to complain to the ambulance service?

[lurcherlover]

I genuinely don't know if IAMBU here, so all thoughts welcome...

I was out walking DDog today with DS (7 months) in his back carrier when my mobile goes. It's DH, who is round at my parents' house as my dad has phoned our house. Dad's had an accident and I need to get there straight away (luckily they only live 5 mins from ours and I hadn't walked far). I get there and find my Dad in absolute agony with what is clearly a dislocated shoulder (the deformity was obvious). He'd tripped and fallen in the garden. My mum was at work (Dad's retired) so he'd phoned our house. He was in shock, grey and clammy, and in unbearable pain. Naturally, we phoned 999 for an ambulance. We were told that as it wasn't a "life threatening injury" an ambulance wouldn't be sent out and we would have to get him to A&E ourselves. If we didn't have our own transport, a "non-emergency ambulance" (ie the minibuses they send out for little old ladies to go to the chiropodist in) would be sent in approximately 2-4 hours' time. So we had to virtually carry my Dad to our car between us and drive him to hospital, with him groaning in pain.

I was fuming - my Dad was in agony, and paramedics would've been able to give him morphine (which the dr did as soon as we got there). Plus, I was worried the injury wasn't stable, and putting him in the car to drive to hospital might do more damage. Added to this the fact that luckily DH wasn't working today - if he had been, I would have had to somehow get my Dad in the car by myself, then get him and DS out at the other end. So I'm thinking of complaining and saying an ambulance should have been sent. Opinions please?

I think they are being unreasonable giving you the alternative of a 2-4 hr wait, unsafe to leave such an injury for so long and your dad was suffering.
However you had transport and were willing to take him so that lets them use the ambulance for life-threatening case.

YABU I'm afraid, there are not enough emergency ambulances to deal with these sorts of injuries. You were offered a non emergency one, but they are so over stretched there is always a long wait.

I'm guessing you would have waited around for the ambulance to arrive and then followed behind it in the car? My DH is a paramedic and he goes 12 hour shifts without a break because he spends so much time attending calls like this. He often gets sent out of our area to attend sprained ankles and stubbed toes (!), leaving our area with no ambulance cover. It must have been very distressing to see your dad in pain though, I hope he is recovering now.

I am shocked that so many people think it is normal to leave an elderly person in terrible pain without emergency help. Or any person for that matter. Shame on ambulance service and I would definitely complain. Many others obviously disagree, but it was very poor service in my opinion.

Why are so many people ready to accept that "there just aren't enough ambulances now"? Sure, the economy is in a bad patch now, but the country is much, much richer than it was 20 or 30 years ago. If we don't have enough ambulances, our priorities have gone very wrong.

and considering some of the reasons people get carted to hospital in an ambulance I think yours is much more worthy.

Another HCP here and I don't think that YABU. As has already been mentioned, there were potential complications with your dads injury which could not have been assessed by a call handler. Whilst I wouldn't complain, I WOULD ask for clarification as to why an ambulance wasn't dispatched - your dad was obviously very shocked and your desciption of him being grey and clammy would have rung alarm bells for me as to the cause of his fall (he may have had an underlying medical problem which caused his fall - again NO way that a call handler could assess that) Hope he's okay.

I feel for you and your Dad, OP. I would have done exactly the same. I think the most difficult thing would have been maneouvering someone in such pain into a car.

I was told on a 1st aid course that they prioritise:

1. Breathing
2. Blood
3. Bones So, it looks like this would be low priority and if they were maxed out with people not breathing, or bleeding, then there would be no ambulance for you.

Umf, there are enough ambulances to deal with emergency calls (including this one) but not for the many, many non-emergency calls that we get. Te problem is, there are not the support services to help the elderly or vulnerable to function independently and so we do get calls for things like "needing help to go to the toilet".

Well, I have dealt with a parent in excruciating pain (several times) due to a life-threatening physiological condition and it was for that reason I once called an ambulance OP. My parent had passed out and was drifting in and out of consciousness, unable to respond or even sit up.
I didn't call 999 lightly but had previously phoned NHS 24 and found them to be useless.
OK my phraseology of "You're joking" could have been better put - so sorry about that part but I still think a dislocated shoulder doesn't require an ambulance.
I used to attend rugby matches years ago and witnessed dislocated shoulders occurring on the pitch. They all just got driven to the local A&E by car.

I don't think you did the wrong thing by calling an ambulance at all. You poor Dad was probably in shock. I hope you are all ok now.

You would be wrong to make a complaint though, I would have thought that if they could have sent you an ambulance they would have done. There could have been a major RTA that required all the local ambulances. You would be surprised how few ambulances (big van type ambulances I mean) are available to cover a large area. That's why you see som many paramedic cars, or paramedics on motorbikes.

They did offer to send other transport, it's just that it wasn't available right away. They might still have sent a car, not one of those van things, although at least a paramedic and pain relief would have been available for the journey.

The call centre probably knew that it would be quicker for you to use your own transport. They can't send you what they don't have.

Really crap for you and your dad, but ultimately they have to prioritise life threatening situations. Hope dad's on the mend x

Dislocated shoulder is quite a common sports injury and occurs in all sorts of locations, and while very painful, many people cope with nursing the afflicted area to the place of treatment. Its not so painful that it is inhumane to expect someone to bear the journey to the place of treatment without morphine, is what I'm trying to say. Mountain bikers do this sort of injury all the time and don't get helicoper rescue off the mountain. My friend did it mountain biking in the French Alps last year and got himself and his bike down the mountain on his own.

The quickest way to get your father to hospital and treated was by car. I would have just got him in the car and driven there asap. I once cut my finger half off, through a nerve, when I was on my own in the house. Rather than panic, I wrapped it up in towels and drove myself to hospital -quickest way to get there - although the parking attendant, on seeing my trail of blood,told me I didn't need to bother paying!

Rugby players aren't old men with potentially fragile bones though are they? And presumably there are first aiders or medics on the pitch who can confirm the injury is a dislocation and nothing else.

It takes longer to train as a dispatcher than it does to traumas a member of ambulance crew!

For "traumas" read train as (I hate auto-correct...)

I don't think YABU to have called an ambulance- seems like they are called out for far less serious things these days, but I do understand that they may not have had one to send immediately. I suppose it comes down to the way they communicated their decision to you.

I took my dd to hospital in the car with a dislocated elbow, screaming in pain, simply because I guessed it would take longer for an ambulance to be made available to me, and I wanted her seen to as quickly as possible.

But conversely I did once call an ambulance for a man I found (drunk and almost comotose) in the street who obviously had a dislocated shoulder. I couldn't have physically gotten him in my car- nor did I want to! Took over an hour for the ambulance to come (I waited with him in subzero temperatures), then the bloody eejit refused to get in, and they were all for driving off! I did manage to persuade him to get in in the end (actually I threatened to dislocate his other shoulder if he didn't ). That time, I initially phoned the local police, but they said they would just arrest him, and THEY told me to phone an ambulance!

I think if you're used to seeing a dislocation, you might not see the need for an ambulance. Personally, I would have panicked and been scared to move the person. I think Bubblecoral's post explains it from the ambulance service's POV very well. I would definitely have rung for an ambulance, but if they had reassured me I'd have been content to drive the person myself. Horrible, though, and it's awful to see someone you love in pain.

I love the ambulance service, but did end up nearly having a blazing row with the 999 operator recently. I got a call from my mum, who was on her way to see me, but had had a suspected heart attack on the train. Some other passengers lifted her onto the platform (and LEFT HER THERE - but that's a rant for another day). She managed to ring me and say, "Call an ambulance! I'm at the station" and then passed out.

I ran straight there, calling 999 on the way. Operator wanted to know which platform she was on (there's only two). Obviously I didn't know. Operator insisted she wouldn't despatch an ambulance till I could tell her. Me: "How can I tell you when I don't know?! Just send them now, and as soon as I get there I'll ring you back, or I'll make sure somebody is outside to direct them". The argument went backwards and forwards for several minutes, till I burst into tears (I really thought my mum was dead or dying). She then told me that if I raised my voice to her she would cut me off, then finally relented.

The care my mum got from the paramedics and at the hospital was excellent and very caring. But I could have throttled that operator.

Fair enough point lurcher - but when you get quoted a wait time of 45-60 minutes anyway for semi-concious patient who is grey and unresponsive (like we did) it's likely that a dislocation would take even longer. So a journey by car will actually get them there faster. Not great but there it is.

I hope your Dad is feeling better soon.

hester

OP I'm a bit on the fence here. I would too have thought grey etc as well could equal shock something I have been told requires 999. But I think what others have said about you being able to get him there and treated by car quicker so should is also correct.

I think think it was portrayed badly or in your concern you misunderstood.

I have always been told call 999 if DS needs his epi-pen - but hospital is 10 minutes away and if I was quoted a longer wait would consider driving him. (ambulance station is 500 m away though!)

Hope your dad is better.

hester. I had someone asking me to call them an ambulance to Glasgow (yes that's the details they gave) and they objected to you narrowing the location down to a 2 platform station

what sassybeast says.

I dont understand that the call handler would have without a doubt known that your dad had not had a stroke, heart attack, emabalism, seizure, etc to cause fall and that his shock symptoms were not worsening, his bp was not dangerously low, or his bones were not broken, or he did not have an internal bleed, considering the symptoms you describe.

A dislocation in an elderly patient in no comparison to a fit, young and healthy sports player.

YANBU. I would ask for a detailed explanation as to their assessment criteria in this situation.