Paramedics ‘chastised’ for using better PPE on lockdown callouts – inquiry told

Paramedics ‘chastised’ for using better PPE

Paramedics were sometimes “chastised” for using higher-level PPE in callouts during the pandemic, an inquiry has heard.

Giving evidence to the Scottish Covid-19 Inquiry, Tracy Nicholls from the College of Paramedics said official guidance on what PPE should be used during the pandemic was inadequate for paramedics, due to the “unique” challenges they faced when responding to call-outs.

She said the fluid-resistant surgical masks, aprons and gloves stipulated by the guidance were often insufficient when working in a patient’s home, or when in the back of an ambulance in close proximity to a patient.

She also told the inquiry that early in the pandemic, when there was not enough evidence to be sure that the virus was not airborne, a “precautionary principle” should have been followed when drawing up guidance to minimise the risk to paramedics and patients.

Equipment was actually locked away so they couldn’t access it unless they had given a rationale as to why they had used higher RPE when the guidance said you should be ok using a fluid-resistant surgical mask

Tracy Nicholls, College of Paramedics

She said: “Our members were incredibly anxious, particularly because the fluid-resistant surgical masks did not feel like PPE at all, and the aprons that they were wearing were not conducive to the environment.

“So you might come out of the patient’s home or care setting and the apron would blow up into the paramedics’ faces, so anything that was on the apron was blown up into the clinicians’ faces.”

She said paramedics were sometimes challenged when they did opt to use higher-level PPE in particular situations.

She said: “A minority of our members gave some quite harrowing accounts that if they had made a judgment on the scene to use higher levels of respiratory protective equipment (RPE), when they returned to a station … they were often challenged around why they had, what the job had been that required them to use the higher level of RPE.

“Sometimes the members told us that the equipment was actually locked away so they couldn’t access it unless they had given a rationale as to why they had used higher RPE when the guidance said you should be okay using a fluid-resistant surgical mask.

“That was very incongruent to us. Paramedics are registered, autonomous, pre-hospital clinicians and they make a dynamic risk assessment about a situation, and they should be trusted to do so rather than chastised for doing something they feel is better placed for them in that particular situation.”

She said her members were also “bemused” at the decision in April 2020 to reclassify CPR (cardiopulmonary resuscitation) and intubation as non-aerosol-generating procedures, which meant they were officially deemed to require a lower level of PPE.

She said the college had tried to raise concerns about the inadequacy of guidance with the Scottish Government, both individually and in an alliance with other health professions such as the Royal College of Nursing, but that they only ever received two responses, leaving them feeling “unheard” by decision-makers.

“We felt unheard, and our profession felt unheard, and what we could see was our members living through this every single day, worried about their families, losing family members, losing colleagues, and it just felt the imperative was so great but we clearly didn’t land our message in the way we needed to” she said.

Earlier the inquiry heard from a care home manager who said care staff had felt “second best” compared with NHS staff who had priority on PPE and benefitted from schemes like special shopping hours.

Duncan McDonald, a house manager at Erskine Home in Bishopton, Renfrewshire, during the pandemic, told the inquiry: “Social care’s always been the poor cousin of care.

“I’ve got friends in the NHS and massive respect to them, especially during what happened, but we felt that we were the second best again.”

He gave the example of staff trying to access special shopping hours using letters confirming that they were care workers, only to be left feeling “embarrassed” when they were turned away.

The Scottish Government earlier issued a statement saying: “Our deepest sympathies go out to all those who lost a loved one during the pandemic.

“The Scottish Government is committed to responding to both the Scottish Covid-19 and UK Covid-19 inquiries, as learning lessons from the pandemic is vital to prepare for the future.

“It would be inappropriate to comment on the detail of evidence being considered by either inquiry while hearings are ongoing.”

The inquiry continues.

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