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Royal (or not) Baby

Posted by Steve at 10:50 on Wednesday 15th May 2019.


A week has gone by since the birth of the latest royal baby. Firstly, I hear the question, why does the title of this month’s article have the words ‘or not’ in brackets. The simple answer to this question is to do with the official title of this newborn baby; we will explore this shortly.


First of all we, along with everyone else, would like to welcome the latest baby to the world and congratulate his parents, the Duke and Duchess of Sussex on the arrival of their ‘little bundle of joy’.


On Bank Holiday Monday at 05:26, baby Archie Harrison Mountbatten-Windsor was born weighing 7lbs 3oz, in doing so becoming the 7th in line to the throne, displacing his Great Uncle, Prince Andrew. We have taken a look at the 20 in line to the throne at the end of this month’s article. At the time of writing, Archie’s place of birth has not been announced although it is thought that his mother, Meghan, had wanted a home birth; there is some rumour that this plan had to be abandoned, due to the child being overdue, as eluded to by Prince Harry.


Archie is the first child to be born to Prince Harry and Meghan and is the first half-American child to be born into the UK’s Royal Family as well as the first multiracial baby in the history of the British Monarchy. He is a citizen of the United Kingdom as well as the United States of America.


The birth was announced in the traditional way, with an announcement being placed on an easel in the grounds of Buckingham Palace as well as on the Sussex’s Instagram page. The Instagram post being a simple blue background with the words, It’s a boy. The difference between Prince Harry and William’s children’s birth announcements are clear for all to see. With Prince William the world was made aware of the birth of his children with the easel at Buckingham Palace and was then introduced to the children on their release from hospital outside the Lindo Wing. With Prince Harry the world had to wait until last Wednesday, 2 and a half days after the child’s birth, for a 3-minute photo call in the hall of Windsor Castle, which was then simulcast around the world. It was only after this initial meeting of the world’s press and having met with Her Majesty the Queen, did the Duke and Duchess make their child’s name known to the waiting world. It is fair to say that the names are not as traditional as some expected them to be.


Welcome to the world Archie Harrison Mountbatten-Windsor


Now, we move on to the original question, which I know has you thinking why we have queried whether a royal baby or not. Of course, we are not questioning the royal-ness of the baby, after all Archie is the son of Prince Harry and the great-grandson of Her Majesty the Queen. The question is more around the title of the child, of which he will not have an official title. He is however heir apparent of his father’s Dukedom of Sussex. Archie will not be automatically entitled to the title of Prince or to be addressed as His Royal Highness (HRH) unlike his cousins, Prince George, Princess Charlotte and Prince Louis. He could however have a subsidiary title for example Earl of Dumbarton, but his parents have decided that he would be simply known as Archie Harrison Mountbatten-Windsor.


So if Archie’s cousins, the children of Prince Harry’s brother, William, are entitled to be addressed as his/her Royal Highness and the title Prince/ss why is Archie not entitled?


This distinction dates back to the reign of King George V and a decree he made in 1917. During this period, it is important to note that there were revolutions occurring across Europe and monarchies were collapsing. So King George wanted a slimmed down version of the monarchy. What the decree said in a simplistic form is that when it comes to the monarch’s great-grandchildren, only the eldest living son, in this case George, of the eldest living son, Prince William, of the eldest living son, Prince Charles of the monarch, Queen Elizabeth, should have the titular dignity of Prince or Princess prefixed to their Christian name. All other great-grandchildren are to be known as Lord or Lady and do not need to be addressed as His/Her Royal Highness.


Since the original decree in 1917, Queen Elizabeth has amended it recently in 2013, a few months before the birth of Prince George, to provide special dispensation for all of Prince William and Kate’s children to be Prince or Princess. A few months after this change in the decree, the UK Government made legal changes to the succession to the throne rules, ensuring that any Princess would not be bumped down the list by any younger brother, hence the reason Princess Charlotte is 4th in line and her younger brother Prince Louis is the 5th. She is the first female heir to the throne to not be displaced by her younger brother.


It is thought that Her Majesty would not provide the same special dispensation to William’s brother Harry’s children, especially as it would take a massive disaster for Archie to ever become King, in that he has 6 people above him in line to the throne, including his father.


Archie is likely to become Prince Archie, should his grandfather, Prince Charles become King, the next in line to take the throne. Since he is the grandson of Charles, he would then be grandchild to the monarch and entitled then to the title Prince.


So, what does Archie Harrison’s name mean?


As we mentioned earlier, the new royal baby’s names were a bit of a surprise and were not on the running list of the names according to the bookmakers, who were offering money on Alexander, Arthur and Albert with Spencer as an outside chance due to his grandmother’s maiden name. It is believed that neither of the 2 names selected have any royal connotations.


Archie means genuine, bold and brave, it is a more common name in the UK than the US, and has often been used as the abbreviated form of Archibald, although in recent years it has been used as a name in its own right. During 2017, Archie was the 18th most commonly used name for a boy in the UK with 2,803 children born with the name. Since 2003, Archie has been in the top 50 names consistently.


Whereas Harrison, in popularity terms, is opposite to Archie and slightly more popular in the United States than the UK, however in 2017 it was the 34th most popular name. Fittingly the name means son of Harry! and has been more commonly a surname.


Whilst there is a lot of love and joy around the world for the birth of this child, who is the 7th in line to the throne and obviously there is a special interest in him, there is always a flip side to the story, and this time we feel we should explore the not so happy side of the story, which is also the reason why on this article we have decided not to show any picture of the new child. And this reason is due to the parents out there, who will look at the picture of happiness and wonder why they aren’t as lucky as the Duke and Duchess. Not in terms of the status, money and international admiration, but more because they are not able to hold their child.


Some parents have never been able to hold their child and although they are happy for the royal couple or anyone who is able to, they still feel the pang of emotion and hurt, and envy of not being able to hold, and cuddle their own children anymore. For some they never got the opportunity to hold their bundle of joy. It is important that we don’t forget these parents, who will always be parents, who never forget their little one.


There is a thought process after the sad news of the loss of a child from people outside of the situation where the idea is to not discuss the child, or avoid situations with the parent where there are children; this is actually an unhelpful thing for the bereaved parent. It is important to talk about the loved one, to allow the bereaved parent to talk about how they are feeling, allowing them the opportunity to feel that someone is there for them. Sadly, some child deaths can cause a massive rift between the 2 bereaved parents, which causes the break-up of their relationship. This is an event when they will need to rely on their friends and families more than ever before, and will need the support network to not apportion blame to the other parent.


As the days and months grind on, other events will arise that will then bring back all the emotions felt for the death of their child sending the intense pain back to the bereaved parents at the point of the initial loss. These events include, birthdays, Christmas, Mothers’ and Fathers’ Day etc.


So how can you support a bereaved parent? The Lullaby Trust has compiled a list that may be helpful but is not a to-do list and it is important to remember that each situation is different. The Lullaby Trust has put together some guidance on how to support a bereaved parent; we use their guidance with thanks to them:



The Lullaby Trust is there for anyone in the family affected by the loss of a child, their helpline is 0808 802 6868 or you can contact them on support@lullabytrust.org.uk.


In returning to the main aim of this month’s article, we take a look at the succession to the throne, the next 20 in line to the British throne are:


Prince Charles, Prince of Wales, (b.1948)

Prince William, Duke of Cambridge, (b.1982)

Prince George of Cambridge, (b.2013)

Princess Charlotte of Cambridge, (b.2015)

Prince Louis of Cambridge, (b.2018)

Prince Harry, Duke of Sussex, (b.1984)

 Archie Mountbatten-Windsor (b.2019)

Prince Andrew, Duke of York, (b.1960)

 Princess Beatrice of York (b.1988)

 Princess Eugenie of York (b.1990)

Prince Edward, Earl of Wessex (b.1964)

 James Mountbatten-Windsor, Viscount Severn (b.2007)

 Lady Louise Mountbatten-Windsor (b.2003)

Princess Anne, Princess Royal (b.1950)

 Peter Phillips (b.1977)

  Savannah Phillips (b.2010)

  Isla Phillips (b.2012)

 Zara Tindall (neé Phillips) (b.1981)

  Mia Tindall (b.2014)

  Lena Tindall (b.2018).

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LGBT Teaching Row

Posted by Steve at 14:50 on Monday 17th June 2019.

LGBT Teaching Row


Over recent weeks and months, we have seen demonstrations outside of a primary school in Birmingham against the school teaching about LGBT relationships to the children inside the school. These demonstrations have taken place until recently right outside the school gates and have been described by some as intimidating, for the parents, teachers and the young children themselves.


We thought we would take a look at what the issues are and to see if we can understand how these issues are actually being taught to the children.


To begin with this month, we need to explore what LGBT means and stands for. Sometimes LGBT is also known as LGBT+ or LGBTTQQIAAP. These letters and therefore the term stand for:


Lesbian,

Gay,

Bisexual,

Transgender,

Transsexual,

Queer,

Questioning,

Intersex,

Asexual,

Ally,

Pansexual.


The use of LGBT has been used since the 1990s, amending the term that was used prior to this, and is used as an umbrella term to label topics pertaining to sexuality and gender identity.


Although this term or initialisation is used to described people’s sexuality and gender identity, not everyone agrees with the use of the term and therefore argues against it. For example, there are some people who argue that transgender and transsexual causes are not the same as that of lesbian, gay and bi causes. The general argument there being that transgender or transsexual is more about a person’s understanding of, or not, being a man or women irrespective of their sexual orientation as being gay, lesbian or bi are.


It has been suggested and trialled over time to change the initialisation or term used to describe this group of people, including rainbow in line with its symbolism of pride and the LGBT community.


So, what is happening in Birmingham?


Since last month, groups of people have been protesting outside of Anderton Park Primary School. One of the protesters doesn’t actually have children attending the school and is on the protest demonstration due to his beliefs as well as in support of parents of children who attend the school, he does however have nieces and nephews who attend the school. These protests have been taking place right outside the school gates and have at times been seen as intimating for parents, who are being told to not take their children in to school, intimidating to the teachers who have turned up to work and the children who are on their way to undertake their learning through their school day. Late last month a court injunction was put into place to ensure that the protests were moved away from the school gates ensuring a safe space for parents, teachers and children to attend school, and on Monday of this week, this has been granted to last by a court until a full trial takes place next month. The case in court will consider if the school is breaking the law in delivering these lessons.


On the 20th of last month it became known that the police were called in to investigate phone calls and emails that were received by the head teacher which were threatening in nature. This clearly is not a conducive way of fairly representing either side of the argument.


The protests are focusing on lessons for which children have been given books featuring cross-dressing children as well as gay families. Most of the protests have come from Muslim protestors. It has been suggested by the leader of the protests that the lessons are leading to ‘social engineering’.


It is important to note that by September 2020 relationships’ education will be compulsory in all schools in England.


We do need to look at the use of the term that the Department for Education is using in draft guidance which is due to come into force in the academic year commencing September next year. The term used for primary schools is relationship education, sex education is not mentioned until secondary education. I feel that this is an important distinction to make! The guidance does say that schools will need to cover puberty in primary education, and it would be for the school to determine if they need to add any additional areas of sex education to meet the needs of their pupils.


The guidance also stresses that where any school goes further into sex education than the guidelines state is necessary, they must have a policy in place, and that they should consult with parents what will be covered. It also stresses that all schools should use teaching materials which are appropriate to the age and religious background of the children they are teaching. Whilst these are draft guidelines for 2020, I would imagine, considering that they are basic good practice principles, the school in Birmingham would have acted on these principles, prior to using the books that depict cross-dressing and gay families, although this is the issue for the parents who believe the teachers have not done so.


The draft guidelines start discussing relationship education by saying:


‘The focus in primary school should be on teaching the fundamental building blocks and characteristics of positive relationships.’


It goes on to say:


‘This starts with pupils being taught about what a relationship is, what friendship is, what family means and who the people are who can support them.’


Reading these few lines of the guidance alone, you can see what the aims of the lessons are, in that it is designed to support children in understanding the relationships that they will develop and go through in their life. I do feel that in the modern world we live in, there is nothing wrong in educating children that same sex relationships can form a family, after all depending on the parent’s music tastes children may come across for instance Elton John, and he has 2 children in a gay married relationship. Obviously, Elton John is not the only person in a married relationship of 2 same sex parents, but with the release of the film around his life last month, he has obviously come back into the prominent limelight.How can children can be encouraged to develop a tolerance of diverse family relationships? Their relationship education should include a basic outline of the possible and diverse family relationships they could encounter in the world around them.


It is true that throughout life children will develop plenty of relationships, and the guidance is designed to ensure that children are prepared to deal with relationships as they develop. Not only are these guidelines dealing with the face-to-face relationships but go further than this and focus on relationships that children will have and face online. As a safeguarding children trainer I would say surely this is a good thing in a world where children are facing grooming, cyberbullying and also accessing information online that could have a detrimental effect on their mental health.


I also worry for the mental health of the youngest of children who attend the Anderton Park Primary School, who were being asked to walk to school through the barrage of noise and protestors. From the pictures that have been seen on the television screens, the environment facing these children appears hostile and threatening. Whether this is actually how it is or how the camera makes it appear could be down to interpretation, but surely the mental health of these children may be affected if only because of the confusion as to why people are protesting outside what is meant to be a safe place for them. I hear the argument from some of these protestors that the lessons are having a negative impact on the child’s mental health, it has been alleged that children have gone home after school, explaining that they no longer know if they are a boy in a girl’s body or vice versa. If this is the case then the lessons would need to be explored to discover how these are being taught, and also discussion would need to be made with the children to see if they are feeling this way or are describing the lessons that they have had, remembering the importance of children discussing what they have learnt at school with their parents.


It can be said that this education of children and the subjects and content covered is an emotive subject. It is important that in a world of free speech that these opinions are discussed and considered by all, however what the education of relationships does not do, and is not designed to do, is to instruct children to become gay or lesbian etc. Moreover, from the guidance I have read it is to help children to be, and become, tolerant and understanding of the differences that exist in what is a very diverse and interesting country like the United Kingdom.


We are living in a country which is diverse culturally, religiously and across genders, and although there are areas still where there appear to be gaps between men and women, for example in the boardroom, and if you look at Parliament as a whole, however the gender gap appears to narrowing. We are lucky enough to live in a country that is welcoming and inclusive to all, even after the referendum in June 2016, which temporarily saw divisions in the wider community, and whilst today not everyone agrees with every other person’s opinions we are tolerant of those views and generally discuss them to move them forward.


I would hope that moving forward, the protestors in Birmingham look at the lessons closely, maybe even get invited into the lessons to observe them themselves, and see whether what they are feeling about the lessons is justified in their mind having seen or whether their reactions were irrational. It is important for the children in the first instance that this issue gets dealt with appropriately in the local area and the country as a whole. I am sure that when the court hears the case next month more facts will emerge and a resolution will be found.


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Shaken Baby Syndrome

Posted by Steve at 15:11 on Wednesday 17th July 2019.


In this month’s article we take a look at the subject of shaken baby syndrome.


Shaken baby syndrome is a serious issue and one that makes the headlines on lots of occasions. Not only can shaking a baby kill a baby it can, at the very least, leave the child with lifelong lasting damage that cannot be repaired.


1 in 4 shaken babies DIE!


So, in this month’s article we thought we would look at what shaken baby syndrome is, and look at a few examples from the headlines.


What is shaken baby syndrome?


Shaken baby syndrome is also referred to as abusive head trauma, shaken impact injury, inflicted head injury or whiplash shake injury. In its simplistic form shaken baby syndrome is a baby or a child being shaken violently, and sometimes repetitively over and over. It is also caused by the child being thrown or slammed against another object; however, the head does not necessarily have to hit an object in order to cause damage, the shaking of the brain inside the skull can be enough.


The damage caused to the child includes, but is not limited to, damage to the brain, bleeding around the surface of the brain, bleeding in the retinas of the eye, and fractures.


As we have already mentioned, shaken baby syndrome can at the very least cause a child to grow up with long-lasting injuries that can affect them for the rest of their lives or can cause death.


Children under the age of 1 are most at risk of shaken baby syndrome due to the nature of the age range, and obviously they tend to cry a lot more, however any child of any age is at risk.


The simple truth here is that NO child should be shaken, EVER.


Estimates show that between 14 and 33.8 per 100,000 children suffer ‘non-accidental head injuries’ each year according to the NSPCC, this includes shaken baby syndrome. To give this some context, if you base population on 800,000 children, between 112 and 270 of these children would be suffering from these non-accidental injuries each year.


The cause of shaken baby syndrome


Babies have weak neck muscles which often struggle to support the weight of the child’s head. Therefore, these muscles are not strong enough to prevent the shaking motion when a baby is shaken with force allowing the brain to be shaking inside of the skull.


One of the most common causes of shaken baby syndrome is the adult’s frustration at the child’s crying. This can cause the adult, usually the parent to ‘snap’ if the child’s crying is persistent over a long period, and in a bid to stop the child crying the adult ‘snaps’ and shakes the baby to stop their crying. In that split 3 to 5 seconds a lot of damage can be caused.


This is NOT an acceptable excuse, STOP and think before you act. Have a plan – Take a break!


Other reasons that have been seen over the years is one parent’s jealousy of another, resulting in taking it out on the child or by causing the child an injury the parents have to come together and therefore the guilty party gets the attention from the other parent that they were seeking. We will look at this particular reason in due course when we look at 2 cases from the news headlines.


Jealousy is no reason to harm a child EVER!


Another cause of shaken baby syndrome can actually be a complete accident, where the child has slipped out of the grasp of the parent’s arms and has shaken their head as they fall to the floor, as well as hitting their head potentially on the floor as well as any other hard surface as they fall to the floor from their parent’s grasp or from the nappy changing table, or even bed. Of course, it is perfectly feasible that a parent could fall over accidently while they are walking with their child and this too can cause the child to suffer from shaken baby syndrome.


Some parents/child carers have unrealistic expectations of the child in their care and therefore lash out at the children through frustration because they are not achieving what they feel is achievable for the child. This could be because of the expectations that they had placed on them by their parents, therefore causing a vicious cycle that repeats itself.


Another risk factor of shaken baby symptom is when the parent is a single parent and therefore trying to cope with looking after a child on their own, maybe with little or no support; it may also be that they are coping with the break-up of a relationship as well as having to meet the needs of their baby. It may be the case that the parent of the child is young and may not have the support of others or little life experience and is unsure of how to soothe and meet the child’s needs.


Other situations that could cause a parent to lash out and shake their baby could be that they are in unstable family relationships or are suffering from domestic abuse. It could be the case however that the domestic abuser is shaking the baby in order to punish the victim for something that the abuser has deemed they have done wrong.


Depression can impact on a parent’s treatment of their child and therefore can result in them shaking a baby.


The final common risk factor for shaken baby syndrome is concerned with alcohol and substance abuse. Being under the influence of these substances can impair the parent’s rational thoughts and when the child cries or pushes for something reasonable, the parent who is under the influence can react in ways that are irrational and once they have sobered are likely to realise that they have behaved in a manner that is not how they would have behaved in another situation.


Statistically men are more likely to cause baby shaken syndrome than women


What damage can shaken baby syndrome cause?


Shaking a baby or infant can damage and destroy the brain cells preventing the brain from getting enough oxygen, and, as we all know, oxygen is the fuel for life. Shaken baby syndrome is a type of child abuse resulting in permanent brain damage at the very least and potentially also death.


Signs and Symptoms of shaken baby syndrome:


There are some signs and symptoms that should be looked out for in the instance that you are worried a child has been shaken, they are as follows:



Although these are all signs that can be seen sadly, due to the nature of the injury inflicted to the child, there may be signs that you cannot see. Injuries that may not be immediately obvious to see include bleeding on the brain, or in the eyes, spinal cord damage, fractures to various bones of the child’s body including, the skull, ribs, and legs as well as any of the other bones in their body.


In mild cases, the child may not actually show any of these signs at all, and may also appear perfectly fine, until much later when they may develop physical or behavioural issues.


No Child should be shaken EVER


If you suspect that a child in your care has been injured by being shaken violently you should seek medical advice immediately. Acting fast and immediately may save the child’s life or prevent serious health issues from occurring. It is worth noting that health practitioners do have a legal duty to report any cases of suspected abuse to the police, however, in the interests of the child this should be seen as a positive step and not a negative one.


Shaken baby syndrome IS child abuse


First Aid textbooks say gently shake


Textbooks that are aimed at adult casualties state that the casualty should be gently shaken in order to determine whether they are responsive or otherwise. Whilst this is written in textbooks and is up-to-date advice from the Resuscitation Councils of Europe and the UK, the key word in that sentence is ‘gently’. This is important for many reasons including not causing any further unnecessary injury to the spine of the casualty. Anyone that has attended one of our first aid courses will be aware that we advise first aiders to press on the clavicle (collarbone) to cause a gentle pain to the casualty rather than gently shaking. This gets away from shaking the casualty and causing further spinal damage. However, some first aid textbooks, including the ones that we use on all our first aid courses state that for a child or an infant under the age of 1, you should gently tap the shoulders and depending on the age of the casualty ask loudly ‘are you all right’ or simply shout loudly to try to wake the casualty. Again, there is no sign of the words ‘gently shake’.


However you decide to try to get a response from a child casualty, you should never shake the child in order to get the response.


Shaking a baby is NOT first aid


We thought at this stage of the article we would have a look at some simple tips parents can use to help soothe their child. We have based our top tips on the advice provided by The Canadian Paediatric Society.


How to soothe your child:



These may seem the simplest things but sometimes, it really can be the simplest act that soothes a child the most and quickest; it is always worth checking this specific needs’ list.



Some parents hold a fear that if I ‘give in’ to my child and I hold them too much they might become clingy or spoiled because I gave them too much attention, however, simply holding your child will not spoil them. Although you should be aware that some babies do not like being passed from person to person.



Tightly wrapping your child can soothe them as they feel protected, could provide some pain relief to the child, and can improve sleep, as long as it done safely it can be a good technique to use. The Canadian Paediatric Society has provided the following advice on how to swaddle a child: https://www.caringforkids.cps.ca/handouts/swaddling



Too much stimulation can trigger crying or make it worse.



A top tip that we would suggest and has worked well over the years is the use of low volume panpipe music being played in the background as the child drifts off to sleep.



You could try walking with baby in a sling or in a stroller. Rock or sway with baby in a gentle, rhythmic motion. Or try going for a car ride, many a child has fallen asleep with the gentle motion of the car in transit; some parents however find that this works until the car comes to a halt and the sudden lack of movement and/or engine can cause the child to wake up.



You can provide this by allowing your baby to breastfeed, or by offering a dummy or even a teething ring. Some children will not want any of these things to suck on and may need a reminder that they can suck their thumb which is their natural soother.



The warm water will help to wash over the child, like it does with an adult, it can have a calming effect and then gently aid the child to fall asleep once they are dried.


What can I do if my child keeps crying and it’s getting to me?


If you have checked that your child does not have any specific needs as we discussed earlier, then maybe it is time for you as the childcarer/parent to help yourself feel calmer.


One of the most important things that you can do is to be aware of how you are feeling, whether it be upset, angry or frustrated. In this situation take a moment to relax.


One of the things that parents worry about is leaving their child to cry. If you leave a child in their cot to cry for a few minutes it is not going to do them any harm, and in the meantime you are able to breathe and relax for yourself without snapping and causing further harm to your child. One of the things that you can do is take some slow deep breaths to help you calm and bring your breathing back under control.


If you are feeling emotional and have the urge to cry, then cry. Don’t be afraid to let your emotions out, if you let the tears out it can help you to come back to the child fresh and ready to take the challenge of the child’s needs again.


If you feel that it will help you, you could take a 5 minute shower to let the warm water fall over your body and the sensation of the falling water can actually help you relax and feel calm. Add your favourite body wash scent and a calmer parent should emerge from the shower.


We would always encourage you to talk to someone who you feel that you are able to trust, so that they can potentially support you and your needs, and maybe if you ask them they can look after your child longer than a 5 minute break to help you have some me time and come back all refreshed.


Should you feel that you are at risk of hurting your child the best thing you can do is to place the child safely in their cot, and walk away, calling for help, whether it be a family member, neighbour, support line, social services or the police. The best thing to do is to have a look in your local telephone book for advice lines and local support numbers. We would suggest that you have these in a plan for when these stressful, I can’t cope, I’m going to hurt my child moments occur.


2 Cases from the headlines


To end this month’s article we thought that we would look at 2 cases that have made the news’ headlines in recent years, one of which occurred in the United States and one more recently from the UK. This recent news story was sent to us and is the inspiration for this article.


The Case of Matthew Eappen


In 1997, a British au pair living in the United States of America was convicted of the involuntary manslaughter of 8-month-old Matthew Eappen while he was in her care in Newton, Massachusetts.


On February the 4th 1997, Matthew Eappen was admitted to hospital, where he fell into a coma and died 5 days later from a fractured skull and a subdural haematoma. Matthew was found to have other injuries including a fractured wrist and an unidentified, untreated month-old injury. An ophthalmologist at the hospital also noted that Matthew had retinal haemorrhages, which was judged as a major characteristic of shaken baby syndrome.  


In her police statement, 19-year-old British au pair, Louise Woodward stated that she had popped Matthew onto the bed. This became a controversial phrase for her to use as it has double meaning depending on the country you are in. In the UK, popped would suggest that she had placed or put Matthew on the bed, in America the phrase implies violence. In addition to the use of the word popped, police maintained that Louise had also said that she had dropped him on the floor and been a little rough with him. The police officer who interviewed her immediately after the incident is adamant that Louise had not used the word popped but rather dropped.


Louise Woodward was arrested on February the 5th for assault and battery, which was upgraded to murder on the death of Matthew Eappen. A grand jury in the US judiciary decided on a first-degree murder charge and she was refused jail and held at a high security prison until her trial.


Obviously, leading up to and including her trial there was a lot of interest in this case not just in the United States but also in the UK as Louise was one of their own.


During the trial, the prosecution used evidence from 8 physicians including:



All of these physicians testified to their belief that the injuries received by Matthew were as a result of violent shaking and from his head hitting a hard object.


The defence however argued that this cannot be the case; the child in question did not have any neck injuries to him that they would have expected had he received the injuries that the prosecution was alleging. The prosecution initially claimed that the child’s injuries were equivalent to the child having fallen from a 2-storey building however equivocated over this throughout the course of the trial.


The defence also highlighted in their submission that Matthew had some injuries that could have occurred some three weeks earlier than his death, implying that his parents who were both doctors could have been responsible for the injuries to their child. They also said that he had an old wrist injury which could have been caused before Louise even entered the household. She herself under cross-examination stated that she never noticed any slight bumps, marks or any abnormal behaviour prior to his admittance to hospital.


Her defence team even requested that the jury not be given the option of determining manslaughter, but that they should only have the choice of guilty of murder or not guilty. Under direct questioning from the judge, Louise agreed with her defence team; she was found guilty by the jury on October 30th 1997 after 26 hours of deliberation and was sentenced the following day to a minimum of 15 years in prison.


This was not the end of the case!


An appeal hearing commenced on the 4th November 1997, in which her defence team were aware that the original jury were split over the murder charge and the jurors who were convinced of an acquittal were convinced to switch to the murder side. This fact is of no legal consequence, one of the jurors is also quoted as saying that ‘none of the jury thought she had tried to kill him’.


In a post-conviction hearing on the 10th November, Judge Zobel stated, ‘the circumstances in which the defendant acted were characterised by confusion, inexperience, frustration, immaturity and some anger, but not malice in the legal sense supporting a conviction for second-degree murder.’ He added ‘I am morally certain that allowing this defendant on this evidence to remain convicted of second-degree murder would be a miscarriage of justice,’ as he reduced her charge to involuntary manslaughter.


Her sentence was reduced to time served, a total of 279 days and she was freed. There was a prosecution appeal against this which was unsuccessful, and on June 16th 1998, Louise Woodward returned to the UK.


This story does seem to hold questions even today from the evidence that was heard, the question being was the right person in the dock, or had the parents had something to do with the little boy’s death. However, once Woodward was no longer subject to criminal exposure she did admit to ‘lightly shaking the child to revive him’.


Shaking a baby is NOT First aid!


After all these years it is still one of the highest profile shaken baby syndrome cases, and is still talked about in newspapers and magazines on both sides of the Atlantic. In 2007, Woodward was described by Boston law magazine, Exhibit A, as the ‘most notorious criminal convicted in Massachusetts’.


Finally, we turn our attention to the article that is the basis for this month’s article; this news story was in the Liverpool Echo and other news’ outlets on June 22nd this year. In the Liverpool Echo the headline read:


Baby robbed of normal life by dad's angry outburst is only the latest in a line of tragedies


This news story revolves around the court case of Mehmet Tufan who left his son permanently brain damaged by shaking him. The child and mother in the case are not able to be named under court rules. The story highlights everything that we have discussed throughout this article and that parents should be aware of the dangers.


The story of this little boy’s injuries starts on a night in April 2018 when Mehmut was jealous that he was left to look after his 5-week-old son alone as the mother had gone on a night out. After an argument over text messages about a lad asking the child’s mother to dance, Mehmut pretended that the child was seriously ill in an effort to make her come home to him and the 5-week-old child.


Mehmut was scolded by his partner and the baby boy’s mother for trying to make her panic and he later inflicted a catastrophic head injury on to the child. The court heard that he had shaken his son for a ‘matter of seconds’ these few seconds were enough to leave the child unable to walk and blind.


The mother told the court that the child nearly died from his injuries which doctors described as ‘an extensive brain injury, blood in his spinal cord and extensive retinal haemorrhages’ which have left the child in a special wheelchair.


Mehmut pleaded guilty to inflicting grievous bodily harm in what the prosecutors had described as ‘a momentary loss of control’, he was sentenced to 2 years in prison, although the judge added that no sentence whatsoever would help the child to ‘live a life to which he was entitled’. The judge had accepted that Mehmut had suffered from anxiety and nervousness and panicked after the incident.  


In summary of this month’s article:


NO child, of any age, should EVER be shaken,

Shaking a child is NOT First Aid

Jealousy is no reason to harm a child EVER.


Shaken baby Syndrome IS Child Abuse.

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Head Injuries

Posted by Steve at 12:00 on Thursday 15th August  2019.


On Saturday afternoon, an 11-year-old boy, called Louis, was waiting outside Melwood, the training ground of his footballing heroes Liverpool Football Club, hoping that he might get a glimpse of one or two of his heroes as they exit the ground from their training session. This boy was in luck! He was lucky enough to catch a glimpse of his hero, Mo Salah. This was the start of a series of events for Louis, one that he would want to avoid and the other that he is happy happened.


On seeing his hero drive out of the training complex he decided to chase the car down the road, colliding with a lamppost in doing so. This knocked him unconscious. The 11-year-old was aided home, not living that far away, and was awaiting the arrival of an ambulance as he had been unconscious with a suspected head injury. However no one expected what arrived before the ambulance….


Mo Salah arrived at the lad’s house to check that he was ok and was then happy to pose for a photograph with him, as well as reminding Louis that he needs to look where he is going when he is running, to avoid causing himself any harm.


The photo has been shared on social media by Louis’ stepdad, Joe Cooper, and we thank him for the photograph used above, and is the basis of this month’s article which focuses on head injuries. Before we get to head injuries themselves, we would just like to reassure you that Louis is perfectly fine, other than having to have his nose reset, during a visit to Liverpool’s Alder Hey Children’s Hospital. When asked if the pain was worth it, his very simple one-word reply came – ‘definitely!’


Head Injuries


Head injuries occur more often than a lot of people realise.


A head injury can be potentially serious, with life-threatening injuries. They can lead to damage to the brain due to the lack of oxygen that gets to the brain; this damage can be permanent and severe. There may be other injuries that occur following the event that causes a head injury which can include injuries to the neck and spine, and scalp wounds. For further information on the spine, please ensure that you check out January’s article. Before we explore the 3 different head injuries, we should look at the make-up of the head.


The head itself is made up of 4 major parts, all of which have a major function in the human body:


1: Skin:


The skin is a major organ of the body which, at the thickest part of itself, is only a few millimetres thick, however it has 7 main functions:


Protection


The skin protects the body from harmful things in the outside world including the cold, germs and the sun’s rays. This is a pretty remarkable job when you consider how thin, delicate and flexible it really is.


Sensation


The skin picks up sensations through the network of nerve endings that feed the skin and sends the signals back, The skin is able to pick up how much pain there is at one point, if there is any pressure on it, as well as whether the body is hot or cold, and then send a message back to the brain to get the temperature regulated!


Allows movement


The skin is an amazing organ, as well as being the largest organ that we have. It has evolved over the years to ensure that whilst it is protecting the body it also allows the body to produce a range of movements that are needed to survive, for example, move and eat.


Endocrine


The skin aids the endocrine system by producing the vitamin D that the body needs, in order to rejuvenate and grow cells as well as for the metabolism of the body.


Excretion


The skin plays a part in the excretion system, through its production of sweat. Sweating is good for the body as it eliminates excess water and salts as well as reducing the amount of urea.


Immunity


The skin is a natural physical barrier to infections, germs and diseases entering the body. It also carries adaptive immune systems to enable it to actively fight off infections.


Regulate temperature


Effectively your skin is your thermostat, it regulates your body heat by instigating shivering so the blood vessels contract when you’re out in the cold or through the secretion of sweat when you are hot.


2. Skull


The skull is the bony structure that traps your brain inside, it forms the head of vertebrates and its most important job is to provide a protective cavity for your brain, as well as structuring the face. The skull is made up of 2 parts: The cranium and the mandible.


3. Cerebrospinal Fluid


Cerebrospinal fluid (CSF) is a colourless clear body fluid that is found in the brain and the spinal cord. It is produced in the specialised ependymal cells of the choroid plexuses of the ventricles of the brain and is absorbed in the arachnoid granulations. CSF has 3 main functions:


Protect the brain and spinal cord from trauma,

Supply nutrients to the nervous system, and

Remove waste products from the cerebral metabolism.


4. The Brain


The brain is one of the most complex and largest of all organs in the human body. It is made up of more than 100 billion nerves that communicate in trillions of connections called synapses. The brain is made of many specialised areas that work together.


It is argued that the brain is the most important organ in the whole of the body. It is the organ that:


Co-ordinates actions and reactions,

Allows us to think and to feel,

Enables us to have memories and feelings.


The above are arguably all the things that make us human, therefore the brain makes us human! Of course, the brain works only by receiving the oxygen and blood that it needs to survive and therefore it is vitally important that these things are preserved to get to it.


From our quick rundown of the 4 important parts of the head, it is clear to see that the head is really important and should be looked after as much as is possible, and of course it can be seen why any head injury can cause such big problems.


Let’s look into head injuries.


There are 3 main head injuries that we will explore in this month’s article, they are:


1. Concussion,

2. Compression,

3. Fractured Skull


1. Concussion


Concussion is often referred to as ‘shaking of the brain’ as this is effectively what concussion is. Because the brain is cushioned by the cerebrospinal fluid, when the head receives a blow the brain can bounce from one side of the head to the other.


The effects of concussion can take up to 24 – 48 hours for them to show themselves, but usually the recovery time is only really a few days with very often little long-term damage.


Should the casualty have concussion you should be on the lookout for:


Unconscious for a short period of time, where the response levels should improve afterwards,

The casualty should recover back to themselves completely with no complications,

Memory loss (of the incident) or confusion is common, as is repetition,

Unusual behaviour,

Pale, clammy skin,

Mild general headache,

Dizziness and

Nausea.


Concussion can be harder to spot in children and therefore you should be on the lookout for any changes in their normal pattern of behaviour, for example are they crying a lot more than normal, have their feeding or sleeping patterns changed, have they even lost an interest in objects or people.


2. Compression


Compression is a serious, and can be a life-threatening, injury. It is caused when the casualty has received a heavy blow to their head causing a bleed or swelling inside the skull which is pressing on the brain.


If you are suspecting cerebral compression, your casualty may show these signs and symptoms:


A recent head injury, which has apparently recovered, but now the casualty is deteriorating,

Levels of response becoming worse as the conditions develops,

Confusion and irritability,

Flushed, dry skin,

Intense headache (Imagine the worst one you can think of!), and

Nausea.


3. Fractured Skull


A fractured skull is serious as the damaged part of the bone may cause direct injury to the brain itself, or it can cause bleeding which can cause pressure to build up on the brain.


You should suspect a skull fracture for a casualty who has received a head injury and their levels of response are dropping and lowering.


Other signs and symptoms may include:


Concussion and/or compressions signs and symptoms may be present,

Cerebrospinal fluid and blood coming from the ears, nose, mouth or tear ducts,

Swelling or bruising of the head,

Swelling or bruising behind one or both ears,

Swelling or bruising around one or both of the eyes.


Treatment


It is very important that you remember any blow which is large enough to cause a head injury can also cause a spinal injury, therefore you must treat your casualty with care. For more on spinal injuries see January 2019’s article.


Should your casualty have been unconscious, or their response levels are dropping, or you are suspecting a spinal injury call 999/112 for emergency help straight away.


Remember to maintain their airway and breathing. If you are unsure how to do this, then why not book onto one of our courses?


Is your casualty unconscious but breathing? If the answer to this question is yes, then keep them still and continually monitor their breathing. If they are struggling to maintain their own airway then they will need to be carefully rolled into the recovery position, remember to keep their head, neck and spine in line.


Is your casualty unconscious and not breathing? Then you will now have to proceed with Cardio-Pulmonary Resuscitation (CPR) in order to help them until the paramedics arrive.


What if your casualty is conscious? In this situation, help the casualty to lie down, keeping their head, neck and spine in line in case there is a spinal injury that you and they are not aware of.


You will need to carefully consider if there are any other injuries that you will need to treat. If they are bleeding then you should try to control it by applying some gentle pressure to the affected area, however, should the blood be coming from the ear, then allow the blood to drain away, do not try to plug the ear.


There are some useful tips that are worth remembering when you are dealing with a suspected head injury as follows:


If you are suspecting that the casualty is suffering from concussion, arrange for them to see a healthcare practitioner as soon as possible. Do not allow them to continue playing sports and remain with them until they have been properly assessed by the trained medical professional.


Always be alert to the casualty’s levels of consciousness, breathing and pulse, and record all of your observations to hand over to the medical staff.


Seek medical advice before allowing the casualty to eat or drink.


Are you ready for the most commonly asked question that we receive about head injuries?


The question is this: Following a head injury is the casualty (usually child instead of casualty) allowed to sleep?


The correct answer to this question is that they are allowed to sleep following a head injury, however you should be able to wake them and get a response. Generally, you should look to get a response every 10 minutes from them.


We would add that even if they have appeared to have recovered sufficiently from their head injury, you should be looking out for subsequent reduction in the levels of their response.


The reason that the advice now allows a casualty to sleep is because it is the body’s natural way of healing. If the casualty wants to go sleep after a head injury at their normal sleep time, then this may be a normal thing as opposed to being a worry, but remember they have just received a head injury and should have their response levels checked. If they would not normally go to sleep at this time, then maybe this is a worry sign, so be extra vigilant and if they are not able to be woken, or they do not respond to your response check then you should call the emergency services for an ambulance.


What should I look out for in the days following a head injury?


Should you see any of these signs and symptoms in your casualty in the days following a head injury, they should go to the hospital immediately:


Worsening headache,

Nausea or vomiting,

Increased drowsiness,

Weakness in an arm or leg,

Speech problems,

Dizziness,

Bleeding or fluid coming from an ear or the nose,

Visual problems,

Seizures, and/or

Confusion.


If you wish to find out more, why not book onto a First Aid course with us that covers head injuries. All our course information pages detail what is covered on that specific course.


We look forward to welcoming you onto a course in the future.

In the meantime,

enjoy the summer and please do stay safe!


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This month we take a look at the human body and, in particular, the spine. The spine is an important part of the human body and has several functions which we will look at through this blog and, as such, is a vital part of the body to be looked after by its owner!


Location of the spine


It is possible that everyone knows the location of the spine. Just for the avoidance of doubt, the spine is located in the centre of the back and reaches from the base of the skull right down the bum.


Main functions of the spine


The human spine has 3 distinct functions:


1. Protect the spinal cord, nerve roots and several of the body’s vital organs.

2. Provide structural support and balance to maintain an upright posture.

3. Enable flexible movement.


Make-up of the spine


The spine is made of several sections as follows:

Cervical

Thoracic

Lumber

Sacral

Caudal.


Cervical Vertebrae

Diagram of the spine

The cervical vertebrae are located in the neck area of the spine. There are 7 vertebrae in this area. They are abbreviated down to C1 through C7 from top to bottom. The role of the cervical vertebrae is to protect the brain stem, support the skull and allow for a wide range of head movements.


If we take a look at the individual vertebra we will see that they are all shaped slightly differently. Vertebra C1 is called the Atlas and is shaped like a ring, supporting the skull. Vertebra C2 is circular in shape, with a blunt tooth type structure which projects upwards to the Atlas, and is known as the Axis. Together the Atlas and Axis allow the skull the full range of movements. Vertebrae C3 through C7 are similar in design, box-shaped with small spinous processes extending from the back of the vertebrae. Spinous processes are finger-like projections; they provide the point of attachment for the ligaments and muscles of the spine.


Thoracic Vertebrae


Beneath vertebrae C7 there are 12 vertebrae collectively known as the thoracic vertebrae. When they are abbreviated by medical staff they are referred to as T1 through T12 from top of the section to the base. Vertebra T1 is the smallest of the thoracic vertebrae with the bottom vertebra T12 being the largest. The thoracic vertebrae are larger than the cervical vertebrae and have longer spinous processes protruding from the back of them.


The thoracic vertebrae are connected to the rib cage which provides strength and stability for the spine, also making this section of the spine one of the strongest and most protected. Not only that, but the rib cage joining on to the spine assists the spine in protecting many of the vital organs contained within this area. Movement in this section is limited due to its restrictions of the rib cage.


Lumber Vertebrae


The lumber vertebrae are the largest of the spinal bones. In this section of the spine you will find 5 vertebrae known collectively as the lumber spine. They are abbreviated by medical staff to L1 through L5 from the top to the bottom. The lumber vertebrae carry most of the body’s weight. They allow a lot of movement but much less than that of the cervical spine. Lumber facet joints enable the lumber area to have significant flexion and extension movement but limit rotation.


What is Flexion and Extension Movements?


Flexion is the bending of a particular joint so that the bones forming the joint are pulled closer together. A visual example of this would be when the elbow bends, it reduces the angle of the ulna and radius bones in the arm.


Extension is the opposite movement to flexion in that it is a straightening movement that increases the angle between body parts.


Sacral Vertebrae


This is the 4th section of the spine vertebrae which is located behind the pelvis. There are 5 bones in this section of the spine and are abbreviated to S1 through S5. The bones are fused together in a triangular shape forming the sacrum. The sacrum fits between the 2 hip bones, connecting the spine securely to the pelvis. The fifth lumber vertebra moves in line with the sacrum.


Caudal Vertebrae


This is the final section of the spine, consisting of 4 bones which are fused together to form the Coccyx.


The spine in its entirety contains 33 of the 206 bones in a human body, that equates to almost 13% of the body’s bones. The other important thing to remember about the spine is that it holds the spinal cord through the middle of it, helping to send your nervous system around your body. Some people want to include the skull and the pelvis into the spine; this is however an incorrect thing to do. However these extra body parts do interrelate with the spinal cord and help to impact balance.


Spine curves


The spine is considered by many people to be straight, this is in fact not the case. The spine, if you look at it from the front, will indeed appear straight, however from the side the spine has 4 distinct curves in it. One of the curves in the spine, around the lumber vertebrae is an important curve as it helps to maintain a person’s centre of gravity. A person’s centre of gravity moves with each load and lift a person takes on before returning to normal. If this particular bend didn’t exist, we as human beings would simply fall over!


The curves in the spine are described as either kyphotic or lordotic. What do these words mean and which section of the spine will we find them in?


Kyphotic:


Found in: Thoracic and sacral sections of the spine.


Means: it is a convex curve in the spine. The convexity of the curve is towards the back of the spine.


Lordotic


Found in: Cervical and lumber sections of the spine.


Means: it is a concave curve in the spine, with the concavity towards the back of the spine.


In the diagram that we provided earlier the back of the spine is towards the labels of the spine sections. If you feel your own back, you are able to feel the spinous processes that are protruding from the back of the vertebrae.


Intervertebral Discs


Intervertebral discsBetween each of the vertebrae there is a cushion, also known as a disc, spinal disc or intervertebral disc. The purpose of the discs is to absorb the stresses the body endures through movement and also to prevent the vertebrae from grinding against each other, therefore preventing the sound of crepitus (2 bones make this sound when grinding against each other!). These objects are the largest structures in the human body without a vascular supply going to them. Each disc will absorb the nutrients  that it needs through the process of Osmosis. Each disc is

made of 2 key parts:



Illustration from Anatomy & Physiology, Connexions Web site.                                                                                Annulus Fibrosus and

http://cnx.org/content/col11496/1.6/, Jun 19, 2013.                                                                                                 Nucleus Pulposus.


Annulus Fibrosus


The Annulus Fibrosis is a tough tyre-like structure that encases a gel-like centre, the Nucleus Pulposus. The Annulus Fibrosus enhances the spine’s ability to rotate and also helps to resist the compressive stress. It has a layered structure which consists of water and sturdy elastic collagen fibres. The fibres are orientated at different angles horizontally similar to that of a tyre. Collagen consists of fibrous bundles made of protein that are held together by proteoglycan gel.


Nucleus Pulposus


The Nucleus Pulposus is found in the centre of each of the Annulus Fibrosus, and is a gel-like elastic substance. Together with the Annulus Fibrosus, the Nucleus Pulposus distributes stress and weight from vertebra to vertebra. Structurally the Nucleus Pulposus is similar in make-up to that of the Annulus Fibrosus in that it contains, water, collagen and proteoglycans. However the concentration varies between the 2 things, especially as the Nucleus Pulposus has more water in it.


Why is it important to look after your spine?


Your spine, as we have looked at, already does an amazing job of looking after your organs, providing support and flexible movements as well as maintaining an upright posture. In life you are given just the one spine and that will see you through the entirety of your life, or at least that is the plan. The sad thing is however that poor manual handling and lifting practices can cause injury. In the workplace over 8.8 million working days are lost due to musculoskeletal disorders, over 40% of these account for back injury.


Safe moving and handling


Manual handling includes:


Pulling,

Pushing,

Lifting,

Carrying,

Moving,

Putting Down,

Using Mechanical aids e.g. trucks and trolleys.


In the workplace, there is legislation in place. This piece of legislation is called The Manual Handling Operations Regulations 1992. Within this piece of legislation, it says that the employer should identify manual handling risks and, where practical, avoid manual handling risks. If avoidance is not possible the employer should take a risk assessment on the task needing to be done.


A good risk assessment that could be used is the TILE assessment, which we will look at now.


The TILE assessment stands for:


Task

Individual

Load

Environment.


Let’s explore these areas:


Task


You will need to look carefully at the task to be done, things that could be considered include:


Does it involve handling away from the body?

Are there movements such as bending, stretching, or twisting?

Is the movement over a long distance or is it repetitive?


The employer will need to consider whether the task can:


Be completed by using machinery, or handling aids,

The task layout be improved,

The movement of the body be modified,

The work routine be improved,

The task be completed in a team.


Individual


Once the task has been analysed the individual capability will need to be considered as follows:


Is the person completing the lift fit and healthy?

Have they been given training and information? Are they competent to do the task?

Is suitable supervision provided?

Are there any unusual circumstances that would cause a risk to certain employees e.g. is she pregnant?


The employer making the risk assessment could consider:


Pre-employment medical,

Provision for training and information,

Ensuring the employee is competent in safe handling techniques,

Providing supervision.


Load


The load is a really important aspect of the assessment to be carried out. The person who is going to lift it should consider:


How heavy is the load?

Is it equally balanced?

Is it stable?

Does it have sharp edges?

Will the contents shift?


If the load really does have to be lifted and moved, then control measures that could be considered are:


Make the load lighter by splitting it,

Make the load smaller,

Provide handles to make it easier to grasp,

Make the load more stable.


Environment


In everyday living we have to consider the environment, and in a moving safely lift this is no exception, you will have to consider the following:


Is there enough space to carry out the task?

Is the floor even or slippery?

Is there good lighting?


In order to maintain safety, you could consider the following things:


Can the workplace layout be improved?

Can you improve the floor condition?

Can we keep the lift to one level?

Can you improve the environmental conditions?

Do we have a good housekeeping process in place?


Of course, there are other things that should be taken into account as well the TILE assessment and these things include:


Is movement hindered by work equipment?

Is movement being hindered by any Personal Protection Equipment (PPE)?

Issues that arise from employees identifying a lack of training or communication.


How to lift and move safely


There is a very easy, simple 6-step process to move safely this is:


Step 1: Stop and think.

Step 2: Position your feet.

Step 3: Bend your knees.

Step 4: Get a firm grip and keep the back slightly flexed.

Step 5: Raise with the legs.

Step 6: Keep the load close to your body.


Below image has been used with thanks to https://www.theimagen.eu


How to lift safely diagram


Want to know more about looking after your spine and how to safely move and handle objects? Why not attend one of our courses? For more information visit the Moving and Handling section of our website by clicking here.



The Spine and Safe Moving and Handling

Posted by Steve at 12:45 on Tuesday 15th January 2019.

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Emergency Services’ Telephone Numbers

Posted by Steve at 12:45 on Friday 15th February 2019.


This month we thought we would have a look at the emergency telephone numbers that are used in the United Kingdom and abroad.


Do you know what telephone number to call when you need emergency assistance around the world?


The number used will vary depending on the country; below is a list of numbers that may be useful:


The UK   - 999


Australia  - 000

Barbados  - 911

The Bahamas  - 911 or 919

Brazil (Police)   - 190

Brazil (Ambulance) - 192

Brazil (Fire)  - 193

China (Police)   - 110

China (Ambulance) - 120

China (Fire)  - 119

European Union  - 112

Hong Kong  - 999

India   - 112

Japan (Police)  - 110

Japan (other services)  -  119

New Zealand   - 111

USA and Canada - 911


So that’s made it much more clearer, hasn’t it? Well technically no it hasn’t as there are so many different emergency numbers for the same purpose, and not only that but the list also shows that there are countries who even have different numbers for each of the different services!


So why 999?


999 was the world’s first automated telephone to contact the emergency services. The first call originated in 1936. The idea of the emergency service contact number goes back even further than this, as in 1935 5 women died during a fire in Wimpole Street, London. Neighbours of the women had dialled ‘0’ to get in touch with the emergency services, which connected them to the switchboard, sadly, what these callers found was that the switchboard was jammed full of other calls that were not an emergency. This method of contacting the emergency services had been recommended since 1927.


During the 1920s and 30s police stations were being overrun with visitors alerting them of emergencies as well as having to field calls from the telephone which was a new invention at the time. The other way, during these decades, to contact the emergency services was to ask the operator for Whitehall 1-2-1-2, which was the Information Room set up at the Metropolitan Police Headquarters on Victoria Embankment.


Following on, from the 5 women’s deaths in Wimpole Street the General Post Office, that ran the telephone network, suggested a 3-digit telephone number that could be dialled to trigger a special signal and flashing light at the exchange. This would then signal to the operators to give their attention into this call. In order to find the new emergency number in the dark or smoke it was suggested to use an end number so that it could be easily found by touch.


Many combinations were suggested, ‘111’, was ruled out immediately as it could be triggered by faulty equipment or lines getting crossed. ‘222’ was also ruled out as it would have connected to the Abbey Local Exchange as in those days the number represented the first three letters ‘ABB’. They also looked at using ‘1’ and decided against this as it could be accidentally triggered, and ‘000’ wasn’t used as the first ‘0’ would have connected to the switchboard.


999 was then deemed to be the most reasonable choice of number. The service came into effect on July 1st 1937 and covered a 12-mile radius from London’s Oxford Circus. Several people claimed to have made the first 999 call, however one newspaper claims the first 999 call was made by Mrs Beard of Hampstead, on July 8th 1937. She was reporting a burglar that her husband was chasing, and he was promptly caught.


It is believed that during the first full week of 999, a total of 1,336 calls were made. In the November the Information Room was able to take over the control of the calls, and the system started to get rolled out around the UK, in particular Glasgow, in 1938.


By 1967, 400,000 calls were made to the Police in London, with over a million for all services across the UK.


What happens when you call 999?


When you call 999, the operator will ask which service you require. Here we take a look at the ambulance. Your call will be connected to an Emergency Operations Centre. The person on the other end of the line, known as a call handler, will then ask you a series of questions. It is important to note that these questions will not slow down the ambulance to reach you but will allow the call handler to fully assess the needs of the casualty.


You will need to ensure that you have the following information available for the call handler:


The address of the emergency including postcode:

This is possibly the most important information you can provide to the call handler, as it will help the ambulance to reach the emergency as quickly as possible. Should you be in a rural, countryside location, if you can provide the grid reference that will be a big help. If you are totally unsure you should look for telephone boxes, members of the public who you could ask for your location, motorway marker boards if these are safe for you to view or street signs. All of these things can assist you in providing location information to the call handler.


The telephone number you are calling from:

This is helpful for the call handler should the call get disconnected and they need to call you back to continue getting information from you to help them assess the casualty.


What has happened:

If you are able to, you should provide the call handler with as much information as you can as to the circumstances around the emergency, the state of the casualty’s health and what you are doing in order to support the casualty.


Once you have handed this information to the call handler, they are able to release an ambulance, the call handler will then ask you further questions. These questions will help the call handler to provide you with first aid advice that can help you to look after the casualty until the ambulance staff arrive to take over.


The questions they may ask include:


The casualty’s age, gender and medical history,

Whether the casualty is conscious and breathing or otherwise,

Is the casualty bleeding?

Does the casualty have any chest pain?

Details of the casualty’s injury and how it has happened,

What part of the body is injured?

Is there any serious bleeding?


Depending on the cause of the injury, you may be asked if the attacker is still on scene, so that the crew can be advised, and if necessary held back until the Police are able to attend and assist. Another relevant question may be is there anyone trapped inside a vehicle, this will then help the call handler to arrange other assistance that their crew may need, e.g. the Fire Service.

While you are at the scene of the emergency it is important that you remain as calm as you possibly can and listen carefully to the questions being asked of you, so that you are then able to provide the call handler with the information they require. While you are waiting for the ambulance the call handler will provide you with information you need to be able to assist the casualty, if you are in the street it is important that you stay with the casualty. Should you have put the telephone down and ended the call, you should call the emergency Operations Centre back should the casualty change, or you change location. If you are calling from home or work, it is advisable that you open windows or doors so that you can signal to the ambulance crew, or you could send someone to wait in a visible place for them to guide them into where you and the casualty are waiting. It is always a good idea to lock away animals and pets for the safety of the crew.


Other things you can do to assist the medical staff are to have written down the casualty’s doctor’s details and any information on medication they take, even better collect their medication up and show this to the paramedics on their arrival. Be aware of any allergies the casualty has and ensure that you have told the call handler so they can pass this on to the ambulance crew, you can also reinforce this with the crew when they arrive.


Always try to stay calm, this is harder to achieve than it is to say but it is important so that you are able to take heed of the advice the call handler has given you and then carry it out.


Do NOT hang up the telephone, stay on the line, unless you are told otherwise by the call handler. The ambulance will be sent as soon as you have passed on the location to the call handler.


999 or 112 in the UK?


Where does this question come from, I hear you ask, and the answer to that is simple. In the UK confusion reigns as to the right number to use for the emergency services. The main reason for the confusion is, as far as I can tell, the advent of social media, although I have been made aware of a video on YouTube which backs up the myth that 112 is better than 999.


Firstly, I would ask how the telephone number that is universally known in the UK as the emergency number became inferior to a number of which not everyone is aware. 112 as discussed earlier is the European Union telephone that is live in all current 28-member states of the EU, (Brexit is not discussed further in this article!).


Secondly, we look at social media, sadly in today’s world, if it’s on social media it must be true and vice versa. This is not the case. You can write anything on social media whether there is evidence behind it or not. The myth on social media is that the telephone call will send more information to the call handler and handles the call in a different way if you use 112 over 999. This is in fact incorrect. Another myth is that a mobile phone’s SIM card is specially preprogrammed to dial 112 in an emergency; this is in fact true however it is important to note that the SIM card is also preprogrammed for 999 and some 911 as well.


The video on YouTube, which could be where some of the myth and incorrect detail of 112 comes from, is entitled, ‘Help me’ The secrets of using 112 on a mobile phone in an emergency or accident. I have taken the decision not to link to this video as it contains incorrect and therefore confusing information, but as of Monday the video has received 236,087 views!


The Truth:


In truth, 999 and 112 are the SAME in the United Kingdom! Yes, you read that correctly, the 2 numbers are exactly the same in the United Kingdom. You can use either one and you will get the same service, with the same location information sent to the call handler as each other. Most people will dial 999 as this is the number that we have been brought up with in the UK since we were knee high to a grasshopper and it will continue to be for many years to come having celebrated its 80th birthday in 2017.


REMEMBER: Should your mobile telephone not have a signal BUT has battery, you will be able to contact the emergency services by calling either 999 or 112 as your mobile will recognise both of these as an emergency.


What has changed to 999


During this article we want to look at 2 major evolutions of the emergency number 999 over its 80 years.


The first of these is the opportunity to be able to text 999 and get an emergency response.


The EmergencySMS service was introduced in September 2009, and was developed by:


Action on Hearing Loss,

British Telecom (BT),

Cable and Wireless,

The Department of Communities and Local Government,

OFCOM,

The UK Emergency Services, and

All the UK mobile network operators.


The idea behind this service is that if you are unable to make voice calls, you can contact the EmergencySMS from your mobile phone. This is a service which is part of the usual 999 service but designed specifically for people with hearing loss or difficulty with speech.


The service should ONLY be used to send notification of an emergency, test texts should not be sent. An emergency is described as:


Someone’s life is at risk,

A crime is happening now,

Someone is injured or threatened,

There is a fire, or someone is trapped,

You need an ambulance urgently,

Someone is troubled on the cliffs, on the shoreline or is missing at sea.


In order to use the service, the person who may need to use it has to register by sending ‘register’ to 999, and then follow the instructions that are sent back to them. Once registered the user can then text 999 in an emergency but will need to ensure that they have included in their message, which service they require, where the problem is and what the emergency is. The emergency services’ operator will then ask for further information if required or will confirm that help is on the way. The assumption of help being on its way should not be made, and if a reply has not been received, usually after 2 minutes, the user should try to send another message usually after 3 minutes or find another way to summon help.


Another change to the emergency services, is the advent of Silent Solutions; this service has been available on the Emergency Operator line since 2001, although even today is relatively unknown. The idea is that if you are unable to speak or make a sound on an emergency call, due to a terrorist attack or domestic abuse for instance, you will be asked to dial 55 and then be put through to the Police. Although, you are being put through to the Police this can also result in a life being saved. You should remember that the Police are unable to attend to all silent calls and therefore this service seems the obvious answer as they now know you are genuinely trying to contact the 999 operator.


The usual protocol in the UK, is for the operator to ask you a series of questions when you dial 999 in doing so trying to identify if you meant to dial the number in the first place. If they have not had a reply to their first question, which is, Which service do you require? The operator will then ask you to either tap the handset, cough or make a noise, should you not do this the operator will divert your call to a message that encourages you then to dial 55.


One of the myths that goes along with this service is that the Police are able to track your location. The emergency services have an array of methods to track your location, but not because you use the 55 process.


Finally, please remember that you DO NOT NEED a mobile phone signal to contact 999, the mobile phone SIM card will recognise this as an emergency number, and when trying to find a signal, will look for your network first, should this be unsuccessful then it will look for the next available network signal to allow the mobile to connect to the emergency services’ operator!



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Knife Crime in the UK

Posted by Steve at 13:00 on Monday 18th March 2019.


This month we dedicate our monthly blog post to

all the victims of knife crime across the UK.


Over recent weeks and months, we have seen on our TV screens, newspapers, social media feeds and the like, a rise in the number of knife attacks in our capital. More recently the attention has turned to other such attacks in other cities up and down the UK.


We are saddened by the stories that we see on our screens mostly such young lives taken, from what we see in the media, for absolutely no reason at all. If we take the story of Jodie Chesney, who was sitting with her group of friends in a park, listening to music and ‘enjoying life’ when a male came up behind her and stabbed her in the back.


Only on Monday, did we see a news interview for ITV in Liverpool, 2 brothers openly told a reporter that they carry a knife and feel safer for doing so, 1 even took his knife from his jacket and showed it to the camera. Yes, these boys’ faces were hidden, but this is an all too familiar story the media are giving us. The same reporter spoke to the boys’ mother, who in simple terms said that she was ok with her boys carrying knives as it made her feel safe that they felt safe. When asked if she considered that she was encouraging her boys to break the law, she said she didn’t feel that, and that it’s better for her boys to come home of an evening than not.


So, this month we thought we would take a look at the rise of knife crime in the UK and see if the statistics support the media view that the UK is indeed in the middle of a rise in crimes involving knives, as well as what a member of the public can do to help someone who has been stabbed by a sharp object.


Is knife crime on the rise?


To help us explore this very question we have looked at the statistics released by the Office for National Statistics.


The statistics in the year up to September 2018, show a total of 42,957 offences involving a knife or a sharp object in England and Wales, equating to 6% of all offences. If we compare this with the previous year, we see 38,171 offences that involved a knife or a sharp object, in that year this also equates to 6% of all offences in England and Wales.


From these statistics we can see that the overall percentage of knife crime across the UK is staying constant at 6%, however individual cases have risen by 4,786 in one year.


What we thought we would do at this point is to take a look at the area of the country that keeps hitting the news, London, as well as coming closer to home and look at the 2 counties we primarily cover with our courses, Gloucestershire and Wiltshire.


London:


October 2016 – September 2017: 13,741

October 2017 – September 2018: 14,847


Gloucestershire:


October 2016 – September 2017: 280

October 2017 – September 2018: 308


Wiltshire:


October 2016 – September 2017: 295

October 2017 – September 2018: 243


What we can see from the local authority areas is that the national rise is certainly occurring in London and Gloucestershire, but actually decreasing in Wiltshire, with a decrease of 18% from the previous year. Gloucestershire’s knife crime has increased by more than that of London in one year up 10% compared to London’s 8%. It will be very interesting to see the 2018/19 statistics when they are released later this year to see how the statistics have changed.


If we look take a look through the years in the statistics, we do see a rise in knife crime statistics since the low point of 2014, of 23,945.


So far in this blog we have used the word offences to explore what’s happening across the country. It may be worth having a look into the word offences and find out which offences knives are being used for. Here we look at the statistics across the UK, then London, Gloucestershire and Wiltshire ending September 2018.


England and Wales:


Attempted Murder:   356,

Threats to Kill:   3,351,

Assault with injury:  19,761,

Robbery:   18,556,

Rape and Sexual assault: 657,

Homicide:   276.


London:


Attempted Murder:   68,

Threats to Kill:   747,

Assault with injury:  5.360,

Robbery:   8,428,

Rape and Sexual assault: 161,

Homicide:   83.


Gloucestershire:


Attempted Murder:   3,

Threats to Kill:   39,

Assault with injury:  173,

Robbery:   84,

Rape and Sexual assault: 6,

Homicide:   3.


Wiltshire:


Attempted Murder:   0,

Threats to Kill:   19,

Assault with injury:  164,

Robbery:   57,

Rape and Sexual assault: 3,

Homicide:   0.


As expected, we can see that London has far more incidents of knife crime across all of the areas that the statistics look at, however it would appear that Wiltshire is safer in these areas than London and Gloucestershire.


Why do people carry knives?


There are understandable reasons why some people carry knives; these people do so for their profession, e.g. carpet fitters, plastic cutters etc, but of course these people are not likely to be the ones who are contributing to the statistics above.


The more important question to be asked should be why more and more young people are coming to think that carrying a knife is a good idea. Some suggestions for this include:


For protection, self-defence, in case they are attacked and need to protect themselves.

To make them feel like the ‘top-dog’ on their estate.

To make people respect them.

Feel that they can push themselves up the social ladder.

Being brought up in a house/environment where carrying a knife is acceptable.

They are cheap and easy to get hold of.

They are not able to have a fist fight and therefore need a weapon to back them up.

Their own mental safety, if I carry a knife, I feel safe.

Instil fear in others.

Peer pressure.

Being forced to carry a knife by older gang members, as the police won’t suspect a 7-year-old.


What does the law say about carrying a knife?


Legislation in England and Wales says that carrying a knife can earn an adult 4 years’ imprisonment and an unlimited fine; should that knife be used to commit a crime the sentences are likely to be a lot higher than this.


What can you do if you know someone carries a knife?


If you know that someone carries a knife, whether this be a friend, brother, father, uncle, son or daughter etc, you should remember that it is a criminal offence. Just because someone else carries a knife does not make it right or okay for another person to do so, even if it is a trusted person, it is still a criminal offence.


If you know someone who carries a knife, we have provided a few tips that you can use to know what you can do:


Never think that you can talk to the person and persuade them to stop carrying.

If possible, you should report this to the police, do not think of this as grassing up a friend or loved one, potentially you are saving theirs or someone else’s life!

If you live with someone who carries a knife, try not to irritate or annoy them as you won’t know what they are capable of.

Do not try to take the knife off a child or young person, as it is likely to anger the person and may escalate the situation out of control.


Should you be in a situation where you feel threatened or at-risk from somebody who is carrying a knife, you should try to walk away, do not run as you may fall over, and try to get to the nearest safest possible place, around other people. Do not think that you will be able to negotiate with the person holding the knife, the best thing to do is to walk away and report the incident as soon as you possibly can. The best piece of advice would be to try to avoid situations and people who scare or bully you and make sure that you report it.


What should I do to help someone who has been stabbed by a sharp object?


The most important thing that a member of the public can do for someone who has been injured by a sharp object is to ensure that they themselves stay safe. If you are unable to approach the casualty as the attacker is still on the scene or likely to be, the best thing that can be done is to call the emergency services and report the incident, not forgetting to mention you believe that there is a sharp object involved.


If you are able to approach the casualty, remember that you may only see a small entry wound, which could have deep internal damage hiding under the skin. This is what you should do for the casualty:


1. Call 999/112 for emergency help and make sure it is safe to approach.

2. Control life-threatening bleeding as a priority:

i. Apply direct pressure to the exact point of bleeding, if needed inside the deep wound,

ii. For life-threatening bleeding to the limbs – consider a tourniquet (see tourniquet section of this blog!).

3. Treat the casualty for hypovolaemic shock – lie them down, elevate their legs.


Tourniquets


What is a tourniquet?


A tourniquet is a device that is tightened around a limb to temporarily reduce blood flow. In recent military conflicts tourniquets have saved many lives and have been reintroduced into the European Resuscitation Council First Aid Guidelines as of the 15th October 2015.


Complications can occur should a tourniquet not be applied correctly, therefore training is essential to make sure application is safe and effective. If a tourniquet is not tightened enough, which is usually the case with improvised tourniquets, they can squash the veins not the arteries that feed blood into the limbs, therefore continuing to bleed out, or make it even worse.


A tourniquet should be reserved for life-threatening

bleeding from an arm and leg that cannot be controlled by direct pressure.


How to apply a tourniquet:


1. Apply the tourniquet around the thigh or the upper arm, at least 5cm above the wound, If the injury is below the knee/elbow, apply it just above the knee/elbow joint.

2. Tighten the tourniquet until the bleeding is no longer life-threatening. This is painful for the casualty. Explain that the pain will subside, but it is necessary to save their life!

3. If the bleeding is not fully controlled, consider direct pressure to the point of bleeding or a haemostatic dressing. Sometimes you may even need to apply a second tourniquet.

4. Make sure that 999/112 have been contacted.

5. Note the exact time of application and make sure that you pass this vital information to medical staff. Write the time on the tourniquet if possible.


What if the object is still in the wound?


An embedded object should not be removed, unless it is a splinter, as it may be stemming bleeding or further damage may result.


As a first-aider you should use sterile dressings and bandages to pack around the object. This will apply pressure around the wound and support the object.


Send the casualty to hospital to have the object removed safely.


In summary, yes, the statistics have shown that knife crime has risen since the low in 2014, but the more important message from us in this blog is to remember that the carrying of an offensive weapon is against the law.


For more information on First Aid techniques to help a casualty

who has been injured by a sharp object,

why not join one of our First aid courses?


But most of all stay safe.



Dedicated to all the victims of knife crime across the UK.


Past Blog Posts

Working at Height

Posted by Steve at 14:55 on Tuesday 16th April 2019.


Working at height can be one of the most dangerous activities that can be carried out at work, due to the variations in height involved, accounting for the highest percentage of injuries caused by falls from height.


Prior to 1974, there were no regulations or legislation for activities at work involving height. This changed with the Health and Safety at Work 1974. The Health and Safety at Work Act 1974 states very clearly that:


‘It shall be the duty of every employer to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all his/her employees.’


The legislation placed the responsibility on the employer to carry out risk assessments as well as to ensure that they provide the tools for their employee to do the required job in the safest possible way. This is a long way from the historical evidence we have of people working at height.


Historic Working at Height


Just taking a look through the history books will show you the sort of work that has been carried out at heights over the years. Even walking around some of the most interesting and beautiful cities and areas of the world you can see evidence of people working at height.


Examples of these structures include:


The Pyramids of Giza, Egypt,

Cathédrale Notre-Dame de Paris, France,

Gloucester Cathedral, England,

Salisbury Cathedral, England,

Canterbury Cathedral, England,

The Houses of Parliament, England,

La Sagrada Familia, Spain.


These are possibly all structures that you will be aware of, if not visited and seen. These major structures would have been built by people who were using the most basic of tools and working in environments that modern Health and Safety rules would frown upon and punish. Not only this, but the people building these structures would have been unskilled and not necessary fully suitable to the task they were being asked to complete. But we must not forget that aside of all the issues with their practice, they managed to build structures which have lasted the test of time and are admired by many people every day.


As we move through the years, the industrial revolution made room for steam-powered machinery to assist in the building sector. In the 20th Century the use of elevators and cranes have made it easier for skyscrapers to be built however, working at height, safety equipment was haphazard and lacking in regulations.


The Health and Safety at Work Act 1974


In 1974, The Health and Safety at Work Act came into force to encourage, regulate and enforce workplace Health and Safety. The Act introduced an additional Code of Practice to improve working conditions for employees and provide guidance for employers and employees working at height.


The Act also applied to the self-employed sector as well as those who are working in the employed sector. The legislation also extended to the provision of the maintenance of plant and systems of work, arrangements for the use, handling, storage and transport of articles and substances, information of safe systems, instruction, training and supervision, and maintenance of any work carried out under the employer’s control.


Want to find out more about Health and Safety at Work?

Why not visit our dedicated Health and Safety at Work page here

 alternatively why not book one of our courses?


According to RIDDOR (Reporting of Injuries, Diseases, Dangerous Occurrences Regulations 2013) reports of fatal injuries to employees have reduced by 86% as of 2015. This is clearly an indicator of how well the legislation has worked, although in that time additional legislation has come into force which has further affected the Working at Height regulations, as well the invention of new and upgraded technology to aid the workers who are working at height.


In 2005, the Work at Height Regulations came into force. These regulations built on and added rules and regulations to that of the Health and Safety at Work 1974. One of the most important things that the regulations did, was to remove the minimum height for a fall from height to be counted. According to the Work at Height Regulations 2005 there is no definition of a fall from height which means that a fall from height could actually take place below sea level. It is important to remember that a fall from standing can be a fall from height.


The regulations make it clear that they apply to any work at height where there is a risk of fall likely to cause injury regardless of the height, type of work and duration of the task taking place.


Why do injuries and accidents from height take place?


Most injuries caused from a fall from height at work include:


People taking shortcuts,

Equipment is not available or in poor condition,

Wrong choice of equipment for the work being carried out,

Equipment not being used accordingly,

Complacency,

Lack of awareness of the risks of working at height,

Inadequate or a lack of training and supervision.


The regulations provide duties for employers and employees, they state that anyone who contracts others to work at height should ensure that the task:


Should be effectively planned and organised,

Takes into account weather conditions,

Utilises trained and competent persons,

Ensures the venue is safe,

Uses safe and inspected equipment,

Ensures risks from fragile surfaces are properly controlled, and

Ensures risks from falling objects are well managed.


It also adds that employers must also:


Only allow the work at height to be carried out if it could not be reasonably carried out at ground level,

Ensure the work is as safe as practical,

Plan for emergencies, and

Take into account risk assessments.


It is important that the person who is carrying out the task at height is a competent person and that they have ensured, as well as the person asking them for the task to be done, that the equipment being used to complete it is safe and in full working order prior to the task taking place.


So, what happens should it all go wrong?


Should an injury or an accident occur in the workplace, the employer or the person who contracted out the work may:


Receive an unlimited fine,

Be imprisoned for up to 2 years,

Face prosecution under the Corporate Manslaughter and Homicide Act (2007) which could include:

Fines,

These can be unlimited, on top of the unlimited fine mentioned above.

Remedial orders,

This will require a company or organisation to take steps to remedy any management failure that led to a death.

Publicity orders.

This is an order that a court can impose which would require the company or organisation to publicise that it has been convicted of the offence.

The order will require the publication of:

The full details of the incident,

The amount of any fine imposed, and

The terms of any remedial order that was made.


The publicity order provisions will not come into force until the Sentencing Guidelines Council has completed its work on the relevant guidance.


The Corporate Manslaughter and Homicide Act 2007 cannot be applied retrospectively, any deaths that occurred before the 6th April 2008 would have been covered and dealt with under the previous corporate manslaughter legislation.


Do you want to learn more about Working at Height?

Why not book onto our new course which we are launching today?

Alternatively, visit the Working at Height dedicated page on our website.

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