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Links in the chain of survival

Chain of survival

We spoke with Martin O’Reilly, EMS Support Officer, Dublin Fire Brigade, to discover more about the chain of survival in Dublin city and county, and how the fire-based EMS service model ensures the effectiveness of this chain.

According to the HSE, surviving a cardiac arrest at any age is “directly related to time to resuscitation and particularly defibrillation”. These are two links in what is known as the ‘chain of survival’ for out of hospital cardiac arrest: early recognition, immediate and effective cardiopulmonary resuscitation, rapid defibrillation, pre-hospital advance life support, and postresuscitation care and aftercare.

Take early and effective CPR, which can keep the brain and vital organs oxygenated, and can also buy time for effective defibrillation to take place – either by members of the public or the emergency services. Time is key, and CPR should commence as soon as possible following a cardiac arrest to provide the best chance for a positive outcome. “We know that after a patient suffers a cardiac arrest, if nothing is done then the patient’s chance of survival diminishes by between 7 and 10 per cent with every minute that passes. Providing bystander CPR gives the patient the best chance possible towards a successful outcome,” explains Martin O’Reilly, EMS Support Officer with Dublin Fire Brigade.

In Dublin and the surrounding area, Dublin Fire Brigade is a key part of this chain and regularly responds to such instances across the capital. DFB recently attended an adult male patient, whose cardiac arrest had been witnessed by a member of the public. The emergency service controller (ESC) provided CPR instruction to the caller over the phone, enabling bystander CPR to take place on scene prior to DFB’s arrival, and simultaneously dispatched the required resources to the scene. “We had paramedics quickly on scene on the fire appliance and an advanced paramedic providing advanced life support as part of the ambulance crew,” says O’Reilly. “The crew achieved a return of spontaneous circulation on scene and commenced post-resuscitation care. The patient was then transported to the nearest emergency department to continue this care. This patient benefited from all of the links in the chain of survival, which greatly increased his chances of survival and is an excellent example of an EMS system working at its best.”

Two-pronged approach

The citizens of Dublin city and county benefit from DFB’s fire-based EMS service, in which firefighters are also trained paramedics. The system is in operation in a number of jurisdictions around the world, particularly in large urban centres, including fire departments across the USA, France and several in Germany, and plays an important role in ensuring a functioning chain of survival.

As O’Reilly outlines, the fire-based EMS system in Dublin ensures the use of a structured approach when responding to cardiac arrests. The nearest fire appliance and ambulance are dispatched to a call, ensuring a sufficient number of paramedics to effectively manage a cardiac arrest. Alongside its clinical abilities, the fire appliance with paramedics onboard also facilitates a rapid response to immediately life-threatening calls – in 68 per cent of cardiac arrests the fire appliance will arrive in advance of the ambulance due to its strategic location and availability.

“Many 112/999 calls are of a medical and traumatic nature, involving single or multiple patients, and have a requirement for additional clinical resources and personnel to perform physical rescue, extrication etc. Firefighter/paramedics provide rescue/extrication skillsets as well as an additional response where needed. These additional resources also improve patient, bystander and practitioner safety on scene,” says O’Reilly.

The combined firefighting and paramedic training all DFB recruits receive proves highly useful within situations that require medical and rescue response – one response vehicle can provide both skillsets. DFB personnel are educated and trained to perform multiple functions, including hazardous materials response, road traffic collision extrication, highline rescue, swiftwater rescue, and pre-hospital emergency care.

“Firefighter/paramedics uniquely can provide patient treatment and rescue immediately on arrival. These highly trained professionals are a valuable resource and a huge benefit to the patient and the community,” O’Reilly explains. “Another important benefit of having multi-skilled FF/P within a fire-based EMS service is seen when a major incident occurs with many casualties involved. A fire-based EMS service can deploy large numbers of equipped paramedics to the scene from its fire service vehicles immediately. They can commence triage, treatment and stabilise patients on arrival at the scene.”

The ability of Dublin Fire Brigade’s fire-based EMS system to simultaneously dispatch fire and EMS resources is vital and saves precious minutes, particularly in life-threatening situations where every second counts, often making the difference between life and death in cases like cardiac arrests. This approach also reduces on scene time and helps get patients to hospital and definitive care much sooner – important links in a patient’s survival.

Expecting the unexpected: Chief Fire Officers’ conference

Chief Fire Officers’ conference

The annual Chief Fire Officers’ Association conference was held in Croke Park in 2017, organised by Dublin Fire Brigade. Conor Forrest was there on the day.

Last May, Croke Park was the location for the Chief Fire Officers’ Association (CFOA) annual conference, an interesting and varied two-day event organised by Dublin Fire Brigade and which tackled the topic of expecting the unexpected. Drawing from fire services far and near, the comprehensive CFOA 2017 conference featured speakers on a broad range of topics from fire safety to media management. Washington DC Fire and EMS Chief Gregory Dean reflected on the systems in use in Seattle and Washington DC; Dublin City Council Senior Systems Officer John Lynch explained how business intelligence can be put to good use in the fire service; and Peter Holland, Chief Fire and Rescue advisor at the Home Officer provided an overview of the local and national structure of the UK’s fire services.

An opportunity to listen and learn from colleagues, not just in Ireland but around the world, and to discover best practice and innovation for the years ahead, the conference also looked to the future of fire services, with topics such as innovation, investment and funding on the agenda.

“As Minister with responsibility for policy oversight for fire safety and the provision of fire services by local authorities, my primary focus is on ensuring that local authority services are effective in achieving their objectives and meeting their statutory obligations in respect of the provision of fire services and fire safety. Key to that is to make sure that local authorities do all they can to do your great work and to give you the resources you need to be able to provide the service you provide,” said Minister for State Damien English, who opened the conference alongside Lord Mayor Cllr Brendan Carr, and reiterated his department’s commitment to fire services. “My job as your minister in this area is to work with my department and all local authorities to make sure that you get your fair share of resources to help you do what you do… If we can prove that you are spending the resources that you get in the best way, in the most effective way and stretching every Euro of that, that helps us with our business case to get more money for the service, to build on that.”

It was a theme that CFOA Chairperson and Dublin Fire Brigade Chief Fire Officer Pat Fleming picked up on later in the morning. “Funding is always an interesting one,” he said with a laugh. “In 2015, 20 new fire appliances for 16 counties were announced. Many of these are now only appearing in fire stations. Fire and rescue services are not discretionary items. Properly funded services are vital in defining a modern society and in supporting economic development and foreign direct investment.”

The issue of fire-based EMS has been in the public eye of late, with calls in some quarters to remove DFB’s ambulance call and dispatch function and to instead merge it with the National Ambulance Service (NAS). Alongside the importance of a collaborative approach to community fire safety, Minister for State Damien English touched on the topic of fire-based EMS services during his speech, noting the possibility of retained fire services assisting the National Ambulance Service in meeting the Pre-Hospital Emergency Care Council (PHECC) response targets, particularly in rural areas.

“I welcome the Minister’s comments on this today. It’s something that I’ve advocated on previous occasions, the positive benefits of providing life-saving medical intervention in support to hard-pressed colleagues in the NAS operating in rural Ireland,” said CFO Fleming. “I’m pleased that a comprehensive draft paper has been prepared under the aegis of the Keeping Communities Safe process, and I look forward to the further progressions and discussion of the feasibility of delivering this service in the interests of patient safety. Inter-agency cooperation in the public interest is not about individual agency status, but rather about delivering the best possible patient-centric service.”

CFO Pat Fleming, Brigadier General Philippe
Boutinaud, Commander of the Paris Fire Brigade and Dublin City Council Lord Mayor Brendan Carr.

Preparation

The main theme of the conference was ‘Expect the unexpected’, with a conference programme reflecting this particular topic. One of the most interesting and well-received talks was given by Brigadier General Philippe Boutinaud, Commander of the Paris Fire Brigade, the largest fire service in Europe. Brigadier General Boutinaud was in command on the night of Friday November 13th 2015, when a series of coordinated terrorist attacks killed 130 people and injured a further 368, the deadliest incident in France since World War II. Later claimed by the Islamic State of Iraq and the Levant (ISIL), the attacks began when three suicide bombers detonated outside the Stade de France during an international friendly between France and Germany, followed shortly after by shootings and bombings at several cafés and restaurants, and then a mass shooting at the Bataclan Theatre during an Eagles of Death Metal concert. Having taken hostages within the theatre, none of the attackers survived following a police raid on the building.

During a discussion on the planning, preparation and response of Paris Fire Brigade, alongside lessons learned from the events, a complete silence blanketed the room as a harrowing video shot on the night of the attacks was shown, depicting the panic-stricken calls received by the emergency service controllers, the firefighters who responded on the ground, and the confusion of the injured who wandered the scenes. “My ambition this morning is to share with you, I’m not here to deliver a speech or deliver a lesson to you,” said Brigadier General Philippe. It’s just a question of… sharing my experience with you in case the unexpected happens in your country. Obviously, I hope that will not be the case.”

Though a terrorist attack of similar proportions on Irish soil is unlikely, there’s no doubt that our emergency services need to be prepared for whatever may come. “Whatever Oscar Wilde thought about that theme, all of us who provide and manage frontline operational emergency response services are very clear as to its meaning. Our primary role is to have the necessary resources in place to protect public safety and render humanitarian aid, which sounds simple enough,” said CFO Fleming. “However, the preparation required for the expected, and the nature and complexity of the unexpected, poses major challenges for us all. The nature of the potential scenarios we now have to prepare for has moved far from a single agency response to a fire or medical incident. Indeed, the complexities of these potential scenarios test all emergency services to the limit both individually and collectively.”

Shades of green and blue: St. Patrick’s Day 2017

Following another successful St. Patrick’s Day parade on March 17th, Third Officer and Pipe Band member John Keogh looks back on a memorable day.

March 17th is an important day in Ireland’s calendar, a day that celebrates the best of what we have to offer to the world. Among those who have become a staple of the annual St. Patrick’s Day parade through Dublin city’s streets is Dublin Fire Brigade, which provides a cohort of uniformed firefighters each year, wowing the crowd with their synchronised marching skills perfected on the drill ground, as well as spotless uniforms and polished medals, and accompanied by the uplifting tunes of the DFB Pipe Band. “It’s a very important day for the fire brigade, it always has been. I’m a member of the DFB Pipe Band as well, and since the foundation of the band in 1985 it was always the view that St. Patrick’s Day would be our biggest event every year,” says Third Officer John Keogh, among those who took to the streets in March.

Alongside a colour party, marchers, and several international firefighters who joined their colleagues in Dublin for the day, the 2017 parade also featured the very first party of recruits from the O’Brien Training Institute, plucked from their training to showcase their newly learned marching skills on a national stage.

“We got them in uniform, and Brigade Training Officer Gerry Stanley marched in front of them with the flag of the DFB training centre, with the recruit instructors leading them off. That was a great event for them, and it got them more involved with life in Dublin Fire Brigade,” says Third Officer Keogh. “Unfortunately they couldn’t participate in the fun afterwards – mixing recruits with trained firefighters at that stage of their training isn’t a good idea. However, the DFB Sports and Social Club arranged a venue for them and they had their own celebrations afterwards. We’ve encouraged them to take part in the parade next year and in parades going forward.” DFB staff and guests from around the world joined the Pipe Band in Diceys on Harcourt Street. The Band wound up providing entertainment to everyone who arrived at the venue, which was recorded and quickly went viral around the globe. “It was a real party atmosphere that was great to be involved in,” Third Officer Keogh says with a smile.

St. Patrick's Day

Members of the Coast Guard at the ceremony in Phibsborough, during which the crew of Rescue 116 were remembered

Structure

For the past 15 years or so, the annual parade has begun at Parnell Square, marching down along O’Connell Street towards St. Stephen’s Green. As the closest station to the start point is Phibsborough, it quickly became a meeting point for those taking part from DFB, with support on the day provided by the station’s crew, particularly those on C watch.

A more formalised structure to the hours before the parade kicks off has also emerged, with an event held that morning in memory of deceased members of the brigade. Beginning with a reading of the names of those who have passed away, a piper from the band plays a lament, followed by a minute’s silence and a flag raising ceremony where the national flag is raised and lowered to half mast. Each year the names are read aloud by the grand marshal selected to lead the DFB contingent along the parade route, usually a person of note within the brigade who has recently retired. For 2017 DFB historian Las Fallon was chosen, with an additional tribute paid to the crew of Rescue 116 – though three former members of DFB who now work with the Coast Guard were unable to attend as they were working at the site of the rescue efforts, representatives from the station in Howth were in attendance.

“We recognise that they’ve gone through a hard time in the past year. We have a great association with them, whether it’s the crews on the helicopters or the shore crews, in Howth or any of the other stations around Dublin,” Third Officer Keogh says.

This year the marchers were joined, as always, by colleagues from further afield, with firefighters from Westchester Fire Service in New York, Berkeley in California and Dunkirk in France taking to the streets. That diverse make-up is the result of deep friendships developed over the years with organisations including the NY Emerald Society and the Washington DC Emerald Society, and close links with brigades such as Leduc Fire Brigade in Edmonton, Canada. “We keep in contact with them, and very good friendships have developed as a result,” Third Officer Keogh explains. “It can be relaxed and dignified at the same time. Nearly every single year our guests are photographed in the national papers. It’s great for the guys who are participating to pick up the paper the next day and see a picture of our friends from Leduc Fire Brigade or New York Fire Department front and centre.”

St. Patrick's Day

The Pipe Band marched in the parade

Standing on ceremony

In the early years, DFB marched solely as part of the main body of the parade, however of late its participation has grown to incorporate a ceremonial role at the beginning with the Lord Mayor of Dublin city. As part of the tradition, the Lord Mayor leads the parade from the start point in the mayoral coach, accompanied by a representative of An Garda Síochána, the Defence Forces (carrying the national flag) and Dublin Fire Brigade. “It’s a unique opportunity and we’re honoured to represent Dublin in that way. DFB has been here for 150 years, so we’re the lifeblood of the city,” says Third Officer Keogh. “We’re a real integral part of what Dublin city is all about. The people working in DFB go beyond the normal routine as regards working for the citizens of Dublin. And I think that’s recognised when we’re on parade – the cheers that DFB get are continuous, right along the whole route.”

Going forward the plan is to grow DFB’s involvement in events like St. Patrick’s Day, taking inspiration from the State parade in 2016 that commemorated the centenary of the Easter Rising, and which saw 150 DFB personnel take part; and the annual FESSEF parade that marches through the city with representation from all full-time and voluntary emergency services. Last year the Sports and Social Club funded the purchase of flags for each station across the city, bearing their name and date of foundation, and Third Officer Keogh envisions future parades in which DFB marchers carry anywhere between 14 and 20 flags, providing a more spectacular and colourful vista along the parade route.

Plans are also in place to ensure the entire day is an event for all the family, and Third Officer Keogh encourages families to head to Phibsborough fire station before the parade begins, to enjoy the family-friendly party atmosphere in the station and the tunes played by the Pipe Band as they prepare. “The St. Patrick’s Day parade is the biggest day in the Pipe Band’s year, every year. And it always has been,” he explains. “It doesn’t matter whether we’re here or abroad, it’s always the biggest day. There’s no bar on who marches with us. If somebody turns up in Phibsborough fire station and they’re in full uniform, that’s all we ask. It’s a tremendous event for DFB and it’s going to get bigger and bigger.”

Learning with leisure: The EMS Gathering

The fourth annual Emergency Gathering took place in Kinsale in May. Conor Forrest spoke with organiser Kieran Henry to discover more about this engaging and diverse two-day event.

In early May, a large group of emergency services personnel from Ireland and around the world gathered in the picturesque town of Kinsale. They were there as part of the annual EMS Gathering, a two-day event organised by a team of people including National Ambulance Service advanced paramedic Kieran Henry. It was initially inspired by The Gathering 2013, a government umbrella tourism initiative that encouraged Ireland’s diaspora to return to their homeland that year.

“Around the same time, there was a group of us involved in emergency medical services – paramedics, doctors responders etc. – and we used to head up the mountains informally, take part in activities on our time off,” Kieran explains. “We would often chat to each other and share information with each other, talking about hypothermia, drowning or various different things, as well as talking about sport, current affairs and things like that. So we thought why don’t we merge the two?”

Thus the EMS Gathering was born, organised and run on a voluntary basis with something for everyone working in the field of pre-hospital emergency care, regardless of qualification or experience. The informal nature inspired by those mountain hikes has remained – though the event includes classroom lectures given by experts in their fields, ‘Learning with Leisure’ remains a key facet of the EMS Gathering. Over the years attendees have travelled to nearby farms to learn about responding to a farm-related emergency, attended talks on drowning at Torc Waterfall outside Killarney, and taken a bus tour while learning the intricacies of dealing with sepsis.

Loading an injured person into a helicopter was one element of the TEMS workshop. Photos courtesy EMS Gathering.

Clearly, the diverse programme has worked – people have flocked to the EMS Gathering each year from all corners of the globe, from New Zealand, Poland, Canada, the United States and further afield, sharing their experiences, supporting one another and exchanging ideas on best practice. It has also inspired other events, including the OBI CPC nights established by DFB’s Glenn Ellis and the team there. “It’s a different angle on the educational aspects of the event, I suppose, and people seem to like it. They keep coming back anyway!” says Kieran. “We’ve heard of individual cases where people learned something at the EMS Gathering and they’ve put it into practice. That’s really satisfying on a personal basis.”

Shared expertise

Collaboration is another factor that drives the EMS Gathering – without so many people from different backgrounds, each with their own individual learnings and experiences, the event would not be as broad in its scope. This year the Gathering moved from Killarney to the maritime town of Kinsale, with a programme covering subjects ranging from insights into mental health emergencies and dealing with drowning incidents to workshops on crew resource management and personal resilience. The Flotilla of Learning included a workshop on silver trauma and sepsis given on the Spirit of Kinsale vessel in the harbour, while attendees learned about behaviours of concern while on a walking tour of the Charlesfort. The Irish Naval Service also gave a highly insightful talk on Operation Pontus, which saw more than 15,000 migrants rescued in the Mediterranean over the course of six three-month rotations by Navy vessels.

Simulations are an important feature of the EMS Gathering.

“We had many agencies, both statutory and voluntary, involved. Within those agencies you have a complete multidisciplinary set of people from clinical to non-clinical,” says Kieran. “People from all different backgrounds be it the emergency medical services, military, fire service and rescue, hospitals, general practice, researchers. We had a range of national and international attendees, and they brought their own experiences.” With the dust having settled on the fourth EMS Gathering held since its foundation, Kieran is delighted with how the diverse programme for 2017 unfolded. There’s no doubt that the combination of social activities, with talks and workshops held both in the classroom and out in the locality, made for a memorable two days.

“We were delighted with the response. The feedback that we have got [for 2017] is phenomenal. Some of the nicest things that we heard [were from] the veterans, who have attended conferences for many years, and told us it’s the best one they’ve been at,” says Kieran. “Our aim was to inspire people to learn and enjoy themselves, and I think we have certainly achieved that.”

Flotilla of learning

A new concept for 2017 was the Flotilla of Learning – a range of workshops held on and around Kinsale Harbour. Those included:

■ Health & Well-being Workshop – Kayaks
■ Silver Trauma & Silver Sepsis – Spirit of Kinsale vessel
■ Deep Dive into Diving – Diving Rib
■ Ultrasound Workshop – Sea Vessel
■ Crew Resource Management – Sailboat
■ Behaviours of Concern/Great Wars & What We Have Learned – Walking Tour of Charlesfort

Nutgrove – At the heart of the community

Nutgrove’s annual open day was a huge success, raising vital funds for children with autism and their families.

Back once more for the third year in a row, Nutgrove fire station’s annual open day proved a big success.Showcasing Dublin Fire Brigade and a number of other emergency response organisations, providing entertainment for kids of all ages, and displaying several vintage (and a few modern) emergency services vehicles, proceedings from the day were in aid of Snowflake, a children’s charity that provides support for kids with autism, as well as their parents and siblings, organising social events, support meetings, workshops and other supports.

Turnout on the day was huge, with the station yard and engine bay thronged from early on. Attended by An Cathaoirleach Cormac Devlin from Dún Laoghaire-Rathdown County Council, Dublin City Council Lord Mayor Brendan Car and Chief Fire Officer Pat Fleming, the open day also played host to a number of emergency services organisations.

“It went really well, we had a few new attendees such as Dublin Airport Fire Service, the Defence Forces and the Coast Guard. The Green Goddess vintage appliance also made a welcome return after a break last year, alongside the RSA, BUMBLEance, the Order of Malta, 501st Legion Garrison, Heroes Unite Ireland, two fire tenders owned by Liam Moore, and an ex-Dublin Civil Defence truck owned by Jerry from Dublin Mountain Rescue,” explains Derek Riordan, a firefighter on C watch who has been instrumental in organising the annual open day. “It goes without saying that having CFO Fleming, and three of the Assistant Chief Fire Officers, there was fantastic, a major highlight. It was nice for the senior officers to come and see the fruits of our labour. Dublin’s Lord Mayor and An Cathaoirleach Cormac Devlin attending on the day was another major achievement for us. The day couldn’t have gone better.”

Derek Riordan, CFO Pat Fleming, Lord Mayor Brendan Carr and ACFO Dennis Keeley.

Also there was Blood Bikes East (BBE), which has been in operation since 2012, using a fleet of five bikes and a car donated by Annseley Williams and Skoda Ireland for the year to transport blood and other emergency items out of hours. “We’re full on, full service emergency service out of hours transport. From 7pm Monday to Friday we’ll go from the lock up and around, we’ll get calls from the different hospitals around the city. We’ll use the Pan European bike to go to the country, link ups with other blood bike groups. And then on the weekend it’s 24 hours a day for Saturday, Sunday and Bank Holiday Mondays,” says Denver Breslin, BBE committee member.

As BBE isn’t State-funded, they have to turn to the public to keep their doors open and their engines on. They set up their stall at No 8’s open day to show their support, and also to raise awareness about what they do. “It’s all about visibility and getting the publicity from it. We’re not here collecting today but it’s about getting the name out there and getting the public’s perception of us, because a lot of people don’t actually realise that we’re not HSE-funded or we’re not Government-funded,” Breslin adds. “Anybody that we speak to is surprised that we’re all volunteers, we do it out of our own time, we don’t take a wage. A lot of people are surprised by that.”

A cheque for €4,312 was presented to Snowflake in early May.

Community support

Derek is quick to point out that Nutgrove’s open day is by no means a one-man show. Support in organising the day came from all quarters – the crew of C watch, Dublin Fire Brigade administration, colleagues in the voluntary emergency response groups as well as the local and wider community. An Garda Síochána assisted with the traffic plan to ensure a steady flow on the day; shops like Tesco, Lidl, Aldi, SuperValu in Templeogue and Churchtown and even Dunnes Stores in Citywest pitched in with teas and coffees; DFB itself provided funding for the DJ and face painters. Local woman Alison Behan again lent her culinary skills, providing around 250 muffins for hungry attendees, again refusing to take any compensation for her time and expenses.

In addition, Starbucks in the nearby Nutgrove Shopping Centre sent across two of their employees to help dispense drinks throughout the afternoon, accompanied by shortbread biscuits, cakes, and their own brand of coffee. Any of the money that came in was 100 per cent profit,” says Derek. “I’d like to say a big thank you to Felicity Gill from Dún Laoghaire – Rathdown County Council, she played a major part. The lads on the watch were absolutely fantastic, nobody said no to anything. All of the watches were great, they all contributed in some way, shape or form which was brilliant. We also had a lot of donations from DFB family and friends.”

The result of these efforts, and the weeks and months of planning, was a cheque for €4,312 that was presented to Snowflake in early May and which will undoubtedly be put to good work. “It’s a fantastic cause,” Derek explains. “One of the lads on the watch, his cousin’s son has autism and he was involved in setting up this children’s autism support group. Anything relating to autism, whether it be young or old, is a worthy cause.”

Driving the BUMBLEance

BUMBLEance

Tony Heffernan speaks to Tiernan Cannon about one of the Saoirse Foundation’s main projects, the BUMBLEance children’s ambulance service.

It is difficult to imagine a pain more harrowing than a parent accompanying their critically-ill child on what they know to be their last journey home. It is a pain that Tony and Mary Heffernan know only too well; both their children were diagnosed with the extremely rare and fatal neurodegenerative disorder, Batten disease. Their daughter Saoirse passed away in 2011, their son Liam in 2014. Both children were aged five at the times of their deaths.

In the wake of these terrible tragedies, the Heffernans set up the Saoirse Foundation. The foundation’s first project, Bees for Battens, provides parents, families, and all those affected by Batten disease in Ireland with a support network and a credible source of information regarding the disease. The foundation’s second project was the BUMBLEance.

Changing lives

Launched in 2013, BUMBLEance offers professional medical transportation services for long-term sick and seriously disabled children that require ambulance transportation to and from their homes and their principal centres of care. It also offers another very important service, which it refers to as ‘angel trips’. An angel trip is when parents travel in the back of the BUMBLEance with their child as they undertake their final journey on earth. Angel trips provide a compassionate and caring journey that allows families to concentrate entirely on the short time they have left together. The first ever angel trip transported the Heffernans’ son Liam on his final journey home, so it’s an experience that the founders are familiar with.

The BUMBLEance service is based on a core principle of positivity, removing the inherent stresses associated with an ambulance trip for both the child and their family, and to make the trip as fun as possible for the child. “Our aim is to distract, comfort and entertain Ireland’s youngest patients as they travel to and from treatment centres nationwide, and to ensure the smoothest and safest journey possible, for both carer and patient, from home to destination,” says Tony Heffernan, CEO of the Saoirse Foundation.

BUMBLEance interior

The BUMBLEance’s unique interior is kitted out with a DVD player, iPad, games console and a fridge for food, drinks and medicine. The vehicle has onboard Wi-Fi and games consoles, as well as sensory lighting and music to soothe and pacify its young patrons, and reading and colouring books. Currently, there are three BUMBLEance vehicles on the road. BUMBLEance 1 is used for interhospital transfers, with BUMBLEance 2 being used for seriously and critically ill children who need transportation to and from hospitals and care centres. BUMBLEance 3 is used as a back-up vehicle for trips, and as a PR vehicle. The PR element to BUMBLEance 3 has proven to be immensely successful, with the vehicle generating income and awareness at festivals, events and corporate showcases nationwide.

Since its launch in September 2013, BUMBLEance 1 has transported 622 children, travelling over 200,000 km to every county in Ireland. It has facilitated 64 angel trips in that time. The people behind the project, however, hope to expand their services even further. “Our plans for future expansion include the roll out of a backup BUMBLEance 4 service, which will be Dublin-based and operated by Dublin Fire Brigade staff on a voluntary basis,” Heffernan explains. Further expansion includes a brand new regional BUMBLEette service – what is essentially a smaller version of the BUMBLEance. “The BUMBLEette service [facilitates] young patients who do not require full ambulance support with a paramedic on board, but who nonetheless are seriously ill and will require transportation to and from paediatric hospitals, respite care centres and hospices throughout Ireland,” Heffernan adds.

The BUMBLEette service is due to be rolled out nationwide over the coming years, with the first service – which will serve the North West region – having launched in the first quarter of 2017. By the close of 2018, the regional BUMBLEette services are estimated to make over 2,000 trips per year across the whole country. “Our fleet will grow to nine vehicles in the next two years, and each vehicle will then be available for operating 250-plus days each year, helping children across rural and urban areas, getting them to where they need to be in safe, reliable and modern vehicles,” says Heffernan.

King Bee and regular BUMBLEance VIP Jack Beattie. Photo: Conor McCabe Photography

The BUMBLEette vehicles themselves will enable the transportation of a driver and two children in wheelchairs with one caregiver or parent each, or a driver plus a fully operational stretcher and four seated passengers. They will be kitted out with the same child-friendly toys and gizmos that make the existing BUMBLEance vehicles what they are, ensuring that their young clients are as comfortable and happy as possible.

The BUMBLEance project was created by parents who understand the struggle of caring for a sick child, and Tony Heffernan and his team work tirelessly to ensure the smoothest and most enjoyable journey for everyone on board – parents and children alike. “We understand how stressful it is to transport a sick child, which is why we will be with you every step of the way,” he says.

Sarahs’ record row

Sarah Good

Dublin Fire Brigade’s Sarah Good and rower Sarah Doyle have set and smashed a world record for tandem rowing this year.

On St. Patrick’s Day 2017, while most of the country was celebrating our national holiday with a pint and a parade, one of Dublin Fire Brigade’s personnel was down in Passage West Rowing Club, Co Cork. Taking turns over the course of the day, Sarah Good (a nine-year veteran working on A watch No 8) and Sarah Doyle (a friend of Sarah’s from outside the world of DFB) managed to set and break an Irish and world record respectively for the 100km tandem row, finishing in an impressive time of 7 hours 29 minutes and 22 seconds. “Another in a long string of ridiculous ideas!” Sarah Good explains with a laugh.

Though it’s quite the achievement, the two Sarahs’ record-breaking effort wasn’t simply a matter of personal pride. As firefighters tend to do, they were raising funds for a very worthy cause (which undoubtedly provided some motivation) – children’s hospice and palliative care provider LauraLynn. As Sarah explains, her fiancé Doug’s nephew passed away several years ago, having received a lot of love and care from the team at LauraLynn. “Obviously the family feel very strongly about the organisation and try to give back as much as possible,” she says. “I try to row in when I can, try and do a bit of fundraising whenever I can. It’s an unbelievable organisation – it’s one of those charities that you don’t have to work very hard fundraising for, because people want to give to it. It’s just extraordinary.”

Training day

Although Sarah is no stranger to rowing machines, her friend Sarah Doyle is the rower, and regularly competes in events around the country. However, despite completing a number of half marathons and marathons, she had never competed in a 100km distance event before. Given that Sarah Good was in the same age group and weight class – and willing to give it a go – team LauraLynn was formed.

“There was about four months of prep,” says Sarah. “I do a lot of other training for other disciplines and sports, and with that your fitness and strength stands to you. It was just about incorporating rowing into my training programme. We have a rower in the station thank God, so I was able to get miles in while I was at work.”

Facing a 100km row might seem like a daunting task (and there’s no doubt that it is), but the key to overcoming the hurdle is by breaking it into small chunks. Both rowers worked in 2km intervals, swapping over roughly every eight minutes while trying not to lose any momentum. “The structure of the event was different than anything I had done before, because we were working as a tandem team. She was going, then I was going – it was a really long event where half of it you were active, and half recovering. It was unusual. The transitions were a bit chaotic, but it was great,” says Sarah. “We had in our head [to finish in] eight hours. I knew fairly soon into it that we would be able to get seven and a half hours, and we really just got that in our head then.”

World rowing record

Record confirmed

The team’s efforts paid off – as the odometer clicked past 100km they had set an Irish and world record in their category, raising almost €1,000 for LauraLynn. “We named the team for the day LauraLynn, so the record will go into LauraLynn’s name – something nice for them to hang on the wall. It was brilliant, really cool,” Sarah explains, while noting they weren’t alone down in Cork. Both of their respective other halves provided support from start to finish. “They were there for the entire time – Doug drove me down, drove me back up from Cork to go to work straight after it, gave us physio on the day and more. The two of them were just brilliant, they were great. It really is a team of four for a two-person event,” Sarah adds.

Now that she’s had a taste of success with oars in hand, does Sarah see herself taking up rowing on top of her other sporting interests? “I would have an interest in doing the odd thing for sure,” she says. “It would be something you’d tip in and out of, try another event, especially as Sarah is involved in it and likes to compete in events as well. It’s something different, it’s good.”

Care and support

LauraLynn provides palliative care and support for children with life-limiting conditions and their families, allowing parents to act as parents rather than full-time carers. Supporting children from birth to age 18 for free, LauraLynn is also piloting a home care programme in Dublin North-East and Dublin Mid Leinster, providing hospice care for children in the comfort of their own homes.

To learn more about LauraLynn or to donate/fundraise, phone 01 289 3151, email [email protected] lauralynn.ie or visit lauralynn.ie.

 

Training day

The OBI played host to a two-part mass casualty training exercise for Class 1/2016 last November, writes Conor Forrest.

Last November, recruits from Class 1/2016 reported to the OBI as part of their paramedic training, having graduated earlier this year and spent the intervening time in their respective stations. They would be taking part in a mass casualty training exercise that day, a test of their skills in the field based on course objectives which have been set by PHECC (the Pre-Hospital Emergency Care Council) on gathering vital information, delivering a clear picture of the scene to control and command, and designating certain areas for casualty clearance, ambulance arrival, etc.

Several years ago I had the opportunity to attend a similar exercise held in the Phoenix Park, which featured the aftermath of a house party gone wrong. This one, however, was a little different in terms of scale. Though the recruits were told they would be taking part in a mass casualty exercise, they weren’t told what to expect. The brainchild of tutor Joe Brady, one of the first practitioners to reach the scene of the recent shooting in Whitehall, onlookers watched as two vehicles entered the yard at speed, screeching to a halt. A mass of armed gardaí tumbled from the vehicles and spread out, bearing down on the rear of the building where there were reports of shooters inside a nightclub. Following an explosion, several masked men emerged from the building and engaged in a shootout with gardaí. The armed unit then moved into the building, clearing it room by room, ensuring the scene was safe for first responders to enter.

Members of the ERU arrive on scene

Once they got the go ahead, DFB crews began to arrive – some began to assess the emerging casualties, while others entered the building to assess and remove the more critically wounded. With music pumping inside the club, the responders had to focus on the tasks at hand and ignore any distractions – their instructors were looking for mental strength in the face of disorientation and pressure. Outside on the quad a casualty clearance station area was set up, with patients brought in, assessed, and then transferred into the waiting ambulances. Though some might have been expecting a different scenario, a second exercise began with the shooting of the assembled crowd from the earlier incident.

“The exercise was designed to test their response to a mass casualty incident; we were looking at their role as first practitioners on the scene, their communication skills, their ability to do what is called a triage sieve – a first look at the patient and then allocate a triage card. If they’re really badly injured they get a red, if they’re not so badly injured they get a yellow, and then the walking wounded can be brought off to a separate area and then bussed off scene,” explains Paul Lambert, EMS training coordinator in the OBI. “It’s about getting into the practice of encountering something that they won’t come across that often, it’s not normal medicine, they don’t come and treat the first person they see – their job is to categorise all of the casualties and to find out which is the highest priority.”

Coordination

Understandably, organising this exercise was a complex process, liaising with An Garda Síochána and the Civil Defence. “Joe Brady decided that since it was in the news and something that there is a possibility of happening – an active shooter scenario – he decided on this format. He interfaced with a number of other agencies, the Civil Defence, An Garda Síochána and the Garda Emergency Response Unit,” Lambert explains. “Logistically it was a big ask, because there are a lot of factors to take into account to develop an exercise that will run well.”

Instructor Dan Fynes readies his crew to enter the building

The first thing to consider was health and safety – designing an exercise plan, conducting a risk assessment, mitigating any potential risks that arose during the planning stage and appointing a safety officer to oversee the process. Ensuring all of the necessary equipment was in place was another challenge – given the scale and scope of the exercise, the organisers needed additional trauma bags, spinal boards, field stretchers, scoop stretchers and defibrillators, and a casualty clearing station. A number of ambulances were also requisitioned from the workshop, placed on standby for use in the exercise.

As the scenario involved a shooting at a nightclub, casualties were also required, provided through the voluntary emergency response organisations. Their varied injuries were made more realistic by the work of makeup students from Dún Laoghaire. The talented students provided moulage [applying mock injuries for emergency services training purposes) – injuries such as eviscerations, penetrating injuries, everything from bruising to a major haemorrhage and eye avulsions, making for a more realistic scene and placing increased pressure on the responders.

“Our first practitioners on scene performed very well, and then our subsequent crews performed very well. It was quite arduous – we had 53 casualties and there were two separate exercises, so it was quite physically and mentally demanding on them. They had to make rapid decisions under pressure and then physically had to remove and treat the patients. It was a lot of pressure for them but we’re very happy with how they performed, and I think they found it to be a very valuable learning experience,” Lambert explains. Thanks are due to all who volunteered their time in coordinating the two exercises, totalling over 100 casualties.

Joe Brady deserves a special mention for his hard work in bringing his idea from concept to execution, liaising with outside agencies and with various elements within DFB, organising the moulage which provided a layer of added realism, and whose effort was vindicated at the end of the day. “I was also very impressed with the tutors in the OBI and the amount of hard work they have done,” says Lambert. “It was a very well thought out exercise, and very well executed.”

Tricky triage

Among the many skills being tested through the incident was the firefighters’ ability to perform a triage sort, a more in depth way of assessing a patient. “They assess the respiratory rate, their systolic blood pressure and their Glasgow coma score, and based on those three things they apportion them a score, and then those patients are moved to the hospital first – it’s like a filtering system,” Lambert explains. “We filter through the casualty clearing station, the people that need to get off scene quickest, and then we can designate those to the hospitals to make sure that the hospitals receive the most critical patients first.”

Firefighters were also tasked with relaying a methane message – declaring a major emergency, providing the exact location, the type of incident, hazards, access, the number and severity of the injured and any extra resources required.

The social scene

DFB’s Sports and Social Club recently held two fun-filled social nights for members in Dublin city centre.

Dublin Fire Brigade is a social organisation – different stations are involved in various events in their local communities, and firefighters across the job are often promoting or taking part in sports, historical or social events in the city. It’s an aspect that the DFB Sports and Social Club is keen to promote and, after a period of absence due to the recession, the annual club nights returned in late 2015, initiated by committee member Paul Marsh from Dún Laoghaire and held in the River Bar on Burgh Quay. A change in the tender process for vendors for events like the kids’ summer party freed up some funds, which Marsh suggested the Club invest in reviving the social nights. “We cover the families with the kids, we cover everything from athletics to cricket – there is a gap there, I think, especially as there are two new classes of recruits,” says Paul.

The first social night of 2016, on November 17th, was held for those on B and D watch, while A and C watches got their turn the following Thursday night – the idea was to bring together those who wouldn’t normally meet one another starting or finishing a shift. Each night featured spot prizes, a certain amount of free drinks and party games, and pitted a member of each watch against one another. “I brought people up and had a quiz – we had a phonetic alphabet quiz for the lads in the control room, questions involving the fire brigade and medical questions,” says Paul. “I got one from C watch and one from A watch, just to get a bit of banter and a bit of craic going. This year, because we had two classes of recruits, we focused on them. I think the recruits enjoyed getting involved.”

Alongside increased attendance on the previous year’s social nights, the Club received a boost in the form of 20 new members. As a result, the social nights are very much back on the Club calendar. “What we’re hoping to do this year is a 999 night – that’s what we used to do in the late nineties,” Paul adds. “We had a couple of them – nurses, guards, firefighters – when we had the Ierne ballroom. They were brilliant nights and I’d love to get them going again.”

Getting to colleagues in DFB is the idea behind these nights out – Paul explains that the fire service is a job in which morale plays a huge role. But it’s also an opportunity to get to know people you might not ordinarily meet. “If there’s good morale you’ll work a lot better…you’re working with guys for 15 hour shifts,” he says. “The next step would be to get to know the people that are in the hospitals, or the guards when you’re out at these incidents. I just think people work better when they know each other that little bit better. You do the 40 hours a week together, but when you get to know them on a social basis as well, you’ll see a different side of them, and I think it helps.”

Class of 2016

Recruit Class 2/2016 participated in the passing out parade held in the OBI last October.

Dublin Fire Brigade welcomed 50 new recruits into its ranks on October 6th last, as Class 2/2016 successfully completed their 15 weeks of training and passed out from the DFB training centre in Marino. The ceremony was attended by the Lord Mayor of Dublin, Brendan Carr, Dublin City Council Assistant Chief Executive Brendan Kenny, and the Mayor of South Dublin, Guss O’Connell.

Over the 15 weeks the recruits completed more than 37,000 combined hours of training at the hands of 60 DFB specialist instructors, complemented by instructors from An Garda Síochána, Dublin Bus, Renault Trucks and Luas. During the event they showcased their impressive range of training, covering a wide variety of skills ranging from working with BA sets and swift water rescue to dealing with road traffic collisions, Hazmat incidents and emergency first response.

Speaking on the day, Lord Mayor Carr noted the city’s pride in witnessing another cohort of highly trained firefighters beginning their new careers. “We are proud to have trained yet another class of recruits this year over the past 15 weeks. The calibre of the recruits passing out is a testament to the hard work and dedication of the instructors and of the recruits themselves,” he said. “Dublin Fire Brigade provides a vital service for the city and county of Dublin and I have no doubt that all new firefighters joining the ranks of Dublin Fire Brigade will continue to uphold that proud service.”