(Image: NORTHUMBRIA POLICE/ PA)
A coroner has issued a warning after ambulance crews struggled to secure the airways of a girl who drowned after being swept from a step into the sea.
Edie Grace Smart, 13, died in hospital four days after being rescued from the sea at Whitley Bay.
Edie had been sitting on disused steps when she was washed into the water on July 24, 2025.
An inquest, which concluded in June, recorded her death was accidental.
Senior Coroner Georgina Nolan has now warned that future deaths could occur if first responders are not given access to a potentially life-saving device.
The inquest heard ambulance support practitioners (ASPs), who were the first to reach Edie, are not allowed to use I-gel airway devices when responding to cardiac arrests without a paramedic to supervise.
The coroner said the emergency crews treating Edie "struggled to secure her airway".
Edie’s medical cause of death was recorded as severe hypoxic ischaemic encephalopathy, out of hospital cardiac arrest and drowning.
Ms Nolan wrote in a prevention of future deaths report: "Ambulance Support Practitioners are often first on scene on an out of hospital cardiac arrest but are only trained to use I-gels to secure a patient’s airway under the supervision of a paramedic.
"In my opinion action should be taken to prevent future deaths."
However, North East Ambulance Service bosses have stuck to their procedures after an independent review.
NEAS said I-gel insertion is an advanced airway management intervention and that he ambulance service said ASPs are trained and authorised to carry out basic airway management independently, but require supervision or direction from a registered healthcare professional to use an I-gel.
Floral tributes laid for Edie Smart, who died after getting into trouble in the sea at Whitley Bay
(Image: NNP)
Crews made up of two ASPs account for around seven per cent of NEAS' total available operational resources without about ten working at any one time. The service said they are mainly used to transport patients who have already been clinically assessed by a registered healthcare professional. However, they can be sent as the first response to a category one incident if no closer paramedic is available, provided a paramedic resource is sent immediately afterwards.
NEAS said this allows crews to begin basic life-saving interventions, including basic airway management, assisted ventilation, CPR and defibrillation.
NEAS also challenged the coroner’s suggestion that ASPs are often first on scene at out-of-hospital cardiac arrests.
Data from December 2024 to May 2025 showed double-ASP crews responded to 251 of 19,608 category one calls, representing around 1.3 per cent of category one responses.
NEAS said I-gels carry additional risks because they are positioned deeper in a patient’s throat and require ongoing assessment to ensure effective ventilation.
It said the decision not to allow ASPs to use the devices independently was based on patient safety, defined scopes of practice and clinical governance.
Andrew Hodge, director of paramedicine at North East Ambulance Service said: "We would like to offer our sincere condolences to the family of Edie Smart following this tragic incident.
"We have carefully considered the concerns raised by the Senior Coroner and have responded directly. Keeping patients safe is always our top priority.
"Ambulance Support Practitioners (ASPs) do respond to a small number of life-threatening 999 calls in circumstances where they are the closest ambulance, but they do so as a first responder and are joined by a registered paramedic shortly afterwards.
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"Our position remains that advanced airway management techniques, including the use of an i-gel, should be carried out under the supervision or direction of a registered paramedic or other appropriate registered healthcare professional."
"We will continue to review our clinical practice, training and governance arrangements to help ensure we provide the safest and highest standard of care possible."
Floral tributes were left at the scene last year after Edie, from the Monkseaton area, died.