How Long is Too Long?

Where’s that bloody ambulance got to?

Many readers will, I’m sure, have read the recent article in the Daily Mail about Tom Reynolds in his war zone of East London. At the end of the article Tom says

“There is a plan to cut the number of ambulances and instead send us out individually in cars so we can assess whether an ambulance is really necessary.”

I’ve blogged previously how Nu-Labor’s target driven culture is leading to ambulance services being re-configured to meet the change in ‘A’ category response times due next April. Leaving the vulnerability issue aside, one of the primary results of this change in ambulance fleet composition is that solo responders will be left at scene with potentially very sick or injured people whilst waiting for Control to send them a back-up ambulance to convey the patient to hospital. From a management/Control point of view a patient with a solo on scene is no longer a priority no matter how sick or injured they may be. The response-time target will have been met (hopefully) and all the boxes ticked with the arrival of the solo. Diverting an ambulance only results in one less ‘resource’ available for the next target job. The are no points, prizes or cash available for using an ambulance to take a patient to hospital – clinical outcomes are not a priority.

We’re currently running a ‘scorecard’ on station for how long solos have had to wait before the cavalry arrived. The record at the moment is held by a trainee para (under-12 EMT) who was with a deteriorating patient for nearly an hour and a quarter. For myself, over just this last weekend, I can cite an 80 minutes wait with a patient having a suspected pelvic fracture and 55 minutes with a patient who’d collapsed in the middle of a car park, suffering a head injury, who subsequently fitted and who additionally had a confirmed tib + fib fracture. Luckily it wasn’t raining.

I admit to being a bit of a pessimist and reckon its only a matter of time before the Daily Mail (and other tabloids) start writing articles about how a patient died in front of a solo responder because the nearest ambulance was diverted away (probably to a patient with a cold that AMPDS had ‘triaged’ as a life threatening call – but more on that another time).

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8 Responses to How Long is Too Long?

  1. tjwood says:

    You really have to wonder what the economic savings are to having all your staff waiting around for hours for backup to arrive.

    Surely in the 80 minutes you were waiting for a truck, if you were instead teamed up with someone else and inside of an ambulance, you could have taken two patients to hospital…?

  2. Gimlet says:

    Just seen you’ve returned. Welcome back!

  3. kingmagic says:

    What is your service doing putting trainee paras out on Solo response? If it went tits up then your service would be shafted.

    All our solos RRVs/RFUs have to be minimum 2 years post qualified and then they have to do the solo course and driving up-date before being allowed to hit the streets.

    Talking to others from around the country it seems that clinical outcomes don’t matter just so long as the response time is hit!

    And as for AMPDS! Its about time that system was sorted out. At best its inaccurate, at worst its deceitful.

    Oh and by the way…welcome back. Thought you’d been kidnapped whilst abroad.

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    Thanks, Interesting read.

  6. […] My thoughts exactly. 3.30 this morning and I was called to a house where someone had fallen down the stairs. Turned out its a 14 year old lad and he’d been drinking. When I arrived he was in a crumpled heap on a small landing half way down a flight of stairs. Claret (blood for the uninitiated) all over the walls and down his head; vomit all over his shirt and covering the stairs; and he’s totally ‘out of it’ – GCS of 7. These kinds of jobs are a nightmare for a solo: what to do? You have to consider a cervical spine injury given the circumstances; you need to maintain his airway what with all the blood and vomit; you can’t drag him down the stairs but he’s thrashing about all over the place (probably from cerebral irritation) so its a case of trying prevent him from toppling the rest of the way down. Things are not helped by Control telling me that “we don’t know where your back-up’s coming from as we haven’t got any vehicles available.” – nothing new there then (remember this one?) […]

  7. Amado says:

    Very interesting!

  8. AlexM says:

    I found your site on technorati and read a few of your other posts. Keep up the good work. I just added your RSS feed to my Google News Reader. Looking forward to reading more from you down the road!

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