Where's my ambulance?

[Accyexplorer]

I thought I'd start this thread after reading a couple of (heart felt) comments from members who ( in their moment of need) felt let down by Emergency services.
Personally I've not had a bad experience but I'm curious to hear your views.
In times of crisis, information and support must be readily available and easy to access for those who need it IMHO.
While I praise the bravery of emergency workers,procedures in areas including communications,response times need to be improved (also my opinion).

After ringing 999 callers are asked a series of questions which are based on the initial query as to why an ambulance is required. The questions link to other questions and depending on how the questions are answered depends on the grading of the call.
Currently the ambulance service use several grades of call, ranging from a Red1 response (immediately life threatening) to Green4 (non-emergency, non-life threatening). Each different grading has a different response time allocated to it, as follows:

· Red 1 – Immediately life threatening call, such as cardiac arrest, requiring a defib. Response time: 8 minutes from call received and 19 minutes for conveying resource to scene.
· Red 2 – Life threatening call, such as cardiac chest pains. Response time: 8 minutes from call coding and 19 minutes for a conveying resource to scene.
· Green 1 – Serious, but not life threatening. Response time of 20 minutes from call received.
· Green 2 – Serious, but not life threatening and with no serious clinical need: Response time of 30 minutes of call received.
· Green 3 – Non-life threatening non-emergency call. Telephone assessment within 20 minutes of call received.
· Green 4 – Non-life threatening non-emergency call. Telephone assessment within 60 minutes of call received.

As you can see, not all 999 calls to the ambulance service will automatically get an ambulance attendance. Green 3 and Green 4 calls will be further triaged and assessed by a health care professional, usually a Paramedic or Nurse. These calls often result in self-care advice but the clinician has the ability to request an ambulance to attend so can re-grade the calls as required.

Good or bad,
What are your thoughts,experiences with our ambulance service??

[Margaret Pilkington]

The ambulance service in the past has been badly misused, almost like a taxi service.
It has meant that changes had to be made.
Also impact of waiting times in A&E departments has a knock on effect of when ambulances are available.
If an ambulance crew cannot hand over their patient to staff at the A&E dept, then that ambulance is out of service until they can hand over the patient.
Then there is the issue of ensuring that the ambluance is clean for the next patient, restocking of any items which have been used in the last 'call'.

Ambulances and ambulance personnel are much more technical than they once were.

My daughter has had to call on the ambulance service a couple of times in the last year.
I have nothing but praise and admiration for the lads and lasses that make up the backbone of this service - their care(kindness) and speed undoubtedly saved her life last April.

I know there are others who have not had the same experiences, when it goes wrong(for whatever reason) it can have tragic consequences. Even if the consequences aren't tragic, it is very difficult to see someone you care about in pain and waiting for help which doesn't come as quickly as you would hope.
In those situations, you have to address your concerns through the appropriate channels to get your complaint investigated.

When I worked in the NHS our complaints procedure was well defined.
A response had to be sent out to the complainant within two days of us receiving the complaint, and we had to specify in our response what we were going to do to investigate, a timeline had to be set for resolution and we would be strictly monitored on how the complaint was being handled......we were not allowed to 'drag our feet'.
Every organisation has its own policies, but they are usually along similar lines.
If you make a complaint, and hear nothing, then you need to phone and ask what the complaints procedure is.

[maxthecollie]

Originally Posted by Margaret Pilkington

The ambulance service in the past has been badly misused, almost like a taxi service.
It has meant that changes had to be made.
Also impact of waiting times in A&E departments has a knock on effect of when ambulances are available.
If an ambulance crew cannot hand over their patient to staff at the A&E dept, then that ambulance is out of service until they can hand over the patient.
Then there is the issue of ensuring that the ambluance is clean for the next patient, restocking of any items which have been used in the last 'call'.

Ambulances and ambulance personnel are much more technical than they once were.

My daughter has had to call on the ambulance service a couple of times in the last year.
I have nothing but praise and admiration for the lads and lasses that make up the backbone of this service - their care(kindness) and speed undoubtedly saved her life last April.

I know there are others who have not had the same experiences, when it goes wrong(for whatever reason) it can have tragic consequences. Even if the consequences aren't tragic, it is very difficult to see someone you care about in pain and waiting for help which doesn't come as quickly as you would hope.
In those situations, you have to address your concerns through the appropriate channels to get your complaint investigated.

When I worked in the NHS our complaints procedure was well defined.
A response had to be sent out to the complainant within two days of us receiving the complaint, and we had to specify in our response what we were going to do to investigate, a timeline had to be set for resolution and we would be strictly monitored on how the complaint was being handled......we were not allowed to 'drag our feet'.
Every organisation has its own policies, but they are usually along similar lines.
If you make a complaint, and hear nothing, then you need to phone and ask what the complaints procedure is.

Just like you Margaret I have nothing but praise for the paramedics on the frontline.It is the telephone operators and the"clinicians" who I have a complaint about

[Accyexplorer]

The two comments that made me start the thread:

Originally Posted by maxthecollie:
I know that when I dialled 999 when my 87 year old mother fell and broke her wrist and could not get up, it took one and a half hours for the paramedics to turn up after several calls.

Originally Posted by westendlass:
About eighteen months ago my son became ill, vomited and collapsed to the floor. We rang an ambulance straight away and was asked by the operator if he was conscious. We explained that he was but very confused and could barely get up from the floor,on that reply we were told they wouldn't send an ambulance and that a nurse would ring back for a chat! In a panic, we managed to get him in to my daughters car and set off to A and E and received the nurses call half way there. She sounded shocked when I explained his condition and her advice? 'If happens again, stop driving and call an ambulance'! He spent the rest of the day on a drip in hospital. What a joke.

[Margaret Pilkington]

It is the 111 service that is dire.
On the hottest day of the year my daughter was desperately sick, she had been taking no fluids and vomiting for 36 hours non stop....yes, she had anti-sicknes meds, but what use are they when they have to be taken by mouth.
I spent from 8am in the morning until 5pm at night trying to get assistance for her.
I was very worried for her - she was passing no urine was confused and was obviously dehydrated( people die from this).
I must have repeated the clinical details to a variety of people at least 40 times during this time span. A doctor came out and did give her an anti sickness injection during the early afternoon...but by this time she was past the point of no return.

In the end I called the ward that she had been on for her treatment and they called an ambulance......it was with us within 15 minutes.
She was seen immediately in A&E...was given further injectable sickness meds and infused with seven litres of fluid.
So I have nothing but praise for them.

[Neil]

Originally Posted by Accyexplorer

The two comments that made me start the thread:

Originally Posted by maxthecollie:

You know what to do next time, say she has fallen and I am not sure if she is breathing. You won't be lying if you haven't checked

[Accyexplorer]

Anyone had experience with Community First Responders (CFRs)?
I believe there's been a thread http://www.accringtonweb.com/forum/f...ers-13650.html

The dispatcher assesses all incoming emergency calls and determines the suitability of sending a first responder.
Given they live in the communities which they volunteer in, they are likely to be much closer than an ambulance crew and can provide life-saving help in the first few vital minutes,for example,a heart attack they can provide a better, long-term outcome for us.Considering first responders have the potential to save a life, A increase in activation would an inspiring figure to see.CFRs are invaluable, especially in rural areas (I take my hat off to them).
However in some communities there are(understandably) very mixed feelings regarding CFRs because there's a difference between a community first responder and a qualified paramedic (and his ambulance),Saying that if the CFR schemes stopped I don't think the local Ambulance Service would increase resources.

Do you think sooner or later there will be no ambulances for one reason or another?

[Eric]

It's a little different over here ... how fast you get an ambulance, and what kind of ambulance it is, depends on where you live. There are thousands of communities that don't have a hospital, and many without highway access. Most of us live within a couple of hundred klicks of the US border; but this is still a country of small communities where ambulances are R.C.A.F. helicopters, or maybe planes with skis or floats on them, depending on the time of year. But wherever you are, the emergency services do their best to get to you. In Kingston we are lucky. Ambulances arrive quickly ... and if there is no ambulance available, and the emergency is dire, many fire fighters are trained paramedics, and a big red fire truck may show up at your home. Also, ambulance service isn't free. There is a nominal charge ... $45.00 I think ... of course, those who can't afford it, pensioners, and those on government assistance don't have to pay a dime. Also, if, in the opinion of the ER physician, an ambulance was not necessary, you get stuck with a big bill. In my humble opinion, this is not a bad idea. People who are not residents of Ontario are billed for the ambulance either directly, or, OHIP will bill the Province you reside in. Health care in Canada is a provincial responsibility (British North America Act, 1867). Furriners, like youse guys, pay the full shot. But no one is turned away, and everyone gets help, 'cause us Canucks are nice folk, eh Bottom line is: the service is great ... and if you can't be transported to the care you need, the care will come to you. I remember that a few years back there was a sick premature baby at KGH who needed the kind of care that only Sick Kids Hospital in TO could provide. A surgical team with all their equipment was flown into Kingston.

I know this is kind of a ramble, but some of you might be interested in how things are done over here where climate and geography are important considerations.

[Margaret Pilkington]

I think there is always going to be an ambulance service.......I cannot see how it could be removed.....especially when you think of the number of 'critical incidents' there have been over the last few years.
But, there are finite resources both financial and logistical, so it goes without saying that there will be times when there isn't enough service to meet the needs.
Therefore, I think the coding of emergencies is the only way for the service to be effectively managed.
The only other way would be(shudder) to put ambulance services out to private tender and perhaps be able to call on these when the service is stretched to its limits.
I'm not sure how this would work in a practical sense, or for that matter how it would be paid for...other than the obvious...which is to make those who misuse the ambulance service pay dearly for that misuse.

[maxthecollie]

Originally Posted by Margaret Pilkington

I think there is always going to be an ambulance service.......I cannot see how it could be removed.....especially when you think of the number of 'critical incidents' there have been over the last few years.
But, there are finite resources both financial and logistical, so it goes without saying that there will be times when there isn't enough service to meet the needs.
Therefore, I think the coding of emergencies is the only way for the service to be effectively managed.
The only other way would be(shudder) to put ambulance services out to private tender and perhaps be able to call on these when the service is stretched to its limits.
I'm not sure how this would work in a practical sense, or for that matter how it would be paid for...other than the obvious...which is to make those who misuse the ambulance service pay dearly for that misuse.

I bet a lot of those who misuse the ambulance service are dropouts and on benefits, so it will end up with us the taxpayers forking out again

[MargaretR]

I think that no improvement in service will happen, because the cost cutting ideology will prevail - sick people are a severe drain on national resources and it is cheaper to let sick people die.

[Accyexplorer]

Originally Posted by Margaret Pilkington

I think there is always going to be an ambulance service.......I cannot see how it could be removed.....especially when you think of the number of 'critical incidents' there have been over the last few years.
But, there are finite resources both financial and logistical, so it goes without saying that there will be times when there isn't enough service to meet the needs.
Therefore, I think the coding of emergencies is the only way for the service to be effectively managed.
The only other way would be(shudder) to put ambulance services out to private tender and perhaps be able to call on these when the service is stretched to its limits.
I'm not sure how this would work in a practical sense, or for that matter how it would be paid for...other than the obvious...which is to make those who misuse the ambulance service pay dearly for that misuse.

Talking of misuse:
Lancashire ambulance bosses accused of being 'tactless' over luxury cars (From The Westmorland Gazette)

[Accyexplorer]

Police say ambulance service putting demand on its resources

BBC News - Police say ambulance service putting demand on its resources

[Margaret Pilkington]

I am quite cynical about news stories from the BBC...at one time the BBC was a politically unbiased reporter of news, but in recent times I haven't found this to be so.(or perhaps I should say I have doubted the motives of the news that is reported by the BBC)
It isn't that these incident didn't happen ,but it is the tone that is used to report the news.

[cashman]

The Beeb is more corrupt than anyone in Strangeways in my view.