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Over 400 medical students joined Welsh police, fire and ambulance services at a multi-agency exercise that saw four challenging road traffic collision scenarios played out over the course of one day giving them an insight into roadside response before casualties are taken to hospital.
This multi-agency exercise has been running annually for the past five years in collaboration with Dr Tim Johnson and his team from Cardiff University’s School of Medicine. Dr Johnson is the driving force behind the event and brings all the agencies together, as well as the team from Cardiff University. He is the main coordinator and responsible for the medical students during this part of their studies.
South Wales Police, the Welsh Ambulance Service and MEDSERVE, a local charity providing specialist medical response to incidents work alongside South Wales Fire and Rescue Service who host the exercise at SWFRS training centre in Cardiff. Watch Manager Richie Matthews says this exercise is an important part of student training.
“The collaboration between SWFRS and Cardiff University has grown year on year to be a first-class training experience endorsed by the British Medical Council and United Kingdom Rescue Organisation.
“By observing the exercise or by taking part as a ‘casualty’, the students get to understand how the emergency services respond to accidents like these simulated road traffic collisions so that when casualties are brought into hospital, the students know the techniques and approaches that a multi-agency response is using to safely extricate people.
“And even if they never end up working in A&E or part of the care for casualties like this, they can be active bystanders should they ever witness it themselves. It’s a win-win either way.”
Watch Manager Richie Matthews, South Wales Fire and Rescue Service.
This year’s exercise involved challenging scenarios that, Richie says, would not be possible to do in a single agency setting. Dr Beth Barton, Consultant in Intensive Care and Pre-Hospital Emergency Medicine, retained firefighter and volunteer for MEDSERVE, plays a pivotal role in the exercise and is crucial in developing the scenarios, ensuring they are relevant and effective for all participating agencies.
With a pregnant woman trapped in one scenario leading to an on-site caesarean delivery to an amputation for a trapped passenger in an electric vehicle at risk of going into thermal runaway in another, these HALO events – High Acuity, Low Occurrence – may only ever be seen by a small number of responders but they provide valuable learning for the crews.
In a recent Emergency Services Times webinar, National Fire Chiefs Council road safety lead, CFO Dan Quin joined a panel focused on changes to the way that the emergency services are extricating people from road traffic collisions. The EXIT programme is the basis of this change that focuses on removing a casualty quickly rather than the long-standing approach that focused on stabilising the spine which often led to delay.
“GM Roger Magan and his team worked with Professor Tim Nutbeam developing evidence to prove the importance of vehicle relocation to assist in reducing extrication times at scenes, implementation of the EXIT project has been embedded in the service’s road traffic collision and trauma training.
The exercise highlights all the different skill sets that the agencies bring in to improve the management of casualties. It’s so important for the students to see that cooperation at the scene and hear the conversations first hand.”
Setting up a large-scale exercise like this is no small feat and SWFRS’s training facility at Cardiff Gate is an ideal space for testing out a range of RTC scenarios with enough space for spectators.
CM George Fisher from SWFRS simulated the communication with the control room. Richie says that involving a member from control highlights the critical role of effective questioning at incidents. He explains: “This ensures the timely collection of intelligence needed by our colleagues in emergency control to support mobilisation and informed decision-making both en route and at the scene.”
Kev Dite from the SWFRS drone team was on hand to provide a bird’s eye view on the activity from 20m up in the sky.
“The beauty of the event is that we can feed in new and emerging practice. Last year we used our ten second triage tools; this year we put our new drone through its paces. Having a large screen on site with the live drone feed showed what was going on throughout the exercise, potentially proving the concept of streaming the situation live to the control room or to incident commanders remotely.”
It’s the continual references to JESIP that brings this exercise to life. During the post scenario debrief SM Jon Holmes talked to all four agencies to pick up learning, observations and information from the crews fresh from the scenario. The students also shared what it was like for them as ‘casualties.’ Doing this five times, recording it and then analysing it will provide valuable learning points for everyone.
“Jon and his team go to exercises like this to feed learning into best practice as well as what we can improve on within SWFRS. Last year we shared the feedback with our fire stations and will do this again this year.
“We will share the learning with the leads in the other services as well as the medical school at Cardiff University, keeping the JESIP principles at the heart of our approach.”
As for the students, they had their own debrief on the day, with groups going through the exercises during the day. They had all been briefed the previous week and knew what to expect. They heard from one student who had taken part in a previous exercise who said she had used what she had learned when she was confronted with an RTC. “It shows the value of doing this, understanding how we operate from roadside to recovery,” says Richie.
Every year at The Emergency Services Show, visitors get to see extrication challenges and have some exposure to how the training, procedures and equipment all align.
“What we have done here in Cardiff is helping medical students – the doctors of the future – to understand what happens at the roadside because one day they may be treating those casualties. Equally, simulation exercises like the ones at The Emergency Services Show are also incredibly useful insights for anyone working across the blue lights, whether they are operational or not.”
Richie, along with the wider team involved with coordinating this exercise, is keen to share their approach with other emergency services and welcomed colleagues from Mid and West Wales Fire and Rescue Service who observed this exercise on the day. He says that five years on, the services in this part of Wales are in a better place as they continue to work together, putting JESIP into practice and is proud that every doctor that graduates from Cardiff’s medical school from now on will have had this experience.
Find out more about JESIP by listening to the recent episode of the For Every Response podcast with JESIP national lead, David Boyle.
