Ambulance

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  • Ambulance
  • Premier Icon TomB
    Subscriber

    In my trust, cardiac arrests get 3 resources, so Ambulance plus 2 cars as minimum, 4 people are needed to perform advanced life support effectively. It is a bid demand on resource, but it’s very rare to get that level of response to a hoax (which thankfully are pretty unusual around here).

    Premier Icon Drac
    Subscriber

    Not sure if you seen it Tom but the vial hoaxer rang in for a 15 year old hanging from a lamp post so they sent maximum resources.

    hooli
    Member

    Thanks for the info, that makes the shortages of ambulances at busy times even more worrying if several are needed for some cases.

    Something I have often wondered, how often do the call operators have to tell people to get in the car or call a taxi?

    We obviously don’t see everything on telly but there have been a few cases where (in my opinion) the person really didn’t need an ambulance and could have got themselves down to A&E relatively easily.

    Premier Icon Drac
    Subscriber

    Something I have often wondered, how often do the call operators have to tell people to get in the car or call a taxi?

    That can sometimes happen with 111 calls, with 999 calls involves a clinician being made aware of the call. Figues I’m not sure to give you an accurate idea as that involves accessing my work email and I’m on holiday.

    When the crew arrive they can also look at referring to them to use their own transport or taxi.

    There is some new ambulance response standards starting at the end of next month which may help relieve some of the pressure.

    hooli
    Member

    Cheers Drac. Don’t worry about figures, was just curios.

    Premier Icon TomB
    Subscriber

    We are moving more and more to “hear and treat” where no physical resources are sent, when appropriate for people to self care, see gp, or make their own way to hospital. Our clinicians also have a range of options which would include self care, primary care referral, asking folks to transport themselves, or booking a contract taxi for them.

    Genuine question following last nights episode….would it not be more cost effective to employ some non-clinical staff who drive around in a van to assist the crews?
    I’ve been watching this series avidly and a recurring theme seems to be multiple crews and ambulances called to incidents to assist with the manhandling of patients in awkward situations or the transport of non emergency patients.

    Premier Icon Drac
    Subscriber

    We have exactly that a clinician and an assistant, it’s extremely rare that we’d have a dual paramedic crew. I not sure why they have 2 qualified staff on.

    We also have crews with none clinical staff on for those cases you describe PP and to help transport those that need no interventions.

    edlong
    Member

    What impressed (and to an extent surprised) me last night was how caring and supportive everyone was for the “frequent fliers” – I would have expected more exasperation, or even anger.

    There was a bit of me that wondered how much that might have been influenced by the presence of a film crew, but it seemed as though what we saw was the norm, given the reactions of the “patients”.

    I was thinking more about when one crew attends and they can’t lift or move a patient like the lady with hoist or the guy a couple of weeks back with the dislocated knee and the narrow staircase.
    They then summon another fully equipped ambulance with two more trained medics when what they really need are a pair of burly porters.
    A secondary support crew who assist with the logistical problems rather than the clinical problems.

    Premier Icon Drac
    Subscriber

    Sorry PP I edited my post as I missed that bit.

    Edlong as a general rule staff are very understanding and caring but at times they can become frustrated and it can come out as anger.

    Premier Icon franksinatra
    Subscriber

    So Leon was sectioned then assessed as having capacity. Should it therefore not follow that he also has the capacity to understand that he will not get a blue light response to his frequent calls, even if there is a risk that one day he has a genuine medical emergency that is missed?

    Premier Icon Drac
    Subscriber

    Yes, that can happen but it is very lengthy and slow process that can lead to a court order even jail.

    Premier Icon v8ninety
    Subscriber

    …understand that he will not get a blue light response to his frequent calls, even if there is a risk that one day he has a genuine medical emergency that is missed?

    Kinda what happens already, as you can see, WMAS held onto his call for hours and eventually only sent a resource when police were available. The problem is;

    if there is a risk that one day he has a genuine medical emergency that is missed?

    Who owns that risk? A common sense approach would suggest he does, but legally; if an ambulance service were to refuse to attend and serious harm or death cane about as a result, I’m pretty sure they’d be answering some difficult questions.

    Premier Icon v8ninety
    Subscriber

    I was thinking more about when one crew attends and they can’t lift or move a patient like the lady with hoist or the guy a couple of weeks back with the dislocated knee and the narrow staircase.
    They then summon another fully equipped ambulance with two more trained medics when what they really need are a pair of burly porters.
    A secondary support crew who assist with the logistical problems rather than the clinical problems.

    This kind of thing has been tried, and it doesn’t work out as cost effective. You’ve still got to equip staff and fuel the vehicle, the only saving is the (slightly; we’re hardly expensive) lower cost of wages for non clinicians. You then have to keep them utilised for the whole shift. The very specific jobs that they would be useful for come in all over the region, at any time, sometimes four or more at once, sometimes none for hours, sometimes hours of travelling time between them. You would have clinical staff waiting far ages for the humperdumpers to arrive. A double crewed paramedic ambulance is the most versatile resource; it can go to any job, convey anything, and if one can’t do it, two almost certainly can. And there’s lots of them. Better to equip them to manage (pretty much) anything.

    Premier Icon Drac
    Subscriber

    You’re joking right?

    It’s almost half the cost for an ECA to a Paramedic, only takes 12 weeks to train an ECA add to that using your current Paramedic staffing being able to cover twice as many vehicles. It’s a huge cost reduction.

    Premier Icon v8ninety
    Subscriber

    It can be done.

    It certainly can, and trust me, there is work ongoing. However, I certainly don’t want to be the one up in front of a clever barrister answering the question; <cynical hat> “So, Mr V8ninety, just why DID you refuse to help my black, disabled, socially isolated and so obviously at risk client when he was self evidently crying out for help?” </cynical hat>

    Premier Icon v8ninety
    Subscriber

    You’re joking right?

    I’m not arguing against skill mix, I’m pointing out that non clinical lifting crews don’t work. (The ECA thing is a separate issue)

    WMAS don’t routinely put out lots of double paramedics. Y’know, telly n’stuff.

    Premier Icon bruneep
    Subscriber

    Or just call out the fire service because if you believe the spin we’re sat about doing nothing, we’ll roll up with no training in handling patients and get stuck in.

    The powers that be now want us to go out and prop up old buddies that have fallen over without any medical training or medical equipment should it be required. They view that they have just fallen over and can’t get back on their own two feet, no medical condition has caused this…….

    Premier Icon v8ninety
    Subscriber

    Not in my patch thanks, Bruneep, you keep your hose pipes and we’ll keep our bandages. 😉 We’re managing just fine. Plus there’s only a few of you compared to us; you’d barely make a scratch on our work load! 😛

    Premier Icon Drac
    Subscriber

    I’m not arguing against skill mix, I’m pointing out that non clinical lifting crews don’t work. (The ECA thing is a separate issue)

    Ah right I got confused when you were talking abut double paramedic crews being beneficial but they do for similar reason the cost are far less and not every patient requires a Paramedic to transport them to hospital.

    Falls aren’t dealt with by your buddies in our area Bruneep as that goes against the care bundles for falls.

    Premier Icon v8ninety
    Subscriber

    Ah right I got confused when you were talking abut double paramedic crews being beneficial

    Ah, I see. By ‘double crewed paramedic ambulance’, I meant a DCA with a para on, not two paras. Double para crews are an expensive luxury, but good for morale (and telly, apparently). We Don’t have ECAs in WMAS any more. Just student Paras/techs.

    Premier Icon Drac
    Subscriber

    Oh! I did wonder about the TV thing.

    Interesting about the ECAs.

    Premier Icon bruneep
    Subscriber

    that goes against the care bundles for falls

    What is this? Looking for sticks to hit the management with.

    Premier Icon Drac
    Subscriber

    Last one tonight.

    Premier Icon NZCol
    Subscriber

    Watching now, massive respect as always.

    Premier Icon Drac
    Subscriber

    That was some episode. Poor Jo was seriously effected by that job.

    Yep, truly moving stuff. Utmost respect.

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