How emergency trauma packs help to save lives

Published on 13 May 2021
Written by Dr Jonathan Townsend, Emergency Medicine Doctor, Special Inspector and Special Operations Medical Advisor, Kent Police
Practice note: Dealing with the 'therapeutic vacuum' when medical assistance to casualties is delayed
Going equipped
3 mins read
Dr Jonathan Townsend, Kent Police

The 7/7 bombings, Manchester Arena, and the 2017 and 2019 London Bridge attacks are just four of the many major incidents that have occurred over the last 20 years. Despite being separated by time and circumstance, all of them – and many more – share commonly identified areas for improvement. One of these is the reported absence of basic medical equipment and training that could save lives.

Reviews have shown that the desire to act and help is strong in critical incidents. Those who want to help may be on- or off-duty emergency service workers, venue staff or willing bystanders, who form a core of spontaneous responders.

In such incidents, getting appropriate resources into the scene presents its own complications, including ongoing risks, capacity, capability and safety zoning, to name a few.

This results in what is termed the 'therapeutic vacuum', where getting medical assistance to casualties is delayed. Evidence indicates that the therapeutic vacuum can cause worsening of injuries, and in some cases deaths. Having created the therapeutic vacuum, how do we help to fill it? This is a complex and multi-factorial issue.

But one game-changer is to empower the police, as well as spontaneous responders who may be able to help, while they wait for specialist teams to get to the incident.

Within Kent and Medway, we have done this by developing the Emergency Trauma Pack (ETP) project. These are small packs specifically designed to initiate treatment of injuries responsible for the major causes of preventable death encountered in these situations. They include:

  • trauma dressings
  • specially impregnated (haemostatic) gauze and tourniquets for massive bleeding
  • chest seals for chest and lung injuries
  • a prompt leaflet designed for quick-time or crisis mindsets

While knife crime and terrorism arguably pose the most obvious threats, the kits address the basic priorities arising from trauma in everyday life, such as non-crime accidents, animal bites and road traffic collisions.

The ETP builds on a scheme by the City of London Police, developing it to fit the diverse geographic and social make-up of Kent and Medway’s health trust area. It targets high-footfall and higher-risk areas, as identified by our Violence Reduction Unit.

The aim is to equip, train and prepare those likely to be first on scene to save lives. To achieve this, we have trained every warranted officer, including special constables and PCSOs, and we have made kits available in all marked police vehicles.

Original funding came from Kent Police and an additional 500 kits were sponsored by the Police and Crime Commissioner and made widely accessible in towns and shopping hubs, iconic sites, venues, businesses, community sites and schools, with staff able to use the kits.

Training has also been given to our Kent Police Cadets, and to emergency service and third-sector partners. This has been complemented with a series of publicly available 'how-to' videos to support the prompt leaflets and written guides.

Our aim has been to make the equipment and knowledge accessible and to demystify emergency aid, by doing what’s intuitive in those vital first minutes to save a life. Businesses can purchase additional kit and contents at a minimal outlay. The cost of a mini ETP is about £40 and a full ETP is £400.

Since the roll out of ETPs, they have been used on multiple occasions throughout the course of routine policing duties, preventing deterioration of critical casualties prior to the ambulance arriving.

They have been warmly received by frontline staff, with officers reporting that they feel better equipped and more empowered to save lives, as the contents are a significant advancement over previous standard first aid kits.

The introduction of ETPs – a simple and cost-effective intervention – has already benefitted the population of Kent and Medway. Just one life saved would have made this project completely worthwhile.

  • This article was peer reviewed by Superintendent Kate Anderson, Cambridgeshire Constabulary