St. John Ambulance is a British charity, dedicated to the teaching and practice of medical first aid. There are many groups (priories) across different countries, and the collective falls under the ownership of the Order of St. John.

St. John Ambulance was originally divided into two fields, teaching first-aid to workplace employees via the St. John Ambulance Association, and providing uniformed medical volunteers to cover public duties via the St. John Ambulance Brigade. However, these two entities merged in 1968 to form a single unified St. John Ambulance, providing both training and first-aid cover.

Structure of the organisation

The organisation is divided into Priories in a country level, and these into Counties. These are further subdivided into Divisions, of which members join. Members of the Brigade complete a number of medical qualifications, ranging from the basic FAW First-Aid At Work course recognised by the HSE, through to advanced Ambulance Technican training approaching that of NHS Ambulance Technicians. Once qualified, they are free to volunteer their time in public duty, covering a variety of public events such as major football matches, concerts and gigs, smaller community events such as 'fun days', and even (qualifications permitting) crewing of emergency ambulances. As a rule they are not paid for their time on duty, although expenses are met whenever possible.

As a ranked organisation, members fall under the command of senior figures. Ranks run from Brigade Member at the bottom, through Corporals, Sergeants and Officers all the way up to high national ranks. However, the voluntary nature of the organisation makes strict observance of rank difficult, and rank is awarded for suitability of purpose rather than reward or skill. First names are generally used by those of all ranks, and formal addressings such as 'Sir' are seldom heard. Similarly, members can receive basic drill instruction, and parade is occasionally used for formal occasions, with saluting, marching and falling in and out of order. Unlike a military organisation, however, this is largely regarded as eye candy for the public than to instill strict obedience.

As well as providing personnel, St. John Ambulance owns a large number of ambulances and transportation vehicles for PTS (Patient Transport Services) and emergency use. The recently designed Mark-4 Crusader is a highly versatile and professional blue-lights emergency ambulance, which can be used in many situations by members. The higher qualifications are usually required to drive or crew these emergency vehicles. In some counties St John provides support to NHS Ambulance services, responding to 999 calls at busy times.

Training and skills

St. John Ambulance runs courses for both members and external individuals, in a variety of different skills and medical issues. The FAW (First-Aid At Work) course is used by many companies to train designated individuals as first-aiders, as required by employment laws. Members are also required to attend Manual Handling and Casualty Handling courses run by the organisation before being permitted to attend public duties.

Beyond these, members can train in additional medical skills, such as administration of medical gases, and use of an Automated external defibrillator. For those wishing to go further still, the organisation runs two internal qualitification courses knows as Ambulance Aid levels 1 and 2. These build upon the first-aid skills with additional skills required for ambulance crewing. Those attaining the first level are allowed to crew St. John vehicles and perform patient transport duties (PTS). Those attaining the second level are additionally called upon to crew emergency ambulances as necessary. Training of the Ambulance Aid courses (especially the second) are sometimes undertaken or suplimented by the NHS Ambulance Services.

In some countries, such as New Zealand, St. John providies the primary national ambulance service, and in these countries additional qualifications right up to Advanced Paramedic are undertaken.

The St. John Ambulance uniform

The St. John Ambulance uniform is well known by many people, and members are required to wear uniform when on duty, both for identification and to generally present a professional image. It is protected by law and may only be worn by registered and qualified brigade members. Unlike many volunteer groups, the St. John uniform is relatively formal, and is similar to a British Police uniform -- for which they are sometimes mistaken! There are presently 8 orders of dress, intended for different situations such as formal ceremonies and nursing care. The two most widely used are #2 (dress uniform without tailored jacket) and #5 (operational uniform), and these two are reasonably similar, consisting of:

• White uniform shirt with black badges and rank markings
• Black clip on tie (for safety as much as ease of use)
• Black trousers, optionally with combat/cargo pockets
• Black NATO style V-neck sweater with similar markings to the shirt
• Epaulettes to carry rank, with any special role indicated via colour (grey for a nurse, red for a doctor, and green for a paramedic)
• Men's peaked cap or ladies' hat, usually reserved for more formal occasions.

These days, high visibility garments, worn over the uniform, are required for outdoor duties, adopting the yellow/green two tone generally accepted for emergency medical services. An alternative operational uniform is a green two-piece suit, similar to those of paramedics and technicians from many other ambulance organisations. This has traditionally been worn by members operating as an ambulance crew, however recently some counties and divisions have adopted it for all duty work (see the Controversies section).

Uniform, equipment and kit are supplied by St. John Supplies (http://www.stjohnsupplies.co.uk), the trading wing of the organisation. This group sells First Aid and Health and Safety products both to members, divisions and the general public, and profits are returned to the organisation as a whole. Certain items are restricted to purchase by members, such as the uniforms.

In addition to the standard uniforms, LINKS units have an exception to wear their own uniform designs. Usually these consist of a polo shirt and/or sweatshirt with the LINKS logo, and the name of the unit placed on the front, and 'FIRST AID' screen-printed on the rear. This uniform is normally only permissible for duties undertaken at student events such as discos at the Student Union bar, which often have their First aid cover provided by the university LINKS unit. This uniform is strictly restricted to LINKS members, and all other adult members, and LINKS members not covering on-campus events have to wear #5 uniform (operational).

Youth within St. John Ambulance

St. John Ambulance is also a major youth organisation, with allegedly over half its membership being made up of those under 25. Cadet groups are run for those 16 and under, and Badger sets are provided for younger children aged 5 to 10. These groups are similar to the scouts, although there is obviously a greater emphasis on teaching first-aid. Members over 16 are encouraged to transfer directly to adult units to continue their training. For members at university, there is often the option to join a LINKS unit at their university. These units were originally established at universities to form a 'link' between cadet and adult membership, allowing members to carry on their membership and maintain their skills whilst in higher education. Today, LINKS is one of the fastest growing sections of St. John Ambulance, and many LINKS members are completely new to St. John Ambulance when they join at university. LINKS units differ from other sections in that they do not use a rank structure, instead having a democratically elected committee, in line with the constitutions of many Student Unions for student societies.

Relations with Order of St. John and the Red Cross

Although the Order of St. John is largely seen as a Protestant Christian organisation for historical reasons, St. John Ambulance does not restrict membership to any particular religion or denomination. Technically, it falls under the sovereignty of the Queen, and thus is linked to the Church of England, however this relationship is more tradition than authority, and adult members are not required to pledge allegiance to either the monarchy or the Christian faith. Cadet members do still make this pledge, however this is again largely seen as tradition.

St. John Ambulance enjoys very positive relations with the Red Cross, with which they often serve alongside. However, St. John Ambulance places a greater focus on first aid training and duty, whereas the Red Cross focuses more on general humanitarian aid. St. Andrews Ambulance is the equivalent organsiation in Scotland, and together these three Voluntary Aid Societies publish the official First Aid Manual, the defacto guide for emergency first aid.

Controversies

One of the major disagreements between members is that of the uniform. Many feel it is old fashioned and impractical, whilst others regard it as an important aspect of the identity and history. The introduction of Police Community Support Officers, who's uniforms are sometimes near-identical, has complicated matters further, and led to members being mistaken for Police Officers and even Traffic Wardens. Whilst St. John Ambulance is well-recognised within certain areas and social groups, as Britian becomes increasingly multicultural, large sections of the population are unaware of the existance of the organisation, and thus understandably assume that members are performing some sort of policing or security service. In certain communities, where Police hatred is high, this can be a potentially dangerous situation.

A number of counties and divisions have suggested adopting the green two-piece suit (known as 'greens') as the primary operational uniform, using the black and white uniforms only for ceremonial activities. This is further justified by the fact that the two-piece suits are more practical to wear in emergency medical situations, and can be washed at a higher temperature. Conversely, others have argued that dressing all members in 'greens' creates confusion as to who is ambulance trained. Because most members are only trained in basic first aid, the concern is that people will mistake them for fully qualified Paramedics or Ambulance Technicans.

The uniform debate goes on, but has rarely caused major problems, as the relaxed nature of the organisation makes strict enforcement of uniform protocols unusual in all but ceremonial activites. For example, many duties stipulate that wearing of ties and caps is optional, sometimes even discouraged.

Key dates within the history of St. John Ambulance

• 1540: The original Order of St. John, the Knights Hospitallers is disbanded in England by Henry VIII
• 1826: An idea to re-establish the Order within England is put forward by some remaining French Knights of the original worldwide Order
• 1841: The "St. John's Day Declaration" is prepared to seek offical recognition of the new Order by the original Order, now known as SMOM
• 10 July 1877: St. John Ambulance Association formed to teach first-aid in large railway centres and mining districts
• June 1887: St. John Ambulance Brigade is formed
• 14 May 1888: English Order of St. John is granted royal charter by Queen Victoria
• March 1922: Cadet units are started
• 1968: The Association and Brigade merge to form a unifed St. John Ambulance
• January 1987: Badger sets introduced to celebrate 100 years of the Brigade

See also:

• Order of St. John

External links

• St John Ambulance (http://www.sja.org.uk/)
• St John Supplies (http://www.stjohnsupplies.co.uk/)