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?

Clemetteatlee. Yes- dispatcher do the IAOED certification- all EMD do. Our dispatch and calling taking areas are seperate but most staff are qualified to do both. There is no seperate dispatch qualification.

Our emergency ambulances responding to cat A and B calls are technicians or paramedics. Green calls (cat c) can be A&E support or non emergency trained staff. Perhaps that's what you mean?

Being cold and clammy after a fall doesn't upgrade a response. Of course it could be shock but MPDS the ambulance services triage system cannot triage all calls with every possible eventuality- else everyone who called would get an ambulance and there aren't always enough for even the Cat A calls. The system is excellent and tried and tested. Callers are always told to call back if anything changes so if he got worse he'd have been re triaged and possibly got a high response if he had any priority life threatening symptoms.

It's not ideal but sometimes there aren't enough ambulances to go round.

I honestly don't know whether you are being unreasonable or not. I had an accident two years ago involving a head injury and a dislocated shoulder and an ambulance was called to take me to hospital. It never occurred to me that this was wasting their time and certainly no one in the ambulance or at the hospital suggested we shouldn't have called.

I can see that it is not an emergency in the way stroke or cardiac arrest are but for all those people above saying 'it is only a dislocated shoulder' I'd just like to point out that dislocating my shoulder was far and away the most painful experience I have ever had. It definitely eclipsed childbirth, a broken ankle and a prolapsed disk. Looking back I have no idea how I could have been taken to hospital without an ambulance because the pain kept making me blackout. So please pass on my sympathies to your Dad and tell him to get arsey about getting a physio referral and to do the exercises! Prompt physio made all the difference to my recovery.

No, that's not what I mean. I have attended my fair share of Cat A calls as a double ECA/probationary technician crew. Which trust do you work for as all our near neighbours operate like this?

Ps the dispatchers here do the NAED qualification specifically for dispatchers.

Really, it shouldn't be the case that there are such wide differences within the same country...

Good grief I am utterly stunned!

I dislocated my ankle a while back and it was the most unbearable pain EVER, the 4 fractures I could just about cope with but the dislocation was agony and I needed gas and air and morphine before I could even be moved by the paramedics.

How on earth were you meant to know that your dad's shoulder wasn't also a break?

IIRC the small paramedic in a van came and then called for a 'proper' ambulance.

usually on MN if your baby sneezes you get told to call an ambulance now!!!!!

I get a dislocated jaw quite often. I drive myself to a&e

Well there must be dislocations and dislocations because it hurt to bloody breathe and I have a very high thresh hold!

YANBU to have called 999 under these circumstances.

But I don't think the response you've got was totally unreasonable either, assuming that resources were stretched at the time.
(to the posters who said the big reason to them why an ambulance/paramedic should have been sent was that no-one knew why your Dad fell, I note 'He'd tripped and fallen in the garden' - so no suggestion of any additional problem causing the fall).

Rather than complaining, perhaps you should try to obtain clarification/guidelines first, see if you think they are reasonable and were adhered to?

My own view of the service at the moment is very good... only ever had to use it before when MIL hypo'd (cue prompt arrival of paramedics who inject something and 20 mins later she's fine) till yesterday when she fell ... cue prompt arrival of paramedic who was wonderful. MIL is 92 though, I guess the computer triage has a U-shaped age parameter included.

Clemetteattlea- London.

I suppose the dispatch training and qualifications differ as different services use different systems.

I just had a look at the LAS website - interesting structure, very different to up here. What role do you hold? I am training to be a paramedic (although I have just handed in my notice).

Clem- I an EMD- we take the 999 calls and dispatch (different days different parts of the room). We have about 30 call takers most days about aboutthe same number dispatching- plus management.

I would love to train as a paramedic but now I'm London you need a paramedic sciences degree. 3 years full time training costing 7k a year. I have a family and a house and can't afford to go back to Uni now. :(

Sorry for hijack Op xx

The courses in Northampton and Sheffield are two years and you get a bursary but that is a big relocate.
I was one of the last to do the direct entry, training on the job route. THe general feeling up here is that all trusts will return to this option alongside the university route so fingers crossed you get the opportunity.

yanbu You thought he had a dislocated shoulder - are you a doctor? An elderly person in extreme pain and shock, possibly with a break, and people think it is not an emergency? My mother (77) had a similar accident, spent over an hour lying face down on the pavement in the rain, waiting for an ambulance. The shock, pain and fear nearly killed her, took months for her to get over it.

Of course it would be ideal if people didn't have to wait for an ambulance, if there were ambulances on every corner, if ambulance crews didn't have to work 12 Hr shifts and get sent on cardiac arrest calls during their lunch breaks. However, resources are limited. Do you think the dispatchers are deliberately making people wait? They try everything they can to get to everyone as quickly as possible. The triage system identifies priority symptoms to help the dispatchers decide who gets an ambulance 1st and who has to wait a bit longer. Difficulty breathing, bleeding and state of consciousness.

Sure, shock can kill you, but not as quickly as a cardiac arrest. Most injuries have the potential to kill you eventually in one way or another .. but they dispatch on priority. Immediately life threatening has to be dealt with 1st. If there are more than the average number of cardiac arrests and severe breathing problems calls one night then those with a lower priority (ie broken legs or dislocated shoulders) may have to wait longer or even be told it's quicker to get a cab. For what we call amber calls (medium priority) it will be after the call and patient has been re questioned by a clinician that you are told to get a cab- the call taker will not do this. For low prority calls (cut fingers, constipation, hiccups- yes, really people call for hiccups) sometimes if the service is extremely busy the call taker will advise the patient to make their own way to hospital or call NHS direct or their GP for advice.

Hopefully that clears it up a little.