Police have released an e-fit of a man suspected of helping a violent offender escape from prison.
Andrew Farndon, who was serving a sentence for a hammer attack which left his victim with a fractured skull, got away from prison guards as they escorted him to hospital.
CCTV images released by the police on Friday show a gunman approaching the guards outside the Accident & Emergency department of West Suffolk hospital as they took Farndon, 26, for treatment for a self inflicted knife wound.
The pictures show the suspect pictured in the e-fit fleeing with Farndon after brandishing his weapon at the guards.
He is described as white, in his mid 40s, around 5ft 8ins tall, of stocky build, possibly with a Scottish accent and was wearing a white top and blue jeans.
Detective chief inspector Nick Bennett said searches were continuing in Suffolk but added that it was unlikely Farndon was still in the county.
Forces across the country, including the neighbouring counties of Norfolk, Essex and Cambridgeshire along with West Midlands Police, have issued appeals for information.
Bennett said the prison officers were "shaken" by the "terrifying ordeal".
"Along with other forces, we are pursuing various lines of inquiry, including contacting his family, friends and associates in the West Midlands," he said.
"We are also studying CCTV and number-plate recognition records to try to identify the car which was used in the escape.
"Another line of inquiry is whether any mobile phones were used in the planning and execution of this escape.
"His prison cell has been searched and various items recovered. No blade was found in this search."
Farndon had previously escaped by leaping from the dock at Coventry Crown Court in 2007, but was sentenced in his absence to an indeterminate sentence for public protection (IPP) and told he must serve at least two years before being considered for parole.
He was found guilty of grievous bodily harm after a hammer attack which left his victim with a fractured skull, but officials only classed him as a category C prisoner - meaning he was deemed unlikely to make a determined escape attempt.
He was also sentenced to 18 months for dangerous driving, 18 months for aggravated vehicle-taking, and banned from driving for two-and-a-half years.
Farndon's escape is the second in just a week, after an "extremely dangerous" category A prisoner, murder suspect John Anslow, was sprung from a prison van after it left Hewell Prison in Worcestershire.