Original article hosted on: Rapid HART response to Jersey building collapse - NARU
For this year’s International Paramedics Day we offer an insight into what specialist paramedics do in the event of highly challenging incidents. The collapse of a block of flats on the Channel Island of Jersey last year required a fast and coordinated response from emergency services. Working closely with HM Coastguard, the fire service and other emergency partners, the National Ambulance Resilience Unit (NARU) sprang into action at dawn on a Sunday to despatch a team of highly trained paramedics skilled in working in the most hazardous environments.
The peace and tranquillity of Jersey was violently disrupted when a suspected gas explosion destroyed a three-story block of flats in St Helier on 10 December last year just before 4 am. That triggered a coordinated race involving multiple agencies to rescue survivors from the residential building.
Sadly, there were no survivors and ten people were killed that night. But the search and rescue operation launched rapidly in the hope of saving lives illustrates the kind of challenges that NARU and NHS Hazardous Area Response Team (HART) operatives face every day.
Due to the need for interoperable capabilities, NARU was informed at 6am of the incident through a standard METHANE message setting out the bare facts followed by images showing the collapsed building. At this point NARU’s on call team convened a multiagency response group and, due to the need for a fast response, this was formed to avoid wasting valuable time coordinating experts to convene at a set location.
This group initially consisted of NHS England’s National Operations Centre, South West Ambulance Service, and authorities in Jersey. Later this group would also include HM Coastguard, army representatives and local police.
“We established quite early on that, because this was a collapsed building, mutual aid and specialist skills would be required including healthcare in confined
spaces, managing unstable terrain and working at height.” says Parsyab Khan, NARU Planning Manager. Pars has been a paramedic for 28 years.
These are skills that front line operational paramedics are not trained in, nor do they have the specialist PPE and other equipment needed to work effectively and safely. A six-strong HART team with commanders, was initially sent by SWAST and later backed up by staff drawn from the London Ambulance Service, West Midlands Ambulance Service (WMAS) and South West Ambulance Service (SWAST) was flown to the site by HM Coastguard helicopter.
With almost 300 HART assignments each week, NARU uses a real time dashboard that monitors all HART activity around the country and makes decisions to ensure no one area is left without this vital capability.
The team, which is self-sufficient, in the initial twenty-four hours of the incident, arrived at 11:50 on the Sunday to assess the situation. Working with local assets on the ground including authorities in Jersey and the island’s fire and rescue service using search dogs, the team fed back regularly into what was two 18-hour days – Saturday and Sunday - overseeing the search and rescue operation.
The control team on the mainland identified an appropriate battle rhythm of meetings and reporting times so that the operation could be rigorously managed. At the same time, staff rotation had to be planned to ensure operatives could be rested and replaced where needed and appropriate, as the search was continuous and an intense operation over the whole weekend.
HART teams around the country are trained to the same standard using the same PPE so necessary shift changes meant minimal disruption to the actual operation on the ground but each HART unit which provided staff would have to be backfilled, which was organised by NARU.
“The pictures we were sent showed the collapsed building, which obviously posed difficult and risky access and recovery challenges as our team and the Jersey Fire & Rescue Service on the ground worked to identify any signs of life.”
At the same time, the NARU team, in consultation with NHS England, on the mainland had to consider alternative hospital provision for survivors, collaborating with the team on the mainland.
“This is important because we have to plan ahead so that we avoid overwhelming local hospitals,” Pars added.
“The HART team on the ground’s role is to identify any patients and provide immediate first aid and identify a way to evacuate any survivors for possible healthcare in hospital.”
JESIP principles, designed for effective joint working throughout incidents, were applied throughout to ensure speedy, relevant, and accurate information on patients is communicated to improve clinical outcomes where possible.
Another challenge was not only transporting the operative and kit to the scene, but also managing the rotation so staff are adequately rested over what was a period of intense activity. That was followed by the logistics around transporting operatives and equipment back to the mainland, because once the operation moves from rescue to recovery, life is no longer at risk and the HM Coastguard is not involved, which meant identifying private aircraft or ferries.
“This was a test of NARU’s capabilities – particularly because it was not on the mainland and required multiple skill sets and equipment including working on unstable terrain and confined spaces with the added danger of associated hazards.”
Recovery was then handed over to SWAST from Sunday at midnight.
“This was a challenging assignment. But it was good to see all the HART training prove effective, the interoperable capabilities evaluated and delivered as well as all agencies applying the JESIP principle and, ‘talking the same language.’ I want to say a big thank you to all the other agencies involved including SWAST, LAS, WMAS, Jersey Fire & Rescue, the Jersey authorities, the army, HM Coastguard, and the police.
“As a multiagency team, we overcame multiple challenges and still delivered an effective response working closely with all our partners and demonstrated our mantra of resilience.”