phased manner and with a number of revised clinical protocols.
The proposal will recommend the changes subject to the following criteria:
- Individual CFRs agree to abide by the revised operating procedures and clinical protocols for all of the drugs available to them
- The re-issue of the drugs is in accordance with new operating procedures, administrative protocols and clinical safeguards
Dr Wyse said: ;The new clinical guidelines are designed to ensure the safest possible use of these three drugs.
In addition, the use of adrenalin has been restricted to life threatening allergic reactions only. The review has also recognised that good practice should lead to the withdrawal of Naloxone, a drug used for treating drugs overdoses. The CFRs will still be able care for patients in this condition using their other skills.
I have been very impressed by the volunteers who I have been working with; their level of knowledge is excellent and they clearly had a genuine desire to find a solution to the issues we were reviewing. Their input was extremely valuable.
Community First Responders play a vital role in the provision of immediate care across Staffordshire and the West Midlands. The volunteers have undoubtedly saved the lives of many people and continue to do so.
I am absolutely certain that the work that we have undertaken here will be of great use right across the West Midlands Region.
Trust Chairman, Robert Lake, said: I am delighted that we have been able to get to this position following a thorough investigation and review of the use of the drugs used by our Community First Responders. I will be urging my colleagues on the Board to support the recommendations.
We always said that the action was a temporary measure that was necessary to establish the facts of the matter and review the arrangements. The decision was taken by this Trust alone on the grounds of patient safety so as to ensure that the volunteers were operating within an appropriate legal framework; the public would expect nothing less. It is important to stress that the CFR's have been operating safely throughout the last few months and previously.
We have always held our volunteers in the highest regard and the decision to re-introduce the drugs is a huge vote of confidence in their skills and knowledge.
Assuming the Board supports this proposal, I would hope that we could start making the necessary changes as early as the beginning of February.
Dr Wyse added: Over the coming months there is more work to be completed to ensure the volunteers receive all the appropriate support they deserve. There will be a complete review of their training programme and regular audits of the care they provide; this is no different to any of the Trusts emergency medical technicians and paramedics. We would also intend to work towards getting their training accredited.
I have little doubt that the progress we have already made will allow us to move forward with this in a timely manner and with the full support of the CFRs.
Note to Editors
For guidance, these are the drugs that were initially in use and final decision about each:
Drugs to be re-introduced under revised protocols
- Salbutamol
- GTN (Glyceryl trinitrate)
- Entonox
No changes to use of drugs
- Glucagon
- Oral Dextrose
- Oxygen
- Paracetamol Suspension
- Aspirin
Use of drug to be changed
- Adrenaline
Drug to be removed from use
- Naloxone
Drugs that will not be re-introduced
- Midazolam
- Pulmicorte
- Diazepam
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