If you've been to a big public event you'll have benefited from the work ofthe Order of Malta Ambulance Corps, writes Berna Cox

If you've ever been to a big concert or a GAA match, gone racing, climbed Croagh Patrick, had a day out at the ploughing championships or some such public event, you've probably seen them. If you're one of the 3,200 unfortunates who, during the course of such events last year, managed to sprain an ankle, fall, cut a finger or worse, then you'll definitely know who they are.

The Order of Malta Ambulance Corps is one of the country's biggest voluntary first-aid operation, with 2,000 adult volunteers and the same number of 10- to 16-year-old cadets making up 80 units. Having first aiders at public events "calms the situation", says Comdt Brian Power, the order's assistant director. "It gives a feel-good factor, and generally the incident is more dramatic than the injury." At big public events the order's work helps to ensure that local emergency services are no more overburdened than usual.

Those who are unfortunate enough to have their days out spoiled by unexpected illness or injury will initially be assessed at a first-aid post. If it's a simple matter it will be dealt with on the spot; if not they'll be brought to an on-site medical centre, where senior personnel will decide whether they can deal with the problem or whether it's one for the nearest accident-and- emergency department.

The corps deals with incidents that range from the mundane to the dramatic. From minor cuts and abrasions to life-threatening situations. Perhaps the most impressive statistic is a 75 per cent success rate with the portable defibrillators, or AEDs, that it bought two years ago. A quarter of its units have the machines, which have been used four times. Three of them were "saves": a 53-year-old man who collapsed at the ploughing championships; a pilgrim to Lourdes who had heart trouble on his flight (Order of Malta volunteers were accompanying the pilgrims); and a 17-year-old who collapsed at a concert at the Point, in Dublin.

The fourth time the corps used one of its defibrillator was in a drowning. "The victim was just too long in the water" to resuscitate, says Power.

The 17-year-old at the Point happened to be in the right place at the right time, he says: the young man turned out to have collapsed because of a previously undiagnosed congenital heart problem."If he had dropped anywhere else he was dead."

Parents might worry about letting their children go to concerts; in this instance, however, Power is convinced that going to the Point saved the young man's life.

All Order of Malta Ambulance Corps volunteers are thoroughly trained, with classes every week. They must master cardiopulmonary- resuscitation skills to at least foundation level, and they also have the opportunity to progress to higher levels of clinical training.

The training for the defibrillators is particularly demanding. "We have to follow a very strict regime," says Power, "because we're giving electric shock." The volunteers have to retrain on the AEDs every three months for the first year and every six months after that.

The corps hopes to equip all of its 127 ambulances with the units over the next five years, but at upwards of €2,500 a unit there will be cost implications, says Power.

The organisation gets its income from general fund-raising and from the first-aid fees that it charges event promoters, but that income is shared among all of the order's services, which also include youth-development and community-care projects across the country.

"The ethos of the organisation is to serve the community to a high standard of practice on a voluntary basis," says Power, "but if our personnel weren't voluntary we couldn't exist". The corps' first ambulance, which it bought in 1941, cost £400 (€500). The most recent cost €130,000.

The Order of Malta Ambulance Corps has been involved with many distressing incidents over the years. "We're conscious," says Power, "of stress levels in our volunteers." The organisation encourages its members to work to the best of their ability but never beyond their level of clinical training. "We're all mortal," says Power, "and there's no such thing as 100 per cent success."

Now that the outdoor-events season is in full swing - and now that the adrenalin generation is at large - are there particular problems? "The vast majority of young people are 100 per cent out for a good time and are generally well behaved," says Power. In his 36 years as a volunteer he cannot recall a single colleague being assaulted.

Does anyone ever come back to say thanks? "That," he says, "would be the exception. We just tend to get on with the job."