hart teams in action: 8 case studies - home -...
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AMBULANCE HARTHazardous Area Response Team
HART TEAMSIN ACTION:
8 CASE STUDIES
www.ambulancehart.org
www.ambulancehart.org
BETHNAL GREEN / MILE ENDUNDERGROUND TRAIN DERAILMENTHow a HART unit provided crucial support to rescue services in theaftermath of a major transport incident.
Underground Passengers Evacuated After Derailment
Over 500 London Underground passengers were led to safety by aHART unit after an underground train derailment. The rescue,between Bethnal Green and Mile End on the Central Line, tookplace amid fears of a terrorist attack.
The London Ambulance Service HART Incident Response Unitattended the scene, along with police and other rescue services,after calls to London’s emergency operations centre.
Reports were also received of a suspect package at anunderground station and a train on fire, sparking further fears ofa terrorist incident.
The five-strong HART unit split into two groups, at Bethnal Greenand Mile End, as the three-hour evacuation of the derailed trainand other trains in the tunnel began.
The Mile End group set up a casualty holding area in a trainalready at the platform and assessed passengers emerging fromthe tunnel. Some were evacuated to ground level and others sentto the casualty area.
The HART unit also took a stretcher and oxygen equipment intothe tunnel to treat a passenger injured in the derailment.
On learning that all passengers would be evacuated via Mile End,the Bethnal Green unit were asked to manage the nearby survivalreception centre.
Both HART units were involved in setting up communications atMile End, Bethnal Green and the survival reception centre and aBritish Transport Police Chief Inspector said: “HART provided aneffective and efficient response.
“We worked very well together and other agencies wouldbenefit from the HART approach and style of engagement.They integrated well at all the correct levels and got thingsdone.”
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WAREHOUSE FIRE, ATHERSTONE ON STOURHow a HART unit gave vital support and medical cover to fire-fighters in their search for the bodies of three colleagues who haddied while attending a fire in a Midlands warehouse.
Four Fire Fighters Die in Warehouse Blaze
A HART Urban Search and Rescue team joined the search for the bodies of three fire-fighters, missing after a Midlandswarehouse fire.
The blaze, at a vegetable warehouse near Stratford upon Avon,raged for 12 hours after the alarm was raised early on a Saturday evening.
Several fire-fighters entered the building during the fire becauseof fears that workers may be trapped inside. One fireman diedafter being pulled from the blaze and three more were missingafter parts of the building collapsed.
Ten paramedics from the Yorkshire Ambulance Service HARTIncident Response Unit joined fire-fighters and ambulance teamsat the scene on the Saturday evening. And 24 hours later, theyjoined the fire brigade urban search and rescue team whilethey conducted a risk and safety check of the burnt-out building.They discovered that parts of the roof had collapsed and neededto be shored up while sections of the floor had melted.
The fire brigade built a wooden pathway, with a 30ft drop oneither side, through the wreckage and members of the HART unitjoined them to provide medical support while they made furthersafety checks.
Once the high-risk search for the missing fire-fighters began, theHART paramedics stayed inside the cordon until the three bodieshad been found and removed from the building.
They were on duty from Saturday evening until Thursdaylunchtime and afterwards, the fire and rescue operationscommander of Buckinghamshire Fire Service said: “We werevery happy to have HART there. They worked in a positive,collaborative way and had no problems working within oursystems and procedures. It worked very well.
“The fire brigade urban search and rescue teams did feel saferhaving the HART paramedics on the scene in case anyonerequired treatment.”
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ROYAL MARSDEN HOSPITAL FIREHow a HART unit provided vital information as fire devastatedone of the UK’s leading cancer hospitals.
Over 1,000 Evacuated As Fire Sweeps Cancer Hospital
Over 1,000 patients and staff were evacuated when fire sweptthrough the top floor of London’s Royal Marsden Hospital, oneof the UK’s leading cancer hospitals.
A four-strong team from the London Ambulance Service HARTIncident Response Unit was on the scene minutes after the alarmwas raised. They gave rescue services vital help in ensuring thesafety of evacuated patients.
The 80 in-patients who were evacuated included people whowere undergoing operations when the fire broke out and alsopatients from the intensive care unit. At first, they were takento Royal Marsden’s reception area, awaiting transfer to otherLondon hospitals.
However, the waiting area was downwind of smoke from theblaze and, after consultation with the HART unit, an alternativeentry route was used so that patients would suffer less exposureto smoke as they were transferred to ambulances.
HART were also worried that scanning equipment in the hospital’s x-ray unit could represent a serious health risk in theevent of a radioactive leak. And they feared that the fire might be contaminated with asbestos from the roof of the 146-year-oldbuilding.
Members of the unit, wearing breathing apparatus, were onstandby for four and a half hours, prompting a LondonAmbulance Service officer to say:
“HART were very helpful. It is important to be aware of whatthey have to offer. They enhance the ambulance service responseand it’s nice to know they are available.”
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DOW CAVE RESCUE, KETTLEWELL,YORKSHIREHow a HART unit helped to rescue teenagers trapped by risingwater in a cave in the Yorkshire Dales.
Teenagers In Cave Rescue Drama
Eleven teenagers trapped in a cave by rising water were rescuedafter HART paramedics were called to a remote North Yorkshirevillage.
The two HART specialists worked alongside local fell rescuevolunteers and teams from the other rescue services to free thestudents, aged between 16 and 18.
The incident began after the two group leaders in charge of theteenagers had escaped from Dow Cave, near Kettlewell, andraised the alarm. The USAR paramedics, members of the YorkshireAmbulance Service HART team based near Leeds, reached therescue rendezvous point two hours later.
Then, guided by a rescue service volunteer, they arrived at thecave entrance after a trek across three-quarters of a mile ofmuddy terrain in poor light, high winds and rain.
They learned from the rescue service paramedic at the scenethat the teenagers, including a diabetic, were all suffering fromvarying degrees of hypothermia and one had sustained a backinjury.
After being released, they were given an on-the-spot assessmentby the HART paramedics and then escorted by rescue volunteersto the rendezvous point.
There, they were given soup and warm blankets before beingtransferred, in a 4x4 vehicle, to the incident room in Kettlewellfor a full medial check-up.
Afterwards, the controller of the Upper Wharfedale Fell Rescuesaid:
“I wanted to make sure everyone was given a quick health checkas they emerged from the cave but this could have taken a longtime with just one paramedic.”
“Having the HART paramedics meant they were checked quicklyto make sure they were OK to walk to the 4x4 before beingtransported to the incident room.”
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ARENA AMMONIA LEAKHow a HART unit played a leading role in treating patientsand managing the scene after an ammonia leak at a majorLondon venue.
Arena Staff Treated After Ammonia Leak
One of London’s biggest entertainment arenas had to beevacuated after an ammonia leak. A six-strong HART unit was on hand to treat and advise patients and to manage the scene of the incident.
The London Ambulance Service HART Incident Response Unitattended the venue after a call to the LAS emergency operationscentre. They discovered that six security guards had been exposedto ammonia vapour while evacuating staff from the building.They were given oxygen from HART’s portable mass oxygendelivery system.
A member of HART also treated another 30 staff and, afterconsultations with Health Protection Agency personnel, warnedthem about the potential effects of inhaling ammonia vapour.
HART personnel recommended that all the evacuated staff shouldgo to hospital for further checks.
Throughout the three-hour incident, the HART unit was involvedin triage and treatment of patients and fulfilled other leadingroles in managing a major incident.
Afterwards, the ambulance service’s tactical support officer said:
“In the early stages of the incident, the HART unit took on thecommand structure of parking, clearing and loading. This led tosmooth incident management. This is really important becauseif you don’t get people in those roles quickly, the incident runsaway with you.”
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6CARBON MONOXIDE INCIDENT ATGO-KART TRACKHow a HART unit helped identify carbon monoxide poisoning asthe cause of multiple illness at a Go-Kart meeting…and treatedaround 60 patients.
Pregnant Woman Among Fans In Go-Kart CarbonMonoxide Scare
The cheers turned to fears when over 60 go-kart enthusiasts,including a pregnant woman, were affected by carbon monoxidepoisoning.
Reports that over a dozen spectators were feeling unwell at atrack in south-east London were received by London AmbulanceService’s emergency operations centre on a busy Friday night.
They immediately called up the ambulance service’s HART IncidentResponse Unit. The five-strong team arrived at the track sevenminutes later to find people complaining of dizziness, nausea,vomiting and headaches. Spectators were evacuated.
The HART unit carried out on-the-spot assessments of people whowere unwell and provided medical cover for the fire brigade’s rapidresponse team, who were carrying out a sweep to detect the sourceof the problem.
The condition of around 60 patients was assessed by the team, whosuspected carbon monoxide poisoning to be the likely cause of theproblem. Those showing the more serious symptoms, including thepregnant woman, were sent to hospital.
Meanwhile other members of the HART unit, wearing protectiveclothing and carrying CO monitoring equipment, worked alongsideLondon Fire Brigade’s Rapid Response Team while they establishedthe cause of the incident and to ensure the building had beencompletely evacuated.
When carbon monoxide poisoning was confirmed, HART administeredoxygen concurrently to nearly 40 patients using their portable massoxygen delivery system. Because of the large number of patientsneeding treatment, HART personnel advised their emergency operationscentre to arrange for several local hospitals to be on standby.
Two patient transport vehicles were used to take patients to hospital,leaving ambulances in the vicinity free to attend other emergencies.
When the four-hour operation was over, the ambulance service dutystation officer said: “The HART unit were fantastic, invaluable.Their presence meant I didn’t have to declare a major incident which,on a Friday night, would have really depleted the service.”
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7HOSPITAL WHITE POWDER INCIDENTHow a HART unit helped rescue services to handle acontamination scare at a London hospital.
Hospital All-Clear After Contamination Scare
A HART unit went to the scene when two wards at a Londonhospital were closed after a contamination scare.
The alarm was raised by London Ambulance Service crews basedat the hospital in south-east London. They reported that a womanwas dropping handfuls of white powder on to the floor of theA&E and outpatient wards, sparking fears that the area and thosepresent could be contaminated with this unknown substance.
Personnel from the London Ambulance Service HART IncidentResponse Unit were quickly on scene and set up a cordon aroundthe two wards. They advised the emergency operations centre todivert ambulances away from the hospital and switched off theair conditioning to prevent any further contaminationby this route.
Wearing protective clothing, a member of HART joined a teamfrom the police decontamination unit as they entered the cordonand conducted a DIM sweep. He was able to assess the conditionof around 25 people, including patients, medical staff and porters,inside the cordon and was also on hand to provide medical coverfor members of the decontamination unit.
Police eventually discovered that the powder was, in fact, amixture of salt and disinfectant and posed no threat to health.A psychiatric patient with a cleaning obsession was later takeninto police care.
The HART unit acted as cordon control throughout the incident,which lasted almost three hours, and a hospital spokesman saidafterwards:
“Over the last year, we have had HART support in two chemicalincidents. They were professional, knowledgeable and had veryquick response times. We would wholeheartedly support thecontinuing existence of the HART team.”
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DEAN FARRAR STREET BUILDING COLLAPSEHow a HART unit provided vital clinical expertise to police andrescue services inside the inner cordon of a major incident.
Trapped Worker Rescued After Building Collapse
A senior London Ambulance Service officer praised HART after aconstruction worker, trapped when the top floor of a four-storeyLondon building collapsed during renovation work, was freed.
The worker, who did not speak English, was pinned under heavygirders, trapping both his legs and one shoulder, when the floorgave way after the removal of a supporting wall.
Police and fire brigade rescue services immediately set up an innercordon or ‘hot zone’ around the unsafe structure and were joinedby staff from the London Ambulance Service HART IncidentResponse Unit.
“HART took our work on to a level that I had not previouslyexperienced in 18 years’ service at the time of the incident,”said the officer, who was on site during the nine-hour rescue.
“I view their contribution to the health and safety of communitiesin London to be invaluable and support any future expansion oftheir service in London and nationally.”
The HART unit’s first task on arrival was to establish on-sitecommunications with other emergency services via UHF radios.
Then, after initial safety measures to shore up the building had beencompleted, the fire brigade’s urban search and rescue team beganto work their way through the rubble towards the injured man.
They were joined in the inner cordon by a member of the HART unit.Using a microphone and speakers, he talked to the patient throughan interpreter and made an initial assessment of his condition.
Working alongside the fire brigade team, two members of theHART unit, roped together with a safety line, then reached theinjured worker via the roof.
They conducted regular medical assessments and were able to advisethe Fire USAR of the likely impact of various release strategies onthe patient’s health.
HART were also in regular contact with the Helicopter EmergencyServices doctor, giving him an estimated time of release. When thepatient was eventually freed, a member of the team immediatelyinserted two intravenous lines and administered oxygen.
Once outside the inner cordon, the patient was ventilated, givenanaesthetic via one of the IV lines and taken to hospital.
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THINKING OF JOINING THE HART TEAM?If you’re considering joining the HART team in your ownNHS ambulance trust, visit the recruitment section of the
www.ambulancehart.org website.
You will be able to find out about the application processand see more about what the job entails.
You can also use the website to sign up to the regularHART e-newsletter.
USEFUL HART CONTACTS
Russ MansfordStrategic Ambulance Adviser (and HART Project Lead for DH)
Department of Health Emergency Preparedness DivisionEmail: [email protected]: [email protected]
Hilary PillinHART Programme Manager
Email: [email protected]
Jamie FountainUSAR Programme Lead
Email: [email protected]
Richard McKeandHART Project Lead (Vehicles & Equipment Procurement)
Email: [email protected]
Dr John StephensonHART Clinical Sub-Group Lead
Email: [email protected]
Seamus ElliottHART Human Resources Sub-Group Lead
Email: [email protected]
Dave BullHART Education & Training Development Sub-Group Lead
Email: [email protected]
Carl ReesHART Communications and PR Lead (Media Enquiries)
Email: [email protected] Publ
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