Saffie-Rose Roussos, the youngest to be murdered in the Manchester Arena bombing, could have survived had she been given key medical interventions at the scene, the public inquiry into the atrocity was told.
Two experts said in a report: “Opportunities to apply recognised and recommended treatments to prevent blood loss were missed.”
Their views are contrary to the opinions of a panel of ‘blast wave’ experts also appointed by the inquiry who have said her injuries were ‘unsurvivable’.
READ MORE: Trapped in anger and grief the parents of Saffie-Rose Roussos want answers not excuses
Paul Greaney QC, counsel to the inquiry, said there remained ‘major issues’ between the experts – largely around whether Saffie had severe vascular damage and whether there was severe lung damage that would have had a physical effect on her.
One expert, Dr Gareth Davies, a consultant in pre-hospital care, said splints and tourniquets should have been applied to eight-year-old Saffie’s legs, saying a ‘strategy for survival’ should have been to ‘stop the bleeding as early as possible’.
Referencing ‘traction’, he said Saffie’s badly injured legs should also have been ‘brought out to length’ to reduce bleeding, an intervention he described at the inquiry as an ‘incredibly important tenant of pre-hospital care’ which could be ‘transformational’ for a patient.
The developments on Friday bring to a close a week of often distressing medical evidence heard to assess Saffie’s ‘survivorbility’.
Saffie’s parents, Lisa and Andrew Roussos, criticised the emergency services response and the failure of the security services to prevent the 2017 atrocity.
Dr Davies, a former medical director of London Air Ambulance, said a ‘window of opportunity to provide therapy for Saffie’ began in the City Room blast zone with an emergency medical technician (EMT) who went to Saffie.
“They would have the key skills and equipment to provide treatments that are important to Saffie, namely splintage, traction and tourniquets,” he said.
The inquiry has heard that an Arena first-aider trained to perform the role of an EMT assessed Saffie as she was lying on the floor, but moved on to assist other casualties as she thought Saffie was not breathing and she couldn’t see signs of catastrophic bleeding.
Saffie, the inquiry has heard, arrived at the Royal Manchester Children’s Hospital 52 minutes after the 10.31pm explosion on May 22, 2017 – at 11.23pm. She was carried out of the City Room on a makeshift stretcher and laid on the pavement on Trinity Way before a police officer flagged down a passing ambulance.
She went into cardiac arrest and was pronounced dead 17 minutes later at 11.40pm.
An advanced paramedic arrived at the scene 11 minutes after explosion – he was the only paramedic to enter the City Room for 40 minutes, the inquiry has heard. He was joined by two members of North West Ambulance Service’s Hazardous Area Response Team at 11.15pm.
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It meant only three paramedics were ever in the City Room – and the advanced paramedic was triaging and not providing medical treatment.
Dr Davies said had all three interventions been carried out, there would be ‘every expectation of improving the situation’.
On Saffie’s ‘survivorbility’, he said: “Our view is that if those injuries had been treated as described…that early in the treatment, we have used the word ‘probable’.”
Questioned, he agreed he meant it was ‘more likely than not’ that Saffie would have survived.
Dr Davies said he also believed it was more likely Saffie would have survived had the procedures been performed in the ambulance.
He agreed ‘without a doubt’ had the interventions been carried in that setting, it would have ‘improved Saffie’s prospects of survival’.
Expert witness Dr Claire Park, who has 20 years experience in military pre-hospital care and has served in Afghanistan, agreed that if the interventions had been carried out in the ambulance, agreed and said it was a ‘material possibility’.
Dr Park said: “In an ideal world, they [paramedics] would have splinted her legs as they moved her onto the scoop stretcher.
“If it had happened in the City Room, it makes her survival probable.”
The report to the inquiry from Drs Davies and Park stated: “Opportunities to apply recognised and recommended treatments to prevent blood loss were missed.”
A panel of ‘blast wave’ experts appointed by the inquiry initially concluded Saffie was unlikely to have survived from extensive bleeding, but could not rule out a ‘very remote’ chance she could have lived had comprehensive and advanced medical treatment been given immediately.
However that possibility was removed when they analysed further information, which outlined her severe lung injuries and the impact it had on her ability to breathe, the inquiry heard.
The panel has said their opinion remains that Saffie’s injuries were ‘unsurvivable’ whatever interventions had been made.
Dr Davies, however, said he believed the fact Saffie survived for more than 50 minutes ‘undermines’ the panel’s view that her injuries were as severe as the experts considered them to be.
He said he believed the injuries Saffie suffered were ‘amenable to treatment’.
A person, Dr Davies said, could not survive for as long as Saffie did if her injuries were as bad as the panel have said they believe they were, adding he ‘attaches importance’ to the fact Saffie was able to survive until hospital, a period of over 50 minutes, without any ‘substantial medical intervention’.
Inquiry chairman Sir John Saunders said Bethany Crook, an off-duty nurse who cared for Saffie, did her best and compressed bleeding.
Sir John questioned whether ‘we are asking a lot’ of people who were there without equipment and whether ‘we are living in the real world here’.
But Dr Park said: “It would be wrong of us to not try to look at what could have been done to make things better.
“Putting a tourniquet on as well as splinting those legs is what we would have expected and I think that would have made a difference.”
Dr Davies said chances were ‘stacked against’ Saffie once she arrived at hospital, but described a decision taken not to perform a resuscitative thoracotomy as ‘wrong’.
That’s a procedure where a patient’s chest is surgically opened to access the heart in the event of cardiac arrest.
Saffie, from Leyland in Lancashire, was at the Ariana Grande concert with her mum Lisa and her sister, Ashlee.
Salman Abedi’s device, which was packed with nuts and bolts, claimed 22 lives and left more than 1,000 other people injured.
The inquiry continues.
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