Nunan Jordan, Palfreyman-Jones Samantha, Milne Rebecca, Wakefield Alison
University of Portsmouth: ORCID iD: https://orcid.org/0000-0002-6187-003X.
London Ambulance Service NHS Trust.
Br Paramed J. 2020 Mar 1;4(4):40-49. doi: 10.29045/14784726.2020.12.4.4.40.
Exercise Unified Response, Europe's largest major incident training exercise to date, provided a rich environment for the emergency services to test their multi-agency crisis response capabilities. Supported by the London Ambulance Service NHS Trust, this service evaluation examined London Ambulance Service NHS Trust front line communication and decision-making via body-worn camera footage.
Twenty London Ambulance Service NHS Trust front line responders and evaluators were each equipped with a body-worn camera during Exercise Unified Response. The service evaluation aimed to: (a) produce timelines of the London Ambulance Service NHS Trust's response in order to identify key events and actions during the 'golden hour' (the crucial first hour in the care of trauma patients), the proceedings of command meetings and the multi-agency response; and (b) develop recommendations for future training and evaluations.
The service evaluation identified that, within the golden hour, London Ambulance Service NHS Trust first responders rightly and rapidly declared the event a major incident, requested resources and assigned roles. Triage crews were tasked quickly, though it was identified that their efficiency may be further enhanced through more detailed triage briefings prior to entering the scene. The command meetings (led by the Metropolitan Police) lacked efficiency, and all agencies could make more effective use of the multi-agency shared radio network to address ongoing matters. Finally, London Fire Brigade and London Ambulance Service NHS Trust teams demonstrated clear communication and co-ordination towards casualty extraction.
Successful multi-agency working requires clear communication, information sharing and timely command meetings. It is recommended that Joint Emergency Services Interoperability Principles multi-agency talk groups should be utilised more frequently and used to complete a joint METHANE report. In addition, training in areas such as communication skills and detailed briefings will enhance the front line response. Finally, body-worn cameras are shown to be an effective service evaluation tool, as a basis for promoting best practice as well as highlighting areas for future training and evaluations.
“联合应急行动”是欧洲迄今为止规模最大的重大事件培训演习，为应急服务部门提供了一个丰富的环境，用以测试其多机构危机应对能力。在伦敦救护车服务国民保健服务信托基金的支持下，这项服务评估通过佩戴在身上的摄像头拍摄的影像，审视了伦敦救护车服务国民保健服务信托基金一线的沟通与决策情况。
在“联合应急行动”演习期间，20名伦敦救护车服务国民保健服务信托基金的一线响应人员和评估人员每人都配备了一台佩戴在身上的摄像头。这项服务评估旨在：（a）制作伦敦救护车服务国民保健服务信托基金响应情况的时间线，以便确定“黄金一小时”（创伤患者护理的关键首个小时）期间的关键事件和行动、指挥会议的进程以及多机构响应情况；（b）为未来的培训和评估制定建议。
服务评估发现，在黄金一小时内，伦敦救护车服务国民保健服务信托基金的首批响应人员正确且迅速地将该事件宣布为重大事件，请求资源并分配了任务。分诊人员很快接到了任务，但发现通过在进入现场之前进行更详细的分诊简报，他们的效率可能会进一步提高。指挥会议（由伦敦警察厅主持）缺乏效率，所有机构都可以更有效地利用多机构共享无线电网络来处理正在进行的事务。最后，伦敦消防队和伦敦救护车服务国民保健服务信托基金的团队在伤员撤离方面展示了清晰的沟通与协调。
成功的多机构协作需要清晰的沟通、信息共享和及时的指挥会议。建议更频繁地使用联合应急服务互操作性原则多机构通话组，并用于完成一份联合甲烷报告。此外，在沟通技巧和详细简报等领域的培训将加强一线响应。最后，佩戴在身上的摄像头被证明是一种有效的服务评估工具，可作为推广最佳实践以及突出未来培训和评估领域的基础。
