PureFivePD London Ambulance

Service Basic Information Guide

1 | Chain of Command -

The chain of command within the London Ambulance Service is a very simple yet effective one. It goes as follows:

-Director Of Ambulance Service
-Deputy Director of Ambulance Service

-Assistant Director of Operations

-Clinical Team Manager

-Head of HART/CBRN
-MERIT Doctor

-Advanced Paramedic Practitioner

-Paramedic

-Technician

-Student Paramedic

2 | Training Information -

Your training within the LAS will mostly be on-the-job, in which you will ride alongside Ambulance Staff in their day to day work and learn on real jobs. However a small portion of your training will be in a classroom environment and learning the core practices of the job.

3 | Divisions -

The main divisions within the London Ambulance Service are as follows:

> [CRU] Cycle Response Unit - You are on a bicycle equipped with all the equipment of an RRV and are tasked with reaching areas quickly in highly populated dense areas.

>[MRU] Motorcycle Response Unit - You are on a Motorcycle with all the same equipment as an RRV and are tasked with getting to a scene as fast as possible to ensure the patient is as stable and receives the best care possible.

>[HART] Hazardous Area Response Team - You are a specialised team meber who responds to calls in dangerous/hazardous areas that a regular Ambulance staff member can not access such as water, Confined spaces, a stuck patient or even in events such as a terrorist attack or CBRNE incident.
[PARAMEDIC+ ONLY]

>[HEMS/AAATT] Helicopter Emergency Medical Services - Air Ambulance Advanced Trauma Team - As a HEMS/AAATT Doctor you are tasked with providing HOSPITAL level of care to the patient and ensure they’re being given the best possible chance of life/recovery.

[ADVANCED PARAMEDIC+ ONLY]

4 | Basic Medical Info -

> Standard Observations:

Respiratory rate: 12 Breaths per minute

Pulse: 100-120 Beats per minute

Oxygen Saturations: 94-95% up to 100% is normal, 88% for COPD Patients

Blood Glucose: 7.8-11.1mMol

Temperature: 37-37.8 degrees celsius

Blood pressure: 120/80

Capillary refill: Less than 3 seconds

Peak flow: 80-100%

Capnography: 35-45mm Hg

> Glasgow Coma Scale

Eye Opening:

Open before stimulus - 4

After spoken or shouted request - 3

After trapezius or fingertip stimulus - 2

No opening at any time - 1

Best Verbal Response:

Correctly gives name, place and date - 5

Not orientated, but communicates coherently - 4

Intelligible single words - 3

Only moans/groans - 2

No audible response - 1

Best Motor Response:

Obeys two part request - 6

Brings hand above clavicle trapezius stimulus - 5

Bends arm at elbow rapidly but movement appears normal - 4

Bends arm at elbow, but clearly abnormal - 3

Extends arm at elbow - 2

No movement in arms/legs - 1

> F.A.S.T

The FAST test is used prehospitally to determine if someone is having a stroke.

F - Face - is the face droopy in any places, are there noticeable changes on the left side to the right?

A - Arms - When they hold their arms out at 90 degrees, does one arm sink down? Does one arm rise up?

S - Speech - Is the speech slurred? Is their mouth droopy?

T - Time - Ensure a time-critical transfer and note the time the symptoms started

5 | Contact SLT -

To contact a member of our Senior Leadership Team, feel free to drop a message in #las-chat and ping the DoAS with your question, concern or enquiry.

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