to to tell you to call 999, rather than 111, if you think you can get away with it?

[AlbertaCampion]

My diabetic DF was admitted to hospital on Tuesday, after being floored by that horrible DV bug that has been going around. My family decided to call an ambulance for him after he became too weak to get out of bed, unable to control his bowel movements and less than lucid.

He was conscious, and not in any great pain, so at 9pm we called 111. We spent close to an hour on the phone to the dispatcher there, running through his symptoms etc., and were told to wait with him. At midnight, phone calls were flying back and forth - but still no ambulance. His condition was getting worse. We called 111 again and were told to call 999 and get him into hospital pronto.

So we called 999 - only to be told that because the initial call had been made to 111, the 999 chaps would have to speak to the 111 chaps and go through the notes and get back to us.

At 2 am there was still no ambulance, and his condition was continuing to get worse, so we got him out to the car (with difficulty), made him as comfortable as we could in the car and my DB drove him to the hospital.

He is still in the hospital, hooked up to fluids etc. while they continue to run tests. His blood sugar is all over the place, so they have whacked up his insulin too.

I know I may get flamed for suggesting that you should call 999 if it isn't a class A urgent priority medical emergency - but the truth is, 111 were bloody useless and I will now think very long and hard before calling them again. AIBU?

What a ridiculous thread!

The ambulance service is stretched to the point where our staff don't even get breaks and you're encouraging folk to ring 999????

Someone with D+V is not an emergency regardless of their diabetes!

This outbreak is being made worse by people coming to A+E with it!

Stay at home and ensure plenty of fluids are taken.

Baffled that you didn't just get him in the car if you were genuinely worried???

Sorry to slightly hijack the thread, but what exactly is 111? Is it supposed to be the same as NHS Direct but a bit more crap?

I only found out about it after it had come in and the website says it is for "if you need medical help fast, but it?s not a 999 emergency". I have rung NHS Direct a few times in the past because I wasn't sure how concerned I should be about certain symptoms (although, in all but one case, I was 100% sure I didn't need an ambulance). Their response then ranged between, "you must see an out-of-hours doctor today" to "that can be treated with self-care at home by doing x but ring back if x happens". My understanding of NHS Direct is that it was to help people assess whether something was suitable for self-care or needed a doctor and, if so, which particular avenue of the NHS they should use (ie how urgent it was). How is 111 different?

Nurseneedhelp (I really hope that isn't an indication of your profession!)

Did you actually read what the OP posted? Someone in that state is very much an emergency and needs to be seen as soon as possible

999 for life threatening things. Not being able to control your bowels and not being lucid is not life threatening. They are not a taxi service.

"999 for life threatening things. Not being able to control your bowels and not being lucid is not life threatening."

But 111 told the OP to call 999 so they must have thought it was??

Actually, sometimes a diabetic with D and V is an emergency. Last year I took my diabetic friend to hospital after a particularly nasty d & v bug. The nurse took one look at her and whisked her straight through to resus. I wasn't allowed to go through "in case it scared the baby" (my toddler). That was the first clue I'd got quite how serious the situation was. She had gone into DKA. My friend was subsequently told she had been 2 hours from death and spent the next week in a high dependency ward (which is not quite intensive care, but not far off). It was very alarming to see how quickly things escalated.

Oh fair play then. Nhs should release a list of what's appropriate to call for and what's not!

I've always been told that you should only call an ambulance in a life threatening emergency!

You should only call an ambulance in an emergency. Not all emergencies are life threatening bug their are still times when ambulances are needed.

I have actually been told off by a and e staff for not calling an ambulance in the past but from what the OP has said then calling 999 would have been very much the right thing to do

I rang 999 when I set the kitchen on fire. DH was able to put the fire out with foam, but the smoke was too thick to get to the window to open it. No immediate danger, but it was in a tenement and the first brigade got there fast!

You should have called 999 initially, because your fil is diabetic and because of te bug could deteriorate rapidly and could die. Really if after 1 hour of getting nowhere put fil in car and drve him to hospital not wait all that time

'999 for life threatening things. Not being able to control your bowels and not being lucid is not life threatening."'

Someone with diabetes who is becoming less than lucid and cannot keep fluids in them from D&V can be in serious trouble. Such a person's blood sugars can become dangerously low or high and kill them.

Your df was a real emergency as he couldn't get out of bed, and has a complication of being diabetic. Therefor you should have called 999 in this situation.

It's because fil was diabetic that 999 should be called because he could deteriorate rapidl and needs medical intervention

I think the pivotal factor here is the diabetes. Someone non-diabetic would have been far more resilient with these initial symptoms, whilst someone with diabetes would be highly likely to lose control of their blood sugar levels with potentially life threatening consequences.

So for a diabetic, I would have called 999 in the first place
For someone who is in good health, normally, then 111 would have been appropriate in the first instance.

herethereandeverywhere: "I can understand the issue here. The issue is that at the outset we need to be able to self-diagnose an emergency - which is easy to do with hindsight but not necessarily at the time."

This. People are unfairly giving the OP a hard time. Presumably the OP started off thinking something like "Don't want to call an ambulance, don't want to bother A&E, don't want to be one of those selfish parasites everyone complains about clogging up A&E and misusing ambulances etc". A lot of the time you just don't know whether it's an emergency or not. In those circumstances, it would seem to make sense to check with 111 first. The fact that it was then not a straightforward matter to escalate to 999 when it became necessary is extremely worrying.

111 should have put you straight through to 999 and all the previous notes should have gone through at the same time. You should not have been told to call 999 yourself (I know that's the case round here). I would ask for a review of the case (although you may be in a bit of a queue...)

D&V in a diabetic patient can become a medical emergency. A diabetic with D&V has extreme difficulty in maintaining blood sugar levels. If Blood sugar dips critically low then results can be very serious indeed including unconsciousness, convulsions and coma. Paramedics can deliver a range of on-the-spot treatments including drugs and intravenous glucose that will stabilise the patient and stop them deteriorating further while they are on their way to hospital.

Calling an ambulance is the absolutely the right thing to do if the patient is clearly unwell and deteriorating, which was the situation here. It would be the wrong thing if the patient had a bit of a funny tummy but was basically well.

ambulance 999 is chest pain, worsening breathing difficulties, severe bleeding, unconsciousness or stroke symptoms.

not normal labour - that's predictable and can be planned for. Even the 'messed up taxi' thing can be covered by discussion beforehand with the taxi firm and getting hold of plastic sheeting. It's not like you don't get a chance to sort this out in advance. Check out the 'nee naw' book!

the 999 operator prioritises.

no-one's mentioned first aid - unless you live next door to the ambulance depot, you may well need to do some CPR if the above happen. Go learn, everybody. I've known a life extended because people knew CPR.

Special about is unpredictable and so are taxi, when you call you basically get any one allocated to you, tey might be coming from a job so might not have te plastic sheet. Labour can change quickly (baby becomes distressed, cord round te neck, baby stuck etc) could turn into an emergency. Really the operator will prioritise not you

nurseneedshelp might I suggest you update your diabetes knowledge. Anyone with diabetes is advised to contact an HCP if they have diarrhoea or vomiting for more than 24hrs, and told to get themselves to hospital ASAP if lethargic, weak, unable to tolerate fluids etc.

They are likely to need IV fluids and quite probably insulin, as any type of illness can cause dramatically elevated blood glucose levels. Couple this with dehydration and you are on your way to DKA or HHS, both potentially life threatening diabetes complications. As the ops father was displaying signs related to both of these complications she was perfectly right to want a paramedic crew to come and commence treatment.

I'm sure that next time hope there isn't one op the family will be seeking help much earlier on, but then then its easy to be wise after the event.

Wishing your father a speedy recovery.

Your experience was awful OP. But your thread title may end up contributing to someone's deterioration or death while waiting for an ambulance which is tied up dealing with someone who took your advice when they didn't really need 999. I suggest you ask MNHQ to amend it ASAP.

For those asking how to decide what needs 999 and what doesn't, look here www.nhsdirect.nhs.uk/about/whatisnhsdirect/choosewell

Sorry if anyone's already linked to this,don't have time to read whole thread"