Here we go again.
More 68 buses this morning: the first four jobs of the day were all category A ‘breathing difficulties’. That means a ‘response’ has to arrive at the location within 8 minutes.
As a prologue, let’s just remind ourselves of what a category A call is supposed to be. In a nutshell:
a condition (trauma or medical) which is immediately life-threatening within minutes of recognition and where rapid intervention and effective treatment by front-line ambulance staff will affect the outcome. [my emphasis]- From Review of Ambulance Performance Standards, July 1996
Or to put it another way – if we don’t get there ‘pronto‘ the patient is going to die.
Now that’s serious stuff so, in order to make sure we get it right, Control have the wonderful AMPDS system to triage our calls.
So, having hot-footed it to the addresses, what did I actually respond to this morning?
- A patient with abdominal discomfort for 5 days. Seen by me on Monday night and his GP on Tuesday. No other symptoms but the ‘ache‘ around his stomach made him feel like he was having to breathe in harder than usual – he stayed at home.
- A patient with a chest infection for 1 week. Seen by her own GP a few days ago and now on anti-biotics, but the carer thought she ‘seemed a bit worse today’ – she stayed at home too.
- A young lady with side pain – seen at A&E last night; had a chest X-ray and all that stuff. Nothing too sinister but was discharged with a diagnosis of a chest infection and given antibiotics. She reckoned the pain was worse today and wanted to re-attend. Nothing life threatening but the crew popped her up the road as requested.
- And finally, a lady having a panic attack. She’d calmed herself down by the time we arrived. We just did the usual checks; everything fine. She stayed at home as well.
There you have it – 4 immediately life-threatening calls – apparently. 3 stayed at home and 1 re-attended ‘just to be sure‘. That’s how ‘good’ AMPDS is (falls off chair laughing), yet on a serious note, ambulance services across the UK are reconfiguring their entire fleets just to make sure they can tick the Nu-Labour box for ‘A’ cat calls like these. What an absolute nonsense and a complete abandonment of patient care.
But hold on to your hats – it will get worse, much worse, next April when the goalposts are moved!
Diagnosis? N.F.I. 
I think everybody in the service, not last control, know that AMPDS ic not worth the disc space it’s written on. Unfortunatly thats the way it is. Chief complaint, drunk and vomiting – consequence breathing funny:- light them up here we go, DIB.
Complete tosh.
With regard to the goal poste being moved; i use to do some work with pepsi-co as a client, locating pizza hut delivery shops. The “drive” time that determined the delivery zones was 8 minutes. Maybe thats what they will get us to do next – sub contract pizza deliveries. 34A02I = deep pan peperoni, garlic bread; general area of shitsville
Magwitch…are these goalposts the reduction in call time from 8 mins to 5 mins?
Or the increase from 75% attendance within ORCON to 95%?
Thats what I,ve been led to believe….are we going to get issued jet packs?
Or is it just rumourville?
Apologies for all the question marks but I,m on nights again…I think?
I was under the impression that it was from when the call was received that the clock starts ticking. I thought that trusts around the country all started the clock at different times? If it was to increase to 95%, I can see the ambulance services not getting any money what so ever!
95%, whow,not heard that. Just not ever going to be met.
The only way ORCON’s get near being met in Northtown is by pulling crews in from the rural stations, where they cant meet ORCON standards anyway – they dont even try. Cant get there in 8 minutes so its a fail, why not take 30 and get all city jobs within the 8.
Sounds like a back hand way of reducing funding. Penalise the service for not meeting impossible targets- rock on new labour.
Locally, we reach the CatA goalpost 36% of the time, with an average response of 12.9mins. Some rural stations do far better than we – because geography favours them with calls which are mainly within spitting distance of the station. ORCON and targets are nonsense, though, principally because the world includes greys, as well as black and white.
CatA call to man collapsed in car park (at a football ground); ongoing CPR. Single crewed ambulance arrives; full cardiac arrest protocol; 3 shocks; evacuated by double-crewed vehicle; patient discharged, fit, from hospital a fortnight later. ORCON FAIL – first responder took 13 minutes to arrive.
But – nip down to the motorway flyover to meet police and confirm that the gent sitting in a car in a field entrance seems to have quietly died after pulling over; do nothing other than attach defib (asystole) + confirm pulseless/not breathing + had been there for some time – ORCON SUCCESS – because we only took 5 minutes to get there.
You really couldn’t make it up