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Our pub debate of the day: ambulances

(74 Posts)
Morethanalittlebitconfused Sun 22-Jun-14 21:41:34

DH and I are still discussing this long after returning home from the pub and now casualty has made it worse

Big road accident (or helicopter accident if it's casualty!) that takes up all the local ambulances. At the same time an elderly person falls at home and has no one who can go to them to pick them up from the floor, other than being shaken frail and unable to get up they are otherwise well. Simultaneously a young adult in their 20's or 30's has a suspected stroke/brain aneurysm and is in a pretty poor way. Alongside this a child falls out a tree and breaks a leg.

The nearest ambulance is 30-40mins away for the closest person, the others need to wait for that ambulance to collect, treat and get to hospital their patients. Which order do you get them seen?

This has also been triggered by a real life incident and the person we know had to wait 90mins for their ambulance. I'll tell you what bracket they fall under tomorrow.

306235388 Sun 22-Jun-14 21:44:46

Young adult
Child
elderly person

Toyed with idea of elderly person first as quick but from my own experience with relatives quite often they seem ok but get taken in just in case.

PartyGateCrasher Sun 22-Jun-14 21:49:10

Young adult
Old person
Child

The last two are presumably not going to die.

However, not enough details in post. What part of the leg is broken and why cant parents take to hospital.

Old person, who alterted services to fall? If it is a fall button system don't the points of contsct get called?

I think its tricky and you cant win in any of the choices you make.

fluffycow Sun 22-Jun-14 21:55:01

Young Adult
Child
Old person

Young adult is at risk of death if they're not seen quickly
Child is likely to be in a lot of pain and be uncomfortable and panicking more
Old person isn't about to die from that situation and isn't in pain so can wait for a while

MrsKCastle Sun 22-Jun-14 21:55:25

Young adult first- life-threatening.

Then it depends on the severity of the child's broken leg- unless it's very serious they could probably be taken to the hospital by car/taxi.

ppplease Sun 22-Jun-14 21:56:25

Definitely young adult first. Suspected stroke/brain thingy is big.

Then child. They may have hit their head

Then elderly person who is otherwise well.

Morethanalittlebitconfused Sun 22-Jun-14 21:56:51

Sorry I should have said in the case of the child we argued worst case scenario (so compound fracture)

AtYourCervix Sun 22-Jun-14 21:56:54

Child
Adult
Old person

ThinkIveBeenHacked Sun 22-Jun-14 21:58:05

Surely their priority is to preserve life? So the ambulance is dispatched to the patient in the most critical condition.

ppplease Sun 22-Jun-14 21:58:09

Ah. Good point about child could be taken by parents? Dont know enough first aid to know if that is risk free. It probably is.

AtYourCervix Sun 22-Jun-14 21:59:56

Children do weird things when damaged though. And a leg is a pretty big injury with potential for massive bleeding.

So i'm still going

Child
Adult
Old

NCISaddict Sun 22-Jun-14 22:01:08

It will always be young person, child, old person. Young person first because they have had a time critical event, child because, depending on how the leg is fractured it can be life changing (open fracture, nerves/blood vessels compromised in a displaced fracture) and elderly person last as you said they are well apart from being on the floor.

This scenario happens all the time and doesn't need a major incident, there are not enough ambulances to meet the demand especially with the rapid increase in the numbers of people calling 999.

Wolfcub Sun 22-Jun-14 22:01:10

Young adult
Old person
Child (unless the child has an open fracture)

VivaLeBeaver Sun 22-Jun-14 22:01:34

Young adult
Child
Older person.

They'd be worried that a kid falling out a tree may have sustained other injuries I'd have thought.

MrsJohnDeere Sun 22-Jun-14 22:02:45

Young adult
Child
Old person

McBear Sun 22-Jun-14 22:03:48

Strokes can kill or permanently injure.

It has to be...

Young adult
Child
Old person.

ppplease Sun 22-Jun-14 22:04:05

True, suspected stroke/brain aneurysm is time critical.
Unfortunately I know someone who nobody was expecting for hours, actually make that two. sad
Both have had a real bad outcome.

VivaLeBeaver Sun 22-Jun-14 22:04:12

I spend a fair amount of time in ambulances and believe me the lack of ambulances in the area is unbelievable. Its not unusual for there to be no free ambulances in the (large) county.

I was with a crew the other day and we got called to a suspected stroke (elderly) amd we were a good two hours (and two counties) away but were the nearest free ambulance.

IwishIwasmoreorganised Sun 22-Jun-14 22:05:31

Young adult,
Child (assuming the worst - long bone fracture, not just fibula)
Old person.

HecatePropylaea Sun 22-Jun-14 22:05:45

Young adult first because in case of stroke, the longer you have to wait for treatment, the more risky
Then child because they are in pain and likely terrified but it is unlikely they are at risk of death or permanant disability
then elderly person, because they are lowest risk.

a paramedic car or bike or even gp could have been dispatched to the child to give some onsite assessment and to assess whether it was a simple break or something more dangerous.

the community nurses etc could have attended the elderly person to give them some reassurance

VivaLeBeaver Sun 22-Jun-14 22:05:54

Actually we were nearer than 2 hours with blues and twos. But over an hour.

SellyMevs Sun 22-Jun-14 22:10:37

Young adult - stroke is a life threatening emergency, time is brain. They need to be in hospital as soon as possible

Child - although injury can be serious, it is not likely to be life threatening. However, life changing injuries may occur so still a priority.

Elderly person - this will wait unfortunately, they are not in any danger and not likely to suffer serious injury. These types of calls also take the longest - a full assessment will be done, their mobility assessed, referrals made to the most appropriate services to avoid this from happening again unnecessarily.

These decisions are made on a daily basis, and aren't always so black and white. Ambulances will just travel further distances to meet the demand.

sallysparrow157 Sun 22-Jun-14 22:11:29

Trouble is the ambulance control can only go on what they're told. So aneurism young adult may have given the impression they have a mild headache, fallen over old person may not want to bother anyone so hasn't even called for help in the first place and broken leg kid's mum has made out on the phone that the kid is a bit of a drama queen. So what actually happens is the ambulance goes out to a toddler with threadworms.

Am I helping the argument?!

Seriously though - adult with an intracranial event is time critical, the longer it takes to get them to a neurosurgical centre the more likely they are o die or be brain damaged. They have to go first.
Child next, will have pain and possibly significant blood loss but thy are not as time critical as an intracranial bleed. A rapid responder could go out and stabilise the fracture and give pain relief whilst waiting for the bus
Old person last or not at all, they are not sick or hurt, they just need help to get up, also door may be locked so would need police anyway, so in a limited ambulance scenario the police could go round, get access, help old person up and assess if further aid is needed

arethereanyleftatall Sun 22-Jun-14 22:14:27

The only person who needs to call 999 for ambulance in your scenarios is the young adult. I thought 999/ambulances were only for life threatening things.

McBear Sun 22-Jun-14 22:15:51

Why is it called blues and twos? I get the blues...

I call it nee-naws. I get told I'm a child grin

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