North West Ambulance Service
There is no charge to patients for use of the service, and under the Patients charter, every person in the United Kingdom has the right to the attendance of an ambulance in an emergency. The trust lost the contract for non-emergency patient transport services in Cheshire, Warrington and it will transfer to the West Midlands Ambulance Service in July 2016. NWAS use Mercedes-Benz Sprinters or Fiat Ducatos as their standard emergency ambulance, Skoda Scouts as the main Rapid response car, the Trust currently operates from 114 ambulance stations and employs around 4,900 staff. NWAS was the first ambulance trust to be inspected by the Care Quality Commission, emergency medical services in the United Kingdom Healthcare in Greater Manchester North West Air Ambulance List of NHS trusts NWAS Website
It includes the work done in providing primary care, secondary care, and tertiary care, as well as in public health. Access to healthcare varies across countries and individuals, largely influenced by social and jurisdictions have different policies and plans in relation to the personal and population-based health care goals within their societies. Healthcare systems are organizations established to meet the needs of target populations. Their exact configuration varies between national and subnational entities, in some countries and jurisdictions, healthcare planning is distributed among market participants, whereas in others, planning occurs more centrally among governments or other coordinating bodies. Healthcare can contribute to a significant part of a countrys economy. In 2011, the healthcare industry consumed an average of 9.3 percent of the GDP or US$3,322 per capita across the 34 members of OECD countries.1 years, a gain of 10 years since 1970. The USA ranges only on place 26 among the 34 OECD member countries, all OECD countries have achieved universal health coverage, except Mexico and the USA.
Healthcare is conventionally regarded as an important determinant in promoting the general physical and mental health, an example of this was the worldwide eradication of smallpox in 1980, declared by the WHO as the first disease in human history to be completely eliminated by deliberate health care interventions. The delivery of health care depends on groups of trained professionals and paraprofessionals coming together as interdisciplinary teams. Healthcare can be defined as public or private. Primary care refers to the work of professionals who act as a first point of consultation for all patients within the health care system. Depending on the nature of the condition, patients may be referred for secondary or tertiary care. Primary care is used as the term for the health care services which play a role in the local community. It can be provided in different settings, such as Urgent care centres which provide services to patients same day with appointment or walk-in bases, consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas.
The International Classification of Primary Care is a tool for understanding and analyzing information on interventions in primary care by the reason for the patient visit. Common chronic illnesses usually treated in primary care may include, for example, diabetes, asthma, COPD, depression and anxiety, back pain, Primary care includes many basic maternal and child health care services, such as family planning services and vaccinations. Physicians in this model bill patients directly for services, either on a monthly, quarterly, or annual basis. Examples of direct primary care practices include Foundation Health in Colorado, the World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary health care strategy
A raft is any flat structure for support or transportation over water. It is the most basic of boat design, characterized by the absence of a hull, traditional or primitive rafts are constructed of wood or reeds. Modern rafts may use pontoons, drums, or extruded polystyrene blocks, inflatable rafts use durable, multi-layered rubberized fabrics. Depending on its use and size, it may have a superstructure, timber rafting is used by the logging industry for the transportation of logs, by tying them together into rafts and drifting or pulling them down a river. This method was common up until the middle of the 20th century but is now used only rarely. Large rafts made of logs and using sails for navigation were important in maritime trade on the Pacific Ocean coast of South America from pre-Columbian times until the 19th century. The type of raft used for recreational rafting is almost exclusively an inflatable boat, in biology, particularly in island biogeography, non-manmade rafts are an important concept. g.
They stay afloat by its buoyancy and can travel for hundreds, even thousands of miles and ultimately are destroyed by wave action and decomposition. Rafting events are important means of dispersal for non-flying animals. World of Boats Collection ~ Australian Reed Raft World of Boats Collection ~ Brazilian Jangada Homemade Raft Plans and Photos of Rafts Neutrino Raft – vessels made from scrap
South Western Ambulance Service
The South Western Ambulance Service NHS Foundation Trust is the organisation responsible for providing ambulance services for the National Health Service across South West England. On March 1,2011 SWASFT was the first ambulance service in the country to become a Foundation Trust, the Trust merged with neighbouring Great Western Ambulance Service on 1 February 2013. SWASFT serves a population of more than 5.3 million, the operational area is predominantly rural but has large urban centres including Bristol, Exeter, Bath, Gloucester and Poole. The Trust’s core operations include, Emergency ambulance 999 services Urgent Care Services – GP out-of-hours medical care NHS111 call-handling and triage services Tiverton Urgent Care Centre. It is one of ten Ambulance Trusts providing England with emergency services and employs more than 4,000 mainly clinical and operational staff plus GPs. The Trust is one of the largest in England and it covers an area of 51,871 km and 827 miles of coastline. In 2015/16 approximately one in eight 999 calls to South Western Ambulance Service are treated over the telephone and treat is 12. 7% of calls and means the patient receives clinical advice over the telephone.
For 36. 4% of incidents the patients experience see and treat, in a further 7. 7% of incidents, the patient is taken to a non-emergency hospital department so that might mean a community hospital or minor injuries unit. The remaining incidents result in a patient being taken to an emergency department. SWASFT is the best performing ambulance service in the country for non-conveyance rates, in addition approximately 62% of patients taken to hospital are admitted – this is again the highest performance for an ambulance trust in the country. SWASFT place a lot of emphasis on patient experience and actively encourage feedback about its services - whether positive or negative, lessons learned from the feedback, and all improvements and changes, are reported to its Board of Directors. The Trust engages with patients and the public at events and shows, the number of compliments received by the Trust in 2014/15 increased by 41% to 2,055. Complaints rose by 20% to 1,268, the easiest way to contact the Trust is online at their website.
In May 2014 the Trust won a contract to run a minor injuries unit at Tiverton and District Hospital
Scottish Ambulance Service
The Scottish Ambulance Service is part of NHS Scotland, and serves all of Scotland. It is a health board funded directly by the Health. The service was known as the St Andrews and Red Cross Scottish Ambulance Service, the Red Cross withdrew from the service in 1967, the service was renamed the St Andrews Scottish Ambulance Service. In 1974 the service was taken over by the NHS, the title being shortened to the Scottish Ambulance Service, St. Andrews First Aid, which is the trading name of St. Andrews Ambulance Association, continues as a voluntary organisation. In 2003 there was a reorganisation of the control centres across Scotland. The original uniform for the service consisted of a blue shirt, black clip-on tie, navy blue sweater. These uniforms were an Irish green colour for Emergency staff and a blue shade for Patient Transport staff. In 2013/2014, the uniform was changed to mirror the NHS National Uniform standard. It is now supplied by Dimensions and is similar to all other Ambulance Services in the UK.
All staff, including control centre staff, now wear the national uniform unless otherwise authorised, the national headquarters are in west side of Edinburgh and there are five divisions within the Service, The Patient Transport Service carries almost 1.6 million patients every year. This service is provided to patients who are physically or medically unfit to travel to hospital out-patient appointments by any means can still make their appointments. The service handles non-emergency admissions, transport of palliative care patients, Patient Transport Vehicles come in a variety of forms and are staffed by Ambulance Care Assistants, whom work either double or single crewed. They are trained to look after patients during the journey, the service has the only government-funded air ambulance service in the UK, operated under contract by Gama Aviation. In 2015/16, the air crews flew 3,849 missions. One helicopter and one King Air are based at a Gama Aviation facility at Glasgow Airport, the other operating bases are Inverness Airport and Aberdeen Airport.
The aircraft based in Glasgow are regularly used by the UKs only Emergency Medical Retrieval Service, the air ambulance service was occasionally featured as part of the popular Channel 5 television documentary series Highland Emergency. In late 2012 a charity was founded to provide an air ambulance, based at Perth Airport. Scotlands Charity Air Ambulance commenced operations in May 2013 with a Bolkow 105 airframe, since November 2015, SCAA operates a Eurocopter EC-135 helicopter
West Midlands Ambulance Service
The West Midlands Ambulance Service NHS Foundation Trust is the second-largest ambulance service in the UK. It is the authority responsible for providing NHS ambulance services in Herefordshire, Staffordshire, West Midlands, the trust won the contract for non-emergency patient transport services in Cheshire and Wirral previously provided by the North West Ambulance Service in 2015. The trust is currently under the leadership of chief executive Dr. Anthony. Marsh and it is one of 10 Ambulance Trusts providing England with Emergency medical services, and is part of the National Health Service. It employs around 4,500 staff and is supported by about 1,000 volunteers, over 63 sites, the trust is currently the best performing ambulance service in the NHS being graded outstanding by CQC inspectors in January 2017 & the only ambulance service to meet Government targets. The trust was formed on 1 July 2006, following the merger of the Hereford & Worcester Ambulance Service NHS Trust, Coventry & Warwickshire Ambulance NHS Trust, on 1 October 2007 the service merged with Staffordshire Ambulance Service NHS Trust.
It became an NHS foundation trust on 1 January 2013, WMAS wanted a “full second tariff” on top of the standard tariff for delays over 60 minutes, and “a smaller second tariff” for delays over 30 minutes, which would have come to around £6 million. After mediation by NHS England and NHS Improvement it was agreed to pay the trust an additional £2. 1m in 2017-18, Worcestershire Acute Hospitals NHS Trust and Shrewsbury and Telford Hospital NHS Trust were singled out as the main culprits. Following the merger of the trusts, WMAS inherited a number of control rooms. On 28 November 2007, the Trust agreed to go ahead with proposals for the reconfiguration of its Emergency Operations Centres, WMAS now only operates from 2 Emergency Operations Centres based at Millenium Point, Brierley Hill and Tollgate Drive, Stafford. There are 2 air ambulance charities serving the WMAS service community, the Air Ambulance Service uses 1 helicopter to cover Warwickshire. The Midlands Air Ambulance has three air ambulance helicopters covering the 8,000 square miles of the Midlands region, based at RAF Cosford, Tattenhill Airport.
The trust has over 400 vehicles, including patient transport vehicles, rapid response vehicles, motorcycle response units. The Medical Emergency Response Intervention Team are a Critical Care Paramedic, see Hazardous Area Response Team In times of emergency, WMAS requests assistance from voluntary ambulance providers, such as St John Ambulance. St John Ambulance provides A&E Support crews at times there is a high level of staff absence or there is an unusually high call volume. This arrangement sees SJA crews attending Emergency or Non-Emergency calls, SJA crews may treat and transport certain categories of patient, although they are expected to ask for further assistance for more serious patients. On some evenings and weekends, support for front-line crews is provided by the West Midlands CARE Team, in Herefordshire and Worcestershire, the Mercia Accident Rescue Service is available to supplement and assist WMAS crews. North Staffordshire BASICS provide similar support in the north of the WMAS region, in times of severe weather, WMAS has the ability to call on the Severn Area Rescue Association who have 4x4 ambulances.
There is a sub Hub in North Birmingham based at Solihull Hospital, Response cars are based at community ambulance stations in Dorridge and Solihull
East Midlands Ambulance Service
In 2011 EMAS received over 776,000 emergency 999 calls. EMAS have a total of 67 ambulance stations, although four are vacant, as of December 2014 EMAS have 522 ambulance vehicles, more than half of which are more than five years old. In 2013 EMAS took on 140 new emergency care assistants, in 2014 EMAS announced they were bringing back the ambulance technician role. In 2010−11 EMAS missed key performance targets after a spell brought snow. By June 2015 EMAS had failed to meet their category 1 response times for the successive year. EMAS previously provided patient transport services until contracts worth £20 million per year were taken over in 2012 by two private sector companies, in 2012−13 EMAS had a budget of £148 million. The Trust spent £4.3 million on voluntary and private services in 2013−14 for support in busy periods. In 2015 the service faced a drop in funding of around £6 million a year, in October 2014 the Trust decided to spend £88,000 on upgrading its computer equipment. Emergency medical services in the United Kingdom Official website
An explosion is a rapid increase in volume and release of energy in an extreme manner, usually with the generation of high temperatures and the release of gases. Supersonic explosions created by high explosives are known as detonations and travel via supersonic shock waves, subsonic explosions are created by low explosives through a slower burning process known as deflagration. When caused by a device such as an exploding rocket or firework. Most natural explosions arise from volcanic processes of various sorts, explosions occur as a result of impact events and in phenomena such as hydrothermal explosions. Explosions can occur outside of Earth in the universe in events such as supernova, explosions frequently occur during bushfires in eucalyptus forests where the volatile oils in the tree tops suddenly combust. Solar flares are an example of common explosion on the Sun, the energy source for solar flare activity comes from the tangling of magnetic field lines resulting from the rotation of the Suns conductive plasma.
Another type of large astronomical explosion occurs when a large meteoroid or an asteroid impacts the surface of another object. The most common artificial explosives are chemical explosives, usually involving a rapid, gunpowder was the first explosive to be discovered and put to use. Other notable early developments in chemical explosive technology were Frederick Augustus Abels development of nitrocellulose in 1865, chemical explosions are often initiated by an electric spark or flame. Accidental explosions may occur in fuel tanks, rocket engines, etc, a high current electrical fault can create an electrical explosion by forming a high energy electrical arc which rapidly vaporizes metal and insulation material. This arc flash hazard is a danger to persons working on energized switchgear, excessive magnetic pressure within an ultra-strong electromagnet can cause a magnetic explosion. Strictly a physical process, as opposed to chemical or nuclear, examples include an overheated boiler or a simple tin can of beans tossed into a fire.
Note that the contents of the container may cause a subsequent chemical explosion, in such a case, to the effects of the mechanical explosion when the tank fails are added the effects from the explosion resulting from the released propane in the presence of an ignition source. For this reason, emergency workers often differentiate between the two events, in addition to stellar nuclear explosions, a man-made nuclear weapon is a type of explosive weapon that derives its destructive force from nuclear fission or from a combination of fission and fusion. Explosive force is released in a perpendicular to the surface of the explosive. If a grenade is in mid air during the explosion, the direction of the blast will be 360°, if the surface is cut or shaped, the explosive forces can be focused to produce a greater local effect, this is known as a shaped charge. The speed of the reaction is what distinguishes an explosive reaction from a combustion reaction. Unless the reaction occurs rapidly, the thermally expanding gases will be moderately dissipated in the medium
Urban search and rescue
Urban Search and Rescue involves the location and initial medical stabilization of victims trapped in structural collapse due to natural disasters and collapsed trenches. The causes of USAR incidents can be categorised as accidental and deliberate, structural collapse incidents can comprise unstable or collapsed structures in an unsafe position. Usually collapse incidents leave voids inside the debris that can result in numerous casualties trapped under large amounts of very heavy, USAR services can be faced with complex rescue operations within hazardous environment. Incidents experience shows that people are found alive many hours and days after rescue operations commence. USAR teams in different countries may be organised in a variety of ways, USAR task forces are often categorized for standardization. Depending upon the classification of the force, there can be close to 70 positions. But to be sure a full team can respond to an emergency, a task force is often a partnership between local fire departments, law enforcement agencies and local governmental agencies and private companies.
In the United States, these can be federally endorsed teams or state teams activated through mutual aid agreements, in England, the responsibility for USAR lies with local authority fire and rescue services. Equipment supplied to them is part of a government initiative known as the New Dimension programme which provides the training, the training that teams receive is an ongoing procedure combining classes from the local fire and rescue services and government agencies. USAR task forces are expected to be totally self-sufficient for the first 72 hours of a deployment, the equipment cache used to support a task force can weigh more than 60,000 pounds and is worth more than $1.4 million US. Katrina proved the difficulty of coordinating disaster response teams from around the country when some used ICS. Gather facts and make decisions on the course of action, for example, what types of structures are involved, the extent of damage, the layout of the building involved, what hazards are present, and what rescue personnel and equipment are available.
Structural damage can be categorized as light, moderate, or heavy, sizeup is an ongoing process which should continue during all phases of search and rescue so operations can be modified as needed. Searchers should use a system or two-in, two-out system and have backup teams available. Techniques for searching for potential victims are based on identifying possible locations of victims, areas of entrapment inside damaged structures are called voids. There are several types of voids, such as the void. Voids can include spaces where victims may have entered for self-protection during a disaster - such as under desks or in bathtubs or closets, possible search patterns include triangulation, a right/left search pattern, or a bottom-up/top-down search pattern. Searchers should stop frequently to listen for noises or attempted communication from victims, trapped victims are removed and medical aid rendered as necessary
South Central Ambulance Service
It is one of 10 NHS Ambulance Trusts providing England with emergency medical services, and is part of the National Health Service, receiving direct government funding for its role. There is no charge to patients for use of the service, as an ambulance service, SCAS primarily responds to emergency 999 calls, in addition to calls from the NHS non-emergency number. The service provides a transport service for patients in life-threatening condition. The NEPTS transports patients unable to use public transport due to their conditions, patients using outpatient clinics. The Trust has a division, which provides first aid training to members of the public. It has a resilience and specialist operations department which plans for major or hazardous incidents and this includes a Hazardous Area Response Team, which responds to emergencies involving chemical, radiological or nuclear materials, as well as major incidents. The Trust trains and supports volunteer community first responders and it is the only NHS ambulance organisation in the UK to be supported by its own League of Friends, a registered charity.
This group had founded in 1982 to raise funds for the former Oxfordshire Ambulance NHS Trust. The Trust achieved Foundation status on 1 March 2012, becoming known as South Central Ambulance Service NHS Foundation Trust. In June 2011 it was named Englands top performing ambulance service, managing to respond to 77. 5% of Cat A calls within the 8 minute target time, compared to the national average of 74. 9%. In October 2011 the BBC discovered that SCAS spent more on private ambulance services to cover 999 calls than any other service in the country, on 1 March 2012, the Trust became an NHS Foundation Trust. In October 2013 the Trust accidentally published on its website a document listing the age, sexuality and it took over patient transport services in Hampshire in October 2014. In 2014 the trust held a recruitment drive in Poland to help fill vacancies, on November 1st 2016, it was announced that the trust would take over the running of NEPTS in the south-east of England from April 2017. Performance of SCAS is provided by national NHS England Ambulance Quality Indicators,1.
^ A Red 1 call is assigned to patients in cardiac arrest. 2. ^ A Red 2 call is assigned to other potentially life-threatening incidents, such as stroke,3. ^ A Red 19 call is assigned to other incidents in which patient transport is needed
Great Western Ambulance Service
It was formed on 1 April 2006, from the merger of the Avon and Wiltshire ambulance services. The ambulance service was acquired by neighbouring Foundation Trust South Western Ambulance Service on 1 February 2013 and it was one of twelve Ambulance Trusts providing England with free Emergency medical services, and is part of the National Health Service, receiving government funding for its role. The Trust headquarters was at Jenner House, Wiltshire, the Trust had one main call handling control room and two dispatch centres. The EOC in Quedgeley, was the hub for the Gloucestershire out-of-hours urgent care service, the emergency control centre for Wiltshire is located in the WES building in Devizes, as the Great Western Ambulance Service in Wiltshire is part of Wiltshire Emergency Services project. In common with all UK ambulance services, the control room triages and categorises 999 calls into three categories — A, B, and C, category A are potentially life-threatening emergencies requiring an immediate response.
Category B are potentially serious but not life-threatening emergencies, category C require do not require an emergency response and are relayed to NHS Direct, specially trained paramedics or nurses for over-the-phone advice, GP services or Emergency Care Practitioners. Below are the targets the government has set out of ambulance trusts to meet. This caused strained relations with its recognised union, UNISON. Huge numbers of ambulance shifts were covered by private agencies, in September 2008, the Chief Executive, Tim Lynch resigned. He was replaced by an Interim Chief Executive, Anthony Marsh, Marsh identified a lack of operational leadership and a competition of priorities within management and removed two Directors. In February 2009, a ceremony was held to present almost 60 staff, partner agencies, in September 2010 a specialist unit, the Hazardous Area Response Team, was established and went live after months of preparation and training. The new revamped service, operating 24/7, went live on 1 October 2010, in 2010 the trust board recommended the closure of at least one countys control room, and gave the go ahead to an Estates Review to prepare the trust for closure of local ambulance stations.
In 2009, the new executive, David Whiting, previously director of operations from East Midlands Ambulance Service, was appointed as Chief Executive. He announced his resignation in November 2010, having served just nineteen months, in December 2010, the Trust announced another interim Chief Executive, Martin Flaherty of the London Ambulance Service. When Mr Flaherty leaves, and his replacement appointed, it will be the 5th Chief Executive in only 3 years, at the beginning of January 2011, UNISON announced the results of a ballot for industrial action. From those that voted, the result was 96% in favour of taking action as a form of protest against the changes implemented during 2010. Great Western Ambulance Services Wiltshire branch is a member of the Wiltshire Emergency Services project, GWAS is supported in Wiltshire by a group of volunteer doctors who respond from home, in their own time, to incidents involving seriously sick or injured parients throughout the county. The doctors involved are all either senior GPs or hospital clinicians, the specially trained prehospital care doctors are able to supplement the skills of paramedics and other ambulance staff
Dangerous goods or hazardous goods are solids, liquids, or gases that can harm people, other living organisms, property, or the environment. They are often subject to chemical regulations, in the United States, United Kingdom and sometimes in Canada, dangerous goods are more commonly known as hazardous materials. In the United States, dangerous goods are often indicated by diamond-shaped signage on the item, its container, mitigating the risks associated with hazardous materials may require the application of safety precautions during their transport, use and disposal. Most countries regulate hazardous materials by law, and they are subject to international treaties as well. Even so, different countries may use different class diamonds for the same product, for example, in Australia, Anhydrous Ammonia UN1005 is classified as 2.3 with sub risk 8, whereas in the U. S. it is only classified as 2.2. People who handle dangerous goods will often wear protective equipment, and metropolitan fire departments often have a team specifically trained to deal with accidents.
Laws and regulations on the use and handling of materials may differ depending on the activity. For example, one set of requirements may apply to their use in the workplace while a different set of requirements may apply to spill response, sale for consumer use, most countries regulate some aspect of hazardous materials. The most widely applied regulatory scheme is that for the transportation of dangerous goods, individual airline and governmental requirements are incorporated with this by the International Air Transport Association to produce the widely used IATA Dangerous Goods Regulations. Similarly, the International Maritime Organization has developed the International Maritime Dangerous Goods Code for transportation of goods by sea. IMO member countries have developed the HNS Convention to provide compensation in case of dangerous goods spills in the sea. The Intergovernmental Organisation for International Carriage by Rail has developed the Regulations concerning the International Carriage of Dangerous Goods by Rail, many individual nations have structured their dangerous goods transportation regulations to harmonize with the UN Model in organization as well as in specific requirements.
GHS will use consistent criteria for classification and labeling on a global level, Dangerous goods are divided into nine classes on the basis of the specific chemical characteristics producing the risk. Note, The graphics and text in this article representing the dangerous goods safety marks are derived from the United Nations-based system of identifying dangerous goods, not all countries use precisely the same graphics in their national regulations. Some use graphic symbols, but without English wording or with similar wording in their national language, refer to the Dangerous Goods Transportation Regulations of the country of interest. For example, see the TDG Bulletin, Dangerous Goods Safety Marks based on the Canadian Transportation of Dangerous Goods Regulations, the statement above applies equally to all the Dangerous Goods classes discussed in this article. Australia uses the standard international UN numbers with a few slightly different signs on the back, the country uses the same Hazchem code system as the UK to provide advisory information to emergency services personnel in the event of an emergency.
New Zealands Land Transport Rule, Dangerous Goods 2005 and the Dangerous Goods Amendment 2010 describe the rules applied to the transportation of hazardous and dangerous goods in New Zealand