December 13th, 2011

I don’t think it’s just us

Posted in The Job - Experience by 200

We had an accident on one of the major roads this week, at work that is, not personally. It wasn’t particularly serious but one of the drivers sustained a head injury.

An ambulance was called. After about 20 minutes we called ambo control to find out an ETA for said ambulance to be told that they didn’t have one available.

The officer continued on with their dealing, making things safe, putting on lane closures, moving vehicles out of the carriageway, calling garages, taking details from those involved. Another 15 minutes later we rang the ambo control again, they still didn’t have a free ambulance. They rang us 10 minutes later to say they now had a free ambulance.

The ambulance arrived on scene 65 minutes after they were called. This was a head injury on one of the busiest roads in the force area and the guy had to wait 65 minutes. I’m not aware the ambulance control ever knew what the level of injury was, they don’t take many details and apart from asking of someone is conscious and breathing every bloody time you call them, I don’t think anyone knew the level of injury when they were called.

Anyway, I’ve noticed over the last few months that this is happening more and more. In my first few years in the control room it never happened. I can’t recall ever being told that there was no ambulance available. So when it happened for the first time earlier this year it was quite a shock. Then it started happening more often.

We had another case this week where someone was quite badly injured. We didn’t want to move them prior to a paramedic checking them out, again no ambulance was available and the officers took the decision to put the victim in the police car and take them to hospital themselves. Who knows what position they’d be in if their actions caused further injury or worse.

I have no idea about the internal machinations of the ambulance service. I can only presume that they are being subjected to similar cuts in service as the police. Doubtless, if they are, the ambulance senior managers are spouting forth about how they can manage without affecting front line service, at the same time as front line service is being affected. It can’t be a coincidence that we are getting more and more calls from ambo control saying they don’t have anyone to send.

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  1. Special_Steve says:

    I went to our local hospital last time I was on duty (for a constant supervision of a detainee).

    On arrival at A&E there were more ambulances than I have ever seen in one place queueing to unload their patients at A&E.

    The paramedic I spoke to told me that the hospital had no beds and the ambulances were being used to keep people warm whilst the hospital did nothing.

    I wonder if it was the ambulance service or the local A&E holding back vehicles & crews?

    December 14th, 2011 at 05:56

  2. John says:

    And emergency ambulance are being used because the commercial ones cost too much….commercial as in private company ambulances

    December 14th, 2011 at 07:34

  3. Ex RAD says:

    I had occasion to take my neighbour to hospital A&E one evening a few months ago. There were 7 ambulances waiting outside to unload their patients. Obe had an 80 year old woman on board with a head injury after falling. They arrived at hospital at about 6pm – the patient was admitted to A&E at 10.50pm!!!!

    I spoke to a couple of crews and this seems to be the norm, if the A&E can’t see the patient in THEIR target time, they won’t allow them off the ambo unless the patient is dying.

    No targets – boll***!

    December 14th, 2011 at 07:42

  4. Dave Cricket says:

    Hit the nail on the head, 200. I’m a para with an NHS Trust: when I started, 9 years ago, you could be reasonably sure that if you called an ambo, one would be dispatched pretty promptly, but now……….I despair. Part of this is due to what’s called ‘The front end model’, whereby response cars have been deemed the way forward at the expense of double manned (oops, ‘staffed’, can’t say manned any more-fact). This is all very well for a lot of the absolute crap that we go to, despite being told that they screen out the rubbish, but when we need back-up, say 2/3 of the time, guess what, there ain’t any. Try explaining to someone whos Dad’s having a stroke in front of their eyes that he’ll get the next vehicle available. Then, to add insult to (literally) injury, I find out that it’s coming 25 miles-this is the most rural service in England. When we finally get the patient to hospital we find that we can’t offload, not because the hospital staff aren’t doing anything, don’t EVER say that, Special Steve, otherwise you may need A&E yourself, courtesy of the extremely hard working hospital staff you criticise, but because as a result of the cutbacks (sorry, efficiency savings) 1/everybody & his dog is at A&E instead of being seen in Primary care, 2/the acute hospitals have few options when it comes to discharging patients to lower dependency units, i.e the likes of cottage hospitals, as they’ve largely disappeared (efficiency savings again), & 3/every idle muppet on earth seems to regard A&E as the place to be;-
    ‘How long have you had this pain?’
    ‘A week.’
    ‘Have you taken anything for it?’

    ‘Do you have any plasters at home?’
    ‘I suggest you go home & put one on it.’


    Get my drift, folks, we’re being shafted, by the politicians; I’d love to go to health Secretary, Andrew Lansley, if he ever needs an ambo, & by the cretins who rise without trace to run this one fine organisation’ & whos only ambition in life is to please their (ultimately) political masters.
    OK, rant over, time to go lie down, I may aven call an ambulance.

    December 14th, 2011 at 08:27

  5. Special_Steve says:

    I didn’t say that the staff weren’t doing anything… It’s not their fault that the system is backed up and out of the door.

    I suppose I’m criticising the building for the political position it’s been put in.

    December 14th, 2011 at 08:34

  6. R/T says:

    Same in MP too. And not just Friday and Saturday nights either.

    December 14th, 2011 at 11:01

  7. MPS(n)P says:

    Agreed – ‘LAS have NUTD’ is a daily occurrence, even during daylight hours on weekdays.

    December 14th, 2011 at 16:14

  8. Civ_In_The_City says:

    If they aren`t offloaded from the ambulance into A&E then the A&E clock hasn`t been started and there`s no chance of waiting times being exceeded.

    It`s called a ‘targets driven performance culture’.

    There is an overwhelming belief, though one without a shred of evidence, that it is ALWAYS possible to either ‘do more with the same resources’ and/or ‘do the same with less resources’ and further that it is also possible to ‘do more with less resources’.

    If that formula was actually true you could have no resources at all and get all the work done all the time.

    Between political correctness and this stats-led ‘performance’ culture we are well and truly fcuked.

    I was kind of hoping an equally fcuked financial situation might shine a light on this crap.

    December 14th, 2011 at 18:58

  9. Anon says:

    I don’t know that it’s a new situation.

    When I lived in Skipton eight years ago, I was home with our youngest son who was coming up for a year old. I gave him some egg to eat, for the first time, and he went into anaphylaxis. His throat closed up, his breathing was severely restricted and he was cyanotic. I’m a first aider, so I knew what was happening and phoned for an ambulance.

    The call taker told me none were available. I explained the situation in detail, again, with my son on the floor, head tilted back to open his airway to the maximum. I explained, again, that he was barely breathing despite his chest heaving and he was very blue. The call taker got very stroppy and told me to make my own way to hospital.

    The nearest hospital with an A&E was at Keighley. I didn’t have a car. None of my neighbours were in. And I had a baby in anaphylaxis. The ambulance call taker was quite clear that I would not receive any help, so I hung up.

    I phoned the doctor’s surgery on the other side of Skipton and told them the situation while putting my son into a carry harness. I told them I was on my way and would need help immediately I got there. Then I ran the mile to the surgery where a doctor was waiting with an syringe of epinephrine. She quickly confirmed anaphylaxis, administered the epinephrine, put my son on oxygen and also called an ambulance. There were still none available.

    I phoned my wife, who was working in Bradford. When she arrived at the surgery 40 minutes later, the doctor still hadn’t managed to get an ambulance. Fortunately, the epinephrine and oxygen were working. The doctor, rightly, wouldn’t allow us to drive our son to A&E in case he worsened again so we stayed at the surgery for several hours, given the lack of ambulances, until she was satisfied he was sufficiently stable for us to take him to hospital for more checks

    I later discovered there’d been a number of similar incidents where ambulances weren’t available, were seriously delayed or where people were put on hold for 5-10 minutes while dealing with life-threatening situations. I have no idea if the subsequent mergers of ambulance services improved things, but it wasn’t pleasant being in a life-and-death situation only to be told no one would be coming to help.

    I was fortunate. My son’s airway didn’t fully close up. I was fit enough to run the mile bloody fast. The surgery had epinephrine available. The doctor was very good. The cards fell in our favour. But it wouldn’t have taken much to go the other way.

    To add insult to injury, the ambulance service’s response to complaints was a form letter quoting statistics about 50% of calls being handled in X amount of time and 50% of ambulances arriving in X amount of time. (I can’t recall the figures.) I know the situation wasn’t the fault of the paramedics and EMTs, and I’ve seen them in action numerous times, but I’m still angry by just how cocked up the situation was and by the pathetic, bureaucratic response afterwards.

    December 15th, 2011 at 12:32

  10. Student Para says:

    It all comes down to classification of calls – RTCs are ‘Green’ calls, because “lay members can’t accurately tell us how serious it is” but an old person falling at home is a ‘Red’ call because of the potential complications… YCMIU

    December 15th, 2011 at 21:14

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