Commission report on our prehospital here in Quebec It's in French ! ? This the Gvt site http://www.msss.gouv.qc.ca/f/documentation/publicaune.htm The Report 334 pages, 1,8 mg ftp://206.167.52.6/acrobat/f/documentation/2000/00-834.pdf The Resume 64 pages, 918k ftp://206.167.52.6/acrobat/f/documentation/2000/00-834-2.pdf Now for you UK cowboys In a realy much less serious line A bit of slosh journalism... Bring us back to these Medics ? And the importance of Medical Director ? Wich existance is never mentioned anywhere... ? And I thought you guys out legislated us by miles ! http://www.bbc.co.uk/scotland/frontline/archive/ambulances.shtml FRONTLINE SCOTLAND "AMBULANCE CHASING" REPORTER: Susan Donald PRODUCER: Murdoch Rodgers ASSISTANT PRODUCER: Judith Ahern SUSAN: Private ambulance services are now big business, but are we safe in their hands ? We've discovered disturbing evidence of paramedics who are untrained, unqualified and unsafe. They may look the part but it could be your life on the line. ALICE MILLER: Just at the point when we were between a jump and the wall I came off ... my horse avoided me with three of the feet and the fourth one just landed in my stomach. MARGARET TAGGART: I was scared she was dying. I felt there is nobody here helping me, I have to keep this child together until we get to somebody that can help. ALICE MILLER: It's a life and death situation, you're talking about half a ton of horse maybe landing on top of you. MARGARET TAGGART: They had no stretcher, they had no ambulance, Northern Paramedics just literally waved his hands in the air, he was useless. SUSAN: If you dial 999 after an accident you could have a fully qualified paramedic at your side in minutes. He will have been trained by the NHS for a minimum of 3 years and can be trusted to save your life. But there's a new breed of paramedic on the streets who can't always be trusted. Increasingly, organisers of privately run events from gymkhanas to go-kart meetings are hiring the cheaper services of private paramedics. There's nothing to stop anyone from setting themselves up as a private ambulance service or calling themselves a paramedic. They need no qualifications at all. As we've discovered, some people's lives have been put at risk. Geoff Young of Northern Paramedicals This is Geoff Young, director of Glasgow-based Northern Paramedicals Services Limited. He set the company up with his wife, Catherine in 1992. Mr Young claims he has a number of medical qualifications, and boasts that his private ambulance company is the most specialised in Scotland. He runs a fleet of 6 ambulances which provide equipment and drugs to cater for any kind of incident from dealing with cuts and bruises to life-threatening emergencies. Though you could not get a stretcher in this one. In recent years, Northern Paramedicals have provided medical cover at hundreds of showjumping events all over the country. They were on duty at Muirmill International Equestrian Centre in Ayrshire the day Margaret Taggart had a horse-riding accident in February 1994. Geoff Young himself dealt with her injuries. Margaret landed on her head and got the full weight of her horse on the left side of her body. MARGARET TAGGART: With the speed we were doing she launched me out of the saddle. I came down over the fence in front of her and she literally landed almost on top of me, as I was lying on the ground I could see her coming down on top of me... and the paramedics that were on, one of them came over. He sat me up and even although I was complaining that my neck was sore, I'd no feeling in my legs, my arm felt as if it was on fire, I literally thought I'd broken my arm at the elbow... eh.... he sat me up and I just felt I was going to be sick and I was going to pass out. My husband kept saying "keep breathing slowly, slow your breathing down and concentrate, talk to me, keep speaking to me" to try and stop me from passing out. The paramedic literally told me just to pass out, he said "it's the best thing you could do just you go ahead and pass out dear". After giving completely the wrong advice Geoff Young left the arena to get something to relieve her pain. He came back with cylinders of gas and air. MARGARET: He brought his equipment and then said that it wasn't working. So I was literally still left lying there... oh it must have been in total fifteen minutes. My husband had to then carry me out of the arena because there was a competition going on and I think people were getting a wee bit frustrated at this time because nothing was being done. So my husband carried me out the arena, I was sat in a chair where the paramedic came up with a safety pin and said "pin her arm to her .... her coat arm to her jacket lapel, and never mind about the charge for the safety pin, you can give me it back another day". SUSAN: So, Northern Paramedicals had no ambulance, no neck brace, no stretcher, and not even a sling. Margaret's husband was forced to take control and drive her to hospital. MARGARET: The nurses came rushing out, they couldn't get me out the car because I couldn't move, so they brought a wheelchair and then they took that away again because they thought there's no way we can get her into a wheelchair. They then brought out a trolley and had to try and get me out and ....between four of them out of the car on to this trolley. SUSAN: Why couldn't they get you out of the car? MARGARET: I just couldn't move my pelvis or my legs.... em... they had to X-ray me literally from head to toe. We asked the Consultant in the Accident and Emergency Unit of Glasgow Royal Infirmary, who trains NHS paramedics what he thought of Margaret's treatment. RUDY CRAWFORD: It is well recognised in emergency medicine that equestrian injuries if they occur have a potential for very serious and life threatening injury, so it would be very important in that situation to go through the simple.... you know... simple A B C's which means airway, breathing and circulation, and also to be aware of the potential a) for a serious head injury and b) for a serious neck injury. So the patient would have to be treated very very carefully and not moved until the neck was properly immobilised. SUSAN: So in fact then they should have had some kind of neck brace for this woman? RUDY: Yes they should have their neck stabilised at the earliest possible moment and they shouldn't be moved until the.... until a collar and possibly sandbags and tape are applied, because in that situation you could sustain a broken neck and you know.... the golden rule is to assume that that injury is there until a doctor has excluded that. So they should be treated as if they have a broken neck in fact. SUSAN: And would you have expected any paramedic to have a stretcher as well? RUDY: Oh absolutely. I mean a patient like that would have to be immobilised and then carried off on the stretcher, and we would expect on arrival at hospital that patient to be brought in on a spine board with a collar, sandbags, tape and eh... being given oxygen. SUSAN: Alice Miller was 15 when she was thrown from her horse in a show-jumping competition in March last year. She suffered serious internal injuries when the horse stepped on her stomach. Northern Paramedicals were on duty again. The paramedic did nothing at all, not even basic first-aid, forcing Alice's mother to take charge. Luckily for Alice, her mother is a qualified doctor. ALICE MILLER: I remember these was a second when his feet were over me and I thought he'd gone...... you know I thought it was going to be OK, he was going to go past... em... and then just the last one came down... down on my stomach... em... I remember everyone coming, running over, asking me if I was OK and stuff. ALICE'S MOTHER: Watching her come off the horse and saying how she fell and how she landed and the fact she didn't move I knew she was hurt... my first sort of reaction was hold her hand, feel her pulse which was not easy to feel at that point. I wanted her out of there and away to hospital as quickly as possible. There was no question that she needed to be in hospital quickly and my next sort of reaction was ... where is the help and... the guy was there beside me but he was flapping around.... a bit scared himself, ... I felt that he was scared... I was very scared. ALICE: I heard her panicking, she said you know... she was screaming for someone to get an ambulance here now, and that was when I realised it must be something bad if she was panicking, you know... it must be something really bad because I hadn't really thought about what it was or anything you know... I just knew that it was sore and it was there.... SUSAN: Northern Paramedicals did have an ambulance there but the paramedic refused to use it because he was on his OWN! a 999 call was made, but precious time had been lost as Alice lay bleeding internally. RUDY CRAWFORD: As far as I'm concerned that's just complete and utter incompetence. I mean that's obviously a very serious and potentially life threatening injury and ... eh... it's very important that people in those situations get skilled treatment you know... at the earliest possible moment. SUSAN: Alice could have bled to death. Surgeons discovered that her liver had been ruptured by the horse's hoof. She needed 5 litres of blood and spent 4 days in intensive care. She has now made a full recovery unlike her riding instructor, former international showjumper Nadine Warwick, who suffers great pain after a riding accident. She had to rely on Northern Paramedicals as well. She knew immediately her leg was broken and that the break was serious but Northern Paramedicals again did everything against the book, providing no stretcher, no ambulance and no splint. They didn't even notice her leg was broken. NADINE WARWICK: The paramedic who was in front me I can remember kept saying to me "can you move your foot?", and I said "yes I can move my foot, but there's something wrong, it's just so painful", and he says "well you can't have broken anything because you can move your foot", and I said "well I haven't broken anything I have never been in such pain in my life and if you don't do something very quickly I'm just going to pass out". When they got me in the upright position I really knew there was something then because it was like wobbling, it was like jelly the top of it... and I said to them "there's something wrong, it feels like jelly, it feels as if it's moving". SUSAN: Once again Geoff Young's paramedics were unable to cope. Nadine was driven to hospital by her husband where x-rays confirmed her fears. Her leg was broken in 2 places. The consultant inserted 4 pins and a plate which has left Nadine with a limp. It's unlikely that she'll ever represent Great Britain in international show-jumping again. NADINE: It was pretty awful laying there thinking about how long you were going to be off, because they said "this take a year to heal"... em... " you mightn't ride for another two years, it could leave you with a really bad limp", and this was all too much to take in. This is the man who treated Nadine. He still works for Northern Paramedicals. We secretly filmed him at a recent go-kart meeting in Larkhall. He claims he's a qualified paramedic as well. NADINE: He just didn't think it was that serious, and he just kept saying to me "well I don't think anything's broken, I think it's just a really bad bruise on the muscle" SUSAN: Have you ever seen him again? NADINE: Yes I saw him when I did come out of hospital and em... I was at a horse show watching, I was still on the sticks obviously ... it was about four weeks later, and he came over to me and he said to me "well how are you?", and eh... he said "I don't know how I missed that", he said "I just really don't know how I missed that injury" and I really felt like hitting him, I felt like grabbing him and punching him or something... because I kept telling him there was something wrong. RUDY CRAWFORD: Even a first aider would try to make an assessment of the injury and eh... if they suspected a fracture they would then immobilise that leg either by bandaging or by splintage, and then transport the patient as a stretcher patient. SUSAN: In this situation the paramedic had no idea that her leg was broken and this woman had to be transported to hospital in her husband's car. RUDY: Well... well from what you tell me I mean that's completely inappropriate and really beggars belief... you know... I think they would have been far better to have dialled 999 and called an ambulance. SUSAN: Then at least you know you're getting qualified professional...they seem to be the only people not taken in by Geoff Young. Grace Peffers is employed as an occupational health nurse at Glasgow's SECC. She met Geoff Young at the European International Show-Jumping Championships held there in 1994 where Northern Paramedicals were providing medical cover. They discussed how they would deal with any emergency that might arise. She was alarmed by some of his comments. GRACE PEFFERS: The first impressions were that he appeared quite confident, but then he started to talk about what he would do in the event of someone having a serious injury, in particular a head injury.... and he indicated that he would em... scramble one of the ambulance services helicopters and well.... I'm pretty sure you know... that it's only Scottish Ambulance Service people who can do that, so I thought that that was a bit strange. All our staff were instructed that if there was any problems at all, if there was any medical problems that I had to see... see the person or deal with it and make sure that all our records were kept up to date. And one of our first aid staff had witnessed Mr Young giving an inhaler to someone, and I was concerned about this because an inhaler is a prescribed medicine, and there was no doctor about that had prescribed this medicine so... I asked him about that. JUDITH: And what did he say to you? GRACE: He didn't have any comment to make about it really. He came at one point and gave me a piece of paper with some details on it... em... a piece of scrap paper with some details on it, which was not really... not really professional as far as record keeping's concerned. SUSAN: But his publicity material seems very professional with lists of drugs and equipment his ambulance staff carry. But are they entitled to use them ? RUDY CRAWFORD: I was very impressed by the comprehensiveness of it, but unfortunately I felt it was too comprehensive because there are drugs on that list and equipment on that list that ....that the paramedics in this area are not allowed to use. The paramedics here, as well as being trained by us also operate to very strict protocols which are agreed with the medical profession, with the Health Service and the Ambulance Service... em... and you know... a lot of the items I saw on that list would not be available to paramedics in this area. SUSAN: And why is that? RUDY: Well because they're very dangerous and they require you know... additional skill, additional knowledge and training. There's one drug in particular which can sometimes be given to severe asthmatics by intravenous injection, and in the wrong hands that could actually kill someone if inappropriately used. There are items of equipment there such as chest drain equipment which again involves a surgical procedure to put a drain in to a chest and I would be very unhappy about any paramedic using that, never mind an unqualified person. SUSAN: So how do they get away with it ? Anyone with medical knowledge can tell the difference between real and bogus paramedics. But most of the people hiring Northern Paramedicals for public events don't have medical training. The publicity material that Geoff Young puts out makes them sound like a well-trained and equipped organisation - and they're considerably cheaper than NHS- trained paramedics. What about Mr. Young himself ? He's a member of the Children's Panel in Glasgow. So well respected is he that he was appointed Chair of the Scottish Youth Drugs Working Group last summer. His credentials seemed to be so impressive that on behalf of the Crown Office he carried out Post-mortem X-rays for a time. And that's not all. The list of people he's conned is extensive, especially since he's moved into the film world, 17 film and television productions last year alone. STV use them and so do the BBC. On the night they filmed this Northern Paramedics were on duty. BAD BOYS extract....... So how does he tout for business?. We wanted to hear his sales pitch for ourselves and pretended to organise a bungee jump for charity. Extracts from the telephone call FRONTLINE: What do you do? GEOFF YOUNG: We do anything.... FRONTLINE: Right .... GEOFF YOUNG: Yes absolutely anything from raves through to motorcycling and showjumping and oh you name it and we get involved with it... FRONTLINE: Right.... YOUNG: The dafter the better.... we sort of sit around in terms of qualification and things... a similar level if not higher than the Scottish Ambulance.... FRONTLINE: Oh right.... YOUNG: em.... we do about six hundred events a year.... FRONTLINE: Oh well that's quite a lot actually isn't it.... YOUNG: Oh it is.... and there's twenty eight of us... FRONTLINE: Right.... Oh that's quite..... YOUNG: Four doctors and we.... sort of ... whoever's available will turn out, but I can certainly put you down on the list and as far as I'm concerned that's it done. FRONTLINE: Is it first aid that you have? YOUNG: There would be at least one paramedic there... FRONTLINE: Right.... YOUNG: At least one paramedic ... with all the appropriate equipment .... em... as I say and an ambulance that would use for transporting if necessary. We carry equipment that Scottish Ambulance don't carry.... because the number of times that they would need it you know... during the course of a shift are few and far between because most of the stuff that they do is not sort of specialised injuries like we handle. SUSAN: So what training does HE have to cope with these specialised injuries? We hit problems when we started to check out Geoff Young's medical qualifications. Despite the claims made in his CV that he is a qualified psychiatric nurse, a State Registered Nurse and a Registered General Nurse, we checked with the British Register of Nurses, who said they had no record of Geoff Young. We also found no trace of an ordinary or a Masters degree with the Open University. All very curious. Next stop Mr Young's headquarters in the south side of Glasgow. SUSAN: This is the address of Northern Paramedical Services Limited and we believe the home of Geoff Young and his business partner and wife, Catherine Stevenson. Mr Young has refused to be interviewed by us so we thought we'd come and ask him in person questions about his medical qualifications. Expensive nameplate - Northern Paramedical Services and Medical and Forensic Screening. SUSAN: That's the company that provided the Crown Office with X-rays. It was struck off the register of companies in October last year. We tried several times to contact Mr Young.... There was no answer this time.. ..or the next time... Well either he's not in or he's not coming to the door. or the time after that.... What's left? we did have one piece of paper which seemed to show that Mr Young DID have a medical qualification Legally, there's nothing to stop you setting up your own private ambulance service and no organisation you MUST register with, but Geoff Young does use a certificate of membership of an organisation called Paramedic UK. This is to signify that Mr G T Young having fulfilled the educational and clinical standards as required by the Council is duly registered with all rights and privileges appertaining thereto as a registered emergency medical technician. But Paramedic UK doesn't train paramedics. So who checked Mr Young's qualifications. We asked the man whose signature is on the certificate. PROF ANTHONY REDMOND: The certificate is not a qualification, it is a certificate of membership. I was prepared in my capacity you know... to volunteer and support these people to sign a specimen document, and on trust and in good faith.. I expected it to be used appropriately. SUSAN: Who to your knowledge checked that Geoff Young had the qualifications necessary. REDMOND: To my knowledge it should have been Sean Ekberg and his staff. Shaun Ekberg runs the British Association of Emergency Medical Technicians and ran its fore-runner Paramedic UK. To gain entry proof of medical competency was required... Had he checked Mr Young's qualifications? SHAUN EKBERG: We took up the references that he gave em... which was the nurse who is the senior clinical nurse in em.... in a Lancaster hospital... and em... I asked him about Geoff Young principally to get him into the membership and he said "yes this chap's kosher, he's a good egg and he is a nurse" and has worked he thought at Leeds, and has also worked for the Manchester Health Authority as a nurse advisor. I have a copy of the competency certificate that was signed and I'm quite satisfied that the competency certificate is accurate. Not according to the man who supposedly signed it: Stuart Westbrook. He's written to Frontline to tell us that this signature is a forgery and that Stuart Ekberg never contacted him about Geoff Young's membership in 1992. EKBERG: Your method of interrogation has obviously got Mr Westbrook rattled... em.. and I would... I forgive him for the fact that he is backtracking, but that is Mr Stuart... eh... Mr Westbrook's competency certificate, that is his printing, that is his handwriting and I did check with Stuart. SUSAN: Young submitted a second competency certificate nearly four weeks later, signed by a Doctor Teanby. Dr Teanby's written to Frontline to say THIS signature is a forgery. Approached by Geoff Young at the time, he'd refused to sign it. EKBERG: I didn't directly check at that time with Dr Teanby because I felt the signature was a reasonable match, I felt that he had come with a reasonable reference from his initial referee. So, first March 1993, Mr Young gets his certificate. Well and good, but to renew his membership in 1994, he has to submit a new competency certificate. Now based in Glasgow, Young produces one signed by Charles Allister, a Consultant at Paisley Royal Infirmary. Mr Allister's written to us to say his signature is a forgery... Did Mr Ekberg check THIS certificate? EKBERG: At this instance I personally tried to contact Dr Allister and he was not available for whatever reason. Part time administration then... em... all I can say is that eh... I didn't follow it up and neither did my part time staff follow it up... so.... yes we were at fault. SUSAN: Did you write Dr Allister a letter? EKBERG: No we didn't. And he didn't contact Mr Allister in 1995 either when Young produced another competency certificate signed by the Paisley Consultant. That is another forgery. Mr Ekberg cited this certificate in February 1996 as proof that Geoff Young was a bona fide paramedic in a letter to the Secretary of an Injured Riders Charity, Jane Pelly. An incredible statement, since Mr Ekberg claims to have discovered four months earlier that all Young's nursing qualifications were bogus. We asked Mr Ekberg to explain his letter to Jane Pelly. EKBERG: That is my wording.... and I don't believe that is on my headed notepaper, that is a .... that is eh... not accurate notepaper. SUSAN: So are you going to tell me this is a forgery too? EKBERG: Eh... I'm going to tell you that eh.... we wrote that on Paramedic UK notepaper when we thought it was ... the wording is on Paramedic UK notepaper I believe.... and I believe... and eh.... and this has been transposed on to BAEMT notepaper. SUSAN: And who would have done that? EKBERG: Eh... well... SUSAN: Well Jane Pelly wrote the letter to you and I've seen the original... Mr Ekberg what kind of organisation are you running when there seem to all these forgeries and all these mysterious bits of paper that you say you know nothing about. EKBERG: eh.... no.... not all these mysterious bits of paper... this bit of paper... em... I have to say that we are running a very small association. We have a thousand members, em... at the time of all this hasheny going on... it was a voluntary run association with small.... with a small turnover and small part time staff... I will admit that we have made a mistake with Geoff Young, and that is the .... we have not made a mistake through malicious intent, we've made a simple honest mistake from a man who was a professional conman. SUSAN: Three days later in a fax to Frontline Scotland, Mr Ekberg admitted writing the letter to Jane Pelly confirming Young's qualifications, but said he had no explanation why... "it was a total error." SUSAN: So there we are then, four different certificates but no one who'll actually admit having checked Mr Young's medical capabilities. And this is precisely what critics say is the problem with private paramedics in Great Britain today. There are no minimum standards and no proper checks and qualifications. The British Medical Association is calling for a legal definition of paramedics. They're deeply concerned by stories of cowboys in yellow jackets masquerading as paramedics up and down the country. Just how many Geoff Youngs are there out there? RUDY CRAWFORD: I think that the National Health Service Training Directorate should be the standard that everyone should work to as an absolute minimum. Those are the only paramedics that we would recognise and call paramedics. I think it's a terrible anomaly that people can take a vehicle and call it an ambulance and there is no regulation for that sort of thing... Even taxi drivers have to have a licence. It's quite clear that these people are in it for one reason and that's money, and therefore they wouldn't appear to have any ethical principles or standards that the other professions and people who work in the Health Service have. When money is the bottom line care goes out the window. MARGARET TAGGART: Nobody that showjumps has any faith in Northern Paramedics. There are parents taking their children to pony shows and these people are dealing... are having to deal with any accidents that happen, and if my child fell off a pony and it was the Northern Paramedics that were dealing with it, I would be really really worried. ALICE MILLER: I feel very very angry that there was someone there that wasn't properly qualified and it could have been risking my life, that I could have been em... that I could have bled to death there because they didn't get an ambulance there quick enough. And that is wrong, and I would hate to think of that happening to anyone else and I think there should be something done about it now. ENDS/ ------------------------------------------------------------ Free Web Email & Filter Enhancements. http://www.freewebemail.com/filtertools/ ------------------------------------------------------------