Do we expect too much of our Ambiwlans service
Discussion
Prompted by this article from the local rag:
Unconsious boy waits 45minutes for Ambiwlans
And then reading some of the comments; have we become unrealistic with our expectations of the service?
Unconsious boy waits 45minutes for Ambiwlans
And then reading some of the comments; have we become unrealistic with our expectations of the service?
911motorsport said:
Prompted by this article from the local rag:
Unconsious boy waits 45minutes for Ambiwlans
And then reading some of the comments; have we become unrealistic with our expectations of the service?
The problem there was the categorisation of the calls - sounds like they responded to a dislocated elbow, and not an unconscious casualty.Unconsious boy waits 45minutes for Ambiwlans
And then reading some of the comments; have we become unrealistic with our expectations of the service?
The London fire brigade have an average response time of under 6 minutes - no reason that ambulances shouldn't hit the same standards (for critical cases).
No - fire engine response times are much much quicker.
My BIL (a fireman) told me that if you ever witness a heart attack call 999 and tell the operator that there's a house fire with persons reported. All wagons carry a defib and they'll be there much quicker than the ambulance - which is sent anyway. You may get a b
king, but at least your loved one will be attached to a defib within minutes.
I've witnessed this first hand on a couple of occasions, once when I had to call out the emergency services for an RTA. FB were there within 10 minutes, ambulance turned up after 30 mins and the police turned up as the Ambulance and FB were leaving.
My BIL (a fireman) told me that if you ever witness a heart attack call 999 and tell the operator that there's a house fire with persons reported. All wagons carry a defib and they'll be there much quicker than the ambulance - which is sent anyway. You may get a b
king, but at least your loved one will be attached to a defib within minutes.I've witnessed this first hand on a couple of occasions, once when I had to call out the emergency services for an RTA. FB were there within 10 minutes, ambulance turned up after 30 mins and the police turned up as the Ambulance and FB were leaving.
They should fine people who ask for an ambulance for stupid reasons - like someone asking for a plaster in the comments below the article! That would reduce some of the calls they have. Also someone mentioned in the comments that it was a 5min drive from the place to the hospital (and therefor unacceptable for a 45min wait) - so how long would it have taken to put him in a car and do the same journey?!
well i suspect he was taken to Southend hospital and i was there on Sunday in a&e, the ambulance guys where in and out like ants, lots of sirens and lights all afternoon (was there for nearly 7 hours).
we dropped down the list a few times as higher priority cases came in, much to the annoyance of mr ill informed sitting near us moaning.
i was lucky i had solitaire on my phone and flight mode, but the paramedics seemed to be flat out, especially as half of Southend and Westcliff rugby club seemed to be down there.
they do a job i would hate to do, and yes perhaps people in the situation are in pain, but it wasn't life threatening.
we dropped down the list a few times as higher priority cases came in, much to the annoyance of mr ill informed sitting near us moaning.
i was lucky i had solitaire on my phone and flight mode, but the paramedics seemed to be flat out, especially as half of Southend and Westcliff rugby club seemed to be down there.
they do a job i would hate to do, and yes perhaps people in the situation are in pain, but it wasn't life threatening.
The simple reason is there are not enough ambulances to go around to meet all the time-waster calls, wrongly categorised calls, and the bullst targets which go with them.
Ambulance call-takers are bound pretty rigidly to the sequence of questions in front of them; A "yes" or "no" to the right questions will give the call priority on AMPDS, and common sense isn't allowed to enter into the equation. So you end up with lots of minor calls being given priority status, or all of the local frequent flyers learning the correct answers to get them a nice big yellow taxi to the nearest warm A&E dept. Pretty soon all your ambulances are tied up and the genuine priority calls can get lost in the aether.
The hospital I work in isn't exactly in the middle of a bustling metropolis yet still I chat to paramedics who are utterly sick of having to drive balls-to-the-wall on blues just to pick up a known drunk - or the target time for the call won't be met and they risk a bking. I can't imagine how bad the problem is in somewhere big like London.
t targets which go with them. Ambulance call-takers are bound pretty rigidly to the sequence of questions in front of them; A "yes" or "no" to the right questions will give the call priority on AMPDS, and common sense isn't allowed to enter into the equation. So you end up with lots of minor calls being given priority status, or all of the local frequent flyers learning the correct answers to get them a nice big yellow taxi to the nearest warm A&E dept. Pretty soon all your ambulances are tied up and the genuine priority calls can get lost in the aether.
The hospital I work in isn't exactly in the middle of a bustling metropolis yet still I chat to paramedics who are utterly sick of having to drive balls-to-the-wall on blues just to pick up a known drunk - or the target time for the call won't be met and they risk a b
king. I can't imagine how bad the problem is in somewhere big like London.Have a read of this http://itunes.apple.com/gb/book/blood-sweat-and-te... it gives an interesting insight into what the London Ambulance Service does/puts up with.
Another reason for delays is where ambulance crews have to sit with their patients in A&E waiting for them to be admitted.
This means that the number of ambulances available reduces as they all end up parked outside A&E waiting for the hospital to triage and accept their patients (that's the case in SWales anyway)
This means that the number of ambulances available reduces as they all end up parked outside A&E waiting for the hospital to triage and accept their patients (that's the case in SWales anyway)
Petrolhead_Rich said:
He fell over, then was waiting for an ambulance when he lost consciousness, then the call was upgraded and the ambulance arrived.
Whats the problem?
Why didn't they just take him to hospital?
FFS!
i agree.Whats the problem?
Why didn't they just take him to hospital?
FFS!
i dislocated a shoulder a couple of months ago and i knew it was low on the priority list. after an hour i asked the paramedic why he couldn't just take me in his car. another half hour passed and the st. john's tuned up to take me in a minibus.
Jerwatt said:
Also someone mentioned in the comments that it was a 5min drive from the place to the hospital (and therefor unacceptable for a 45min wait) - so how long would it have taken to put him in a car and do the same journey?!
I guess it's the perception of response time - if someone's injured and you don't know how to deal with them, the idea that someone qualified is on the way (and is more able to get through/around traffic etc) is more attractive than taking them to the hospital yourself.BonzoG said:
The simple reason is there are not enough ambulances to go around to meet all the time-waster calls, wrongly categorised calls, and the bullst targets which go with them.
Ambulance call-takers are bound pretty rigidly to the sequence of questions in front of them; A "yes" or "no" to the right questions will give the call priority on AMPDS, and common sense isn't allowed to enter into the equation. So you end up with lots of minor calls being given priority status, or all of the local frequent flyers learning the correct answers to get them a nice big yellow taxi to the nearest warm A&E dept. Pretty soon all your ambulances are tied up and the genuine priority calls can get lost in the aether.
The hospital I work in isn't exactly in the middle of a bustling metropolis yet still I chat to paramedics who are utterly sick of having to drive balls-to-the-wall on blues just to pick up a known drunk - or the target time for the call won't be met and they risk a bking. I can't imagine how bad the problem is in somewhere big like London.
Yup.t targets which go with them. Ambulance call-takers are bound pretty rigidly to the sequence of questions in front of them; A "yes" or "no" to the right questions will give the call priority on AMPDS, and common sense isn't allowed to enter into the equation. So you end up with lots of minor calls being given priority status, or all of the local frequent flyers learning the correct answers to get them a nice big yellow taxi to the nearest warm A&E dept. Pretty soon all your ambulances are tied up and the genuine priority calls can get lost in the aether.
The hospital I work in isn't exactly in the middle of a bustling metropolis yet still I chat to paramedics who are utterly sick of having to drive balls-to-the-wall on blues just to pick up a known drunk - or the target time for the call won't be met and they risk a b
king. I can't imagine how bad the problem is in somewhere big like London.Spent a couple of weeks 3rd-manning with ambulance crews.
Dealt with one true touch and go time-limited emergency where the intervention of the paramedic stopped an imminent death. -Although that was an opiates overdose in a dodgy seafront hotel.
The rest of them were drunks, 'my tummy hurts' types, ferrying old dears from GP practices and an old bloke who'd cut his toe clipping his nails.
The reason why they wear those green jump suits/overalls by the way is that the old shirt/tie combo led to them getting attacked by drunks who mistook them for the police.
PeetBee said:
(that's the case in SWales anyway)
Did a first aid course in West/Mid Wales (somewhere North of Llandovery) and got told around there they'd changed the idea of an ambiwlans arriving within so long (8 minutes?) to one being assigned within the same time. As we were a good 40 minutes or more (one way) from the nearest A&E of any size at all, the main advice was "don't need an ambulance". I've driven a friend to hospital with a disloctaed (and fractured as it turned out) shoulder and it didn't really occur to us to phone an ambulance. They were comfortable enough sat in the car with their arm in a sling and at the first hospital they didn't have enough of an A&E- minor injuries only- we then had to drive on to a second hospital. At that point there wasn't any suggestion of an ambulance either....
Taking the opposite view a former school contemporary was involved in a big fatal accident trying to rush his mate to hospital after his mate had suffered a fall leading to what sounded like concussion. In some cases where it is obvious something serious has happened but not 100% what it is then you are best calling and waiting for an ambulance, at least that way you get some advice even if it is drive them to the hospital you muppet.
rhinochopig said:
No - fire engine response times are much much quicker.
My BIL (a fireman) told me that if you ever witness a heart attack call 999 and tell the operator that there's a house fire with persons reported. All wagons carry a defib and they'll be there much quicker than the ambulance - which is sent anyway. You may get a bking, but at least your loved one will be attached to a defib within minutes.
I'm sorry, but that is a terrible idea. If anyone goes into cardiac arrest then ask for an ambulance. If someone is in arrest then you need a Paramedic there to provide the correct drugs etc. If there is a cardiac arrest then a broadcast radio transmission can be aired to get the nearest para to scene as quickly as possible. A cardiac arrest is a Cat A emergency, 8 minute government response time. A house fire with persons reported is (From memory) a Category B emergency, which means we have 19 minutes to get there, and quite possibly a paramedic crew will not be sent. Also, the paramedic who is responding on the rapid response car will not be sent, and it can take a fair few minutes for fire to pass details to ambulance control. In addition, I reckon there is a good chance that a paramedic on a motorbike or Volvo sat on a stanby location will be able to mobilise quicker, and scythe through the traffic a ot quicker than 15 tonnes of fire engine. Can I just reiterate, with all due respect, this is really not a good idea.My BIL (a fireman) told me that if you ever witness a heart attack call 999 and tell the operator that there's a house fire with persons reported. All wagons carry a defib and they'll be there much quicker than the ambulance - which is sent anyway. You may get a b
king, but at least your loved one will be attached to a defib within minutes.newspaper idiot said:
I couldn’t fault the crews, and the treatment he got at hospital was also fantastic, but the call centre was an absolute nightmare.
“No matter how many times we asked, they refused to confirm whether an ambulance was coming and just kept asking irrelevant questions.
The questions are not irrelevant, they are designed to establish if there is a clinical deterioration in the patient, not that they are uncomfortable, or in pain, or bored of waiting. If there is a clinical deterioration then suitable instructions can be given to maintain their airway etc. “No matter how many times we asked, they refused to confirm whether an ambulance was coming and just kept asking irrelevant questions.
In addition to that, you can never tell anyone that an ambulance is en route, or how long it will be, or where it is coming from. If you verbally commit to the fact that an ambulance is on the way, or is five minutes away and then it breaks down or is diverted to the 2yr old that has fallen in the pool and stopped breathing, whose fault is that? There have been court cases in the US where people have been convicted for doing such a thing, it is something to do with giving false hope, which may compromise the care being given to the patient by bystanders if they believe the arrival of an ambulance is imminent.
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