Wed. Aug 10th, 2022

Senior Paramedic and Army Reservist Philip Keogh describes the loss of John Atkinson


The investigation has heard John Atkinson’s death had a profound impact on the paramedic after caregivers begged him not to let him die.

He was treated on the ‘cold show floor’ by Philip Keogh, of the North West Ambulance Service, who had ‘self-posted’ to the Arena because of his experience as an Army-reserved paramedic.

He said he had tried to reassure the 28-year-old from Bury when he spoke to him, but he told the query that he knew he was seriously ill and his chances of survival were ‘extremely slim’.

He said his death was a ‘catalyst’ and he told them on the spot, ‘we need to get patients off the floor that were ever so cold and on to ambulances’.

Philip Keogh, senior paramedic and Army reservist who treated Philip Atkinson

Keogh had served in Afghanistan between October 2010 and February 2011 in charge of military and civilian casualties with battlefield damage and also had experience dealing with gunfire and grenade damage.

On the day of the Arena attack, he was based in Rochdale in a ‘quick response vehicle’ when he received the call to inform him of ‘an incident in Manchester’, although it was not clear what it was at the time.

He was 40km away in Rossendale in Lancashire when he suggested going to Manchester. He arrived at 23.10.

Mr Keogh said when he arrived that he was told by his control room that there might be an ‘active shooter’ in the Arena.

He added that if he had not gone, ‘people would have had to wait longer for care’.

He said he put dressing, tours and gloves in his pockets and took a medical bag of medicine into the train station.

The study heard that at this point, about 13 patients have come down from the urban space. He first triaged a female patient near the doors.

He said he put his equipment bags down and later lost sight of it. The investigation heard that he ‘lost’ his bags for medical equipment.

Mr Keogh said he heard a ‘tumult’ and was told by NWAS bronze chief Dan Smith to help John Atkinson who had just been brought down the stairs to the emergency room.

Barriers were used to get John down the stairs, it took seven minutes to get him down.

He described the situation as ‘ever so confusing, chaotic … it became a very difficult situation to deal with due to the large number of people who were there.’

The nurse said Mr Atkinson was only wearing his t-shirt and even it was partially cut off.

Keogh said he was extremely concerned about hypothermia.

He agreed that he was already in danger ‘because of the trauma he had suffered’, the fact that he had not been covered in blankets and he had been placed in a doorway to the station which exposed him more for the cold.

He told the query trauma and blood loss increase with hypothermia and can lead to ‘deadly triad of death’.

The inquiry heard about the five minutes he spent with Mr. Atkinson, who was conscious and breathing, but ‘waxy as hell’, ‘pale and clammy’.

He compared Mr Atkinson to a model at Madame Tussauds’ before the make-up was applied, indicating ‘massive blood loss’.

“My first reaction was that he had lost an awful lot of blood,” Keogh said.

He noticed blood staining on the victim’s legs and fragments of the bomb had penetrated his limbs.

But he said there was no ‘catastrophic bleeding’ at the time, and ‘temporary tours’, one a belt and the other possibly a t-shirt, seemed to be working at the time.

John Atkinson, was a Bury care worker who died of his injuries in the Arena attack

He said he felt John Atkinson needed blood products and he did not have the equipment in the bag he had lost sight of.

The nurse accepted that he should have requested that his patient be given the drug TXA or could have instructed someone to do so.

But he added that the administration of the drugs was not straightforward and should be administered via ‘IV access’ over a ten minute period and that he had to consider whether there was further harm.

Keogh recalled that the patient had said to him, ‘Let me not die.’


Paramedic Philip Keogh answered questions from Sophie Cartwright QC, counselor for the inquiry into Philip Atkinson’s condition.


He recounted the query: “The impending sense of doom is a sign that this patient is not feeling well and is ill and at high risk of dying.”

Paramedic Keogh said he tried to get a ‘pulse oximeter’ on Atkinson’s finger, but he could not read. He said he thought the injured person ‘shut down’.

The 28-year-old lay in pain in the foyer for 47 minutes before police officers carried him on a temporary stretcher and placed him on the ground near the station entrance.

It was another 30 minutes after John Atkinson was first assessed by paramedic Keogh that he was taken to the hospital where he died.

John Atkinson lay in pain in the foyer for 47 minutes before police officers carried him on a temporary stretcher

Mr Keogh said he began chest compressions when he saw Mr Atkinson go into cardiac arrest on the stretcher while waiting to be driven to an ambulance which was ‘farthest ambulance’ away.

The patient was pushed along the Station Approach and negotiated up to an ‘awful lot of obstacles’ while trying to continue chest compressions. Philip Keogh agrees that the delay in taking him to the hospital had reduced John’s chances of survival.

He said that after treating John Atkinson, he realized that they needed to get other victims to the hospital faster. “Losing John had a profound impact on me that night … in terms of me wanting to get people off the floor and get them to be where they need to be.”

We had patients everywhere on the Victoria station floor, a marble-type floor that is ever so cold, and we needed to get them off the floor to provide that level of protection against hypothermia.

Keogh said by then the fire brigade had arrived and he ‘grabbed them’ and ordered them to get stretchers from the ambulances into the train station to get the patients off the floor.



Keogh agreed with John Cooper QC, representing Atkinson’s family, that he ‘felt overwhelmed’ and ‘desperately needed more paramedics there to help you do the job you did’.

He also accepted that the injured, including Mr Atkinson, were left on the floor “longer than they needed to”.

Cooper suggests that it was obvious that Atkinson had lost a lot of blood.

Keogh agreed, though he pointed out that the injured man did not bleed when he saw him.

He agreed that it was possible because it was at that time that he had run out of blood.



Manchester Arena Inquiry – everything you need to know

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