Paramedic "terrified" by Manchester Arena bomb casualties

A senior paramedic has told the Manchester Arena bombing inquiry she was "terrified'' after being told how many critically injured casualties there were.

Joanne Hedges arrived at the venue in a convoy of ambulances after Salman Abedi detonated a bomb which killed 22 people and injured hundreds of others at the end of an Ariana Grande concert on May 22 2017.

The North West Ambulance Service (NWAS) medic said there were already patients in the train station, where people were being brought down from the blast area in the City Room foyer by police officers and Patrick Ennis, the first NWAS paramedic on the scene.

"I think he gave us an indication of 30 or more patients, critically injured patients, being brought down,'' Ms Hedges told the public inquiry on Tuesday.

Sophie Cartwright QC, counsel to the inquiry, asked her: "What went through your head?''

The paramedic replied: "Terrified, absolutely terrified. That's all I can think of what's happening in my head at that particular point.''

The inquiry has previously heard no-one from Greater Manchester Fire and Rescue Service attended the arena until more than two hours after the explosion, while only three paramedics entered the City Room.

Ms Hedges explained that casualties were brought down, with those who had not been triaged already assessed and prioritised before treatment by ambulance crews was arranged.

'We were told not to go upstairs and literally wait for the casualties to be brought down'

The inquiry heard just one patient was brought down on a stretcher, with 26 casualties on makeshift stretchers, one on a sked, three in wheelchairs and six assisted down, while one walked.

"We were told not to go upstairs and literally wait for the casualties to be brought down,'' said Ms Hedges.

"I had no idea who was in the City Room. I assumed the Hazardous Area Response Team (HART) and fire crews were in the City Room, with the police as well.''

The inquiry heard some P1 patients - those with life-threatening injuries - were waiting for hours to be taken to hospital.

Asked about the delay, Ms Hedges said: "At that point we were waiting for the hospitals to be cleared.

"It would take a period of time for the hospitals to get extra staff in, to cancel the non-urgent patients.

"It takes quite a while for that to happen, is the only reason I can think of.''

Ms Hedges said that at one point she saw a "walking wounded'' patient getting onto the back of an ambulance but added: "That was dealt with quite quickly.''

She also told of "heated discussions'' with police officers who "didn't quite understand the principles of a major incident plan'' about why the patients were not instantly going to hospital.

Asked if she thought the system had worked, Ms Hedges said: "From a clinical point of view, the patients had the clinical intervention needed from the paramedic crews in the train station at that particular point.

"They had ongoing treatment, which was to a high standard I believe.''

Asked about what could have been better, she said: "I think clarification of what we were entering into on the night and from a command structure, who was doing what role.''

She also highlighted the need for more extrication devices and more information on the night.

"I think it was a lack of communication from the fire (service) to ourselves and the understanding of why they weren't helping the extrication of patients from a dangerous zone.

"That lack of understanding of what was really happening and why we didn't have the resources there to help us to extricate the patients down to a place of safety.''

Ms Hedges added: "There has been improvement since with the major incident being a priority of the mandatory training.''