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The Quiet Storm

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Manchester Arena inquiry: ‘Disaster gap’ means public may need to treat traumatic injuries

Written by on 01/03/2021

Members of the public are likely to have to treat traumatic injuries from a terrorist attack without help from paramedics, a leading doctor has told the Manchester Arena inquiry.

A “disaster gap” exists in which the emergency services may be held back from the scene because they are worried they may be attacked, Brigadier Tim Hodgetts, a professor of emergency medicine, told the inquiry.

In the “platinum 10 minutes”, members of the public may have to triage, clear airways and apply tourniquets themselves, Brig Hodgetts, the medical director to the UK Defence Medical Services, said.

The military learned the importance of tourniquets in saving lives during the Iraq War and introduced a new policy in 2009, but it has taken a decade for the NHS to catch up, the inquiry was told.

The public should now be told: “Run, hide, tell, treat,” adding the last instruction to the standard advice, and a “critical mass” need to learn how to use tourniquets, Brig Hodgetts said.

Only one paramedic entered the City Room where the explosion took place in the first 40 minutes and it is possible two of the victims, including eight-year-old Saffie-Rose Roussos, could have survived.

Saffie-Rose Roussos
Image: Saffie-Rose Roussos, eight, could have survived

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Brig Hodgetts said: “There remains a recognised therapeutic vacuum.

“Responding healthcare providers may be held back when the security of the incident is uncertain.

“As avoidable deaths from bleeding can occur in minutes, the opportunity to save life rests with those who are part of the incident. This is the public.”

Doctors launched a video to show how the public could save lives in the event of an attack in April 2017, just three weeks before the Manchester Arena attack.

The video showed how to improvise tourniquets in the event of a bomb explosion at a train station in a situation similar to the arena bombing, which took place above Manchester’s Victoria Station.

Manchester attack victims
Image: Twenty two people were killed in the Manchester attack

Paul Greaney QC for the inquiry said: “It was to be prescient and shared many of the features of what happened at the arena.”

The doctors had launched a charity called CitizenAid in November 2016 in response to the Paris attack a year earlier and also came up with an app that gives step-by-step advice on what to do.

“We took it on ourselves, we were not asked to do it, we saw as moral duty to give this information out to the public,” Brig Hodgetts said.

“The people able to intervene are those trapped in the incident, they need to be able to help themselves and others.

“Our battlefield experience is that the most commonly avoidable cause of death is external bleeding and particular external bleeding from limbs.

“Just dressing wounds is inadequate, wounds need to be packed and pressure applied, where this does not stem the bleeding, a tourniquet is needed. First aid must recognise this paradigm.

“The prevailing narrative that a tourniquet will cause harm if applied for the wrong reason needs revising that a tourniquet applied for the right reason will save life.”

 Sky News

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