In a preview of her article in the November issue of FIRE Magazine, Sarah Dornford-May, Communications Officer with Cheshire Fire and Rescue Service, reports on the service's approach to 'first class' trauma care training -click here to subscribeto read this piece in full 

Cheshire Fire and Rescue Service covers an area with one of the largest and most dangerous stretches of motorway networks in the county. With over 150 miles of motorway traversing its area, industrial and commercial outlets inclusive of petrochemical sites all utilising large goods vehicles for every type of need, the road networks can expect to have in excess of 50,000 freight movements every day. All too often this can result in some catastrophic incidents in some very challenging and demanding risk environments.

The service has recently undertaken two major RTC exercises and hosted the Advanced Trauma and Critical Care (ATACC) course on behalf of the Anaesthesia Trauma and Critical Care organisation.

Candidates from around the globe attended the three-day ATACC course with over 70 doctors, nurses, firefighters, paramedics and other trauma medics attending from Australia, New Zealand, Israel, Germany, Holland, Czech Republic, America, Ireland and the United Kingdom. 

Cheshire's medical director, Dr Mark Forrest, is the founder of the organisation which adopts a multi-disciplinary approach with medics, firefighters and others working together, adopting crew resource management techniques from the aviation industry and fire and rescue service.

"A high point of the advanced course is always the major incident exercise on day two which this year involved a multi-vehicle entrapment. Candidates also experienced the demands of Silver Command and the perceived pressures of carrying out media interviews," explained Gus O'Rourke, the service's Head of Operational Policy and Assurance. 

All Cheshire firefighters on all watches are now trained to Basic Trauma and Critical Care (BTACC) standard which involves the use of the fully integrated trauma care package. Training is underway to ensure that there will also be an ATACC trained firefighter on every watch who will be designated Fire Medic.  Each fire engine is equipped with a trauma care package which includes tourniquets to manage mass haemorrhage, use of oral and nasal pharyngeal for airway management and Bolin chest seals for sucking chest wounds. There are also bag valves and masks to support breathing, and automatic external defibrillators. 

An overnight closure of the M56 near Chester, gave the service the perfect opportunity to carry out a major training exercise which would incorporate a chemical incident and motorway pile up and put into practice their BTACC training. "The exercise involved a multi-vehicle collision involving chemicals and was set up at 2230 in the evening. A tanker carrying a potentially hazardous chemical that had crashed into the central reservation and a number of other vehicles were subsequently involved in what became a major RTC incident," says Gus.

Once the scene was set, five fire crews based at Ellesmere Port, Chester and Warrington fire stations, who knew nothing about what they would be facing, were called in to deal with the incident and rescue the actors and Service volunteers who were playing the part of casualties. "This was a fantastic opportunity to provide our crews with a realistic training scenario that would help prepare them should something like this ever happen in real life," adds Gus. "This sort of exercise really helps us prepare for major incident, which thankfully are a rare occurrence."

Multi-agency co-ordination was also put into practice as fire crews were joined on the night by North West Ambulance Service's Hazardous Area Response Teams (HART) so that they could work alongside one another as they would in a real chemical emergency.

Cheshire Police were also involved with both the development of the course and its implementation. They provided accident investigation and scene preservation skills and knowledge. This input helped to develop an excellent understanding of the police role and the need to consider the essential important work post-incident, after rescue and risk control measures have been carried out.

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