Ambulance - Attend or not attend????

[Dawn19]

My son was knocked off his bike recently (not by a motor vehicle I may add) and was knocked unconscious and due to his asthma had difficulty breathing, his friends whom he was with at the time phoned for an ambulance whilst another of them ran to our house luckily only 5 mins away to inform us. We waited for over an hour and half and still no ambulance arrived, in the end I phoned and cancelled it and took him myself in the car as he regained consciousness by this time and was experiencing dizziness and nausea, where we had a lovely 3 hour wait in A & E. Is it just me or should the ambulance have arrived before 1 & half hours?

I know funding cuts etc have meant that unfortunately there's just not enough ambulances for the emergency calls half the time so they really have to prioritise what they deem to be more serious emergencies over other ones. Obviously someone unconscious is serious, however someone suffering a heart attack or severe blood loss etc is even more serious so would be prioritised.

I don't think they believed the kids.

At uni, our lecturer had a stroke (although we didn't know it was that at the time) whilst lecturing. A couple of students went off to the phone box and were not believed by the dispatcher initially. It makes you wonder if the ambulance arriving any sooner would have made a difference to the outcome.

I was shocked at how slow the operator was on the line

This has no bearing on how quickly the ambulance is sent - they don't wait until the end of the call to dispatch the ambulance, but send it immediately if necessary and continue to ask questions so that they can relay further information to the paramedics en route. I read a really interesting book by a 999 call operator a few months back which explained that: while you are answering the seemingly hundreds of questions, the ambulance is already on its way if it's a priority call.

There is not a call taker/dispatcher in the land that would 'bin' a job. If a child has made a call it's still a call. I've attended numerous ?hoax calls. We still go!
What were the actual details given? Our responses are based on whatever the person making the call says at the time, sadly call takers are not mind readers

I'm my trust, an uncons with dib would generate a red 2 response - that's the second highest priority call and (if available) a car or motorbike and an ambulance would be dispatched as soon as possible.....

The caveat being that the number of calls in our trust far outweigh the number of ambulances. And with extreme weather like the last few days the call rates spike.
Lesser Priorty calls are usually bounced off for the higher Priorty ones. It's not unusual to attend amber/green calls and they've been waiting for hours. Less so with reds but it does happen.

When we stop going to shit calls for people with coughs/colds, whipcash claims (you read that right), doling out paracetamol because some people are too poorly educated to self treat minor ailments, then maybe more trucks would be available for Doris that has fallen and ?fractured her hip.....

Sorry, mini rant.
If it concerns you OP, contact your local ambulance service trust PALS dept.
All trusts have web pages with relevant links.

One big benefit of arriving at hospital in an ambulance is that you skip initial triage and go straight into the system

I've recently spent 3 weeks in hospital with cavitating pneumonia, 4 days of which I spent in CCU. My DH rang for an ambulance as I was struggling to breath etc and they refused to come!

You'd think an unconscious child with difficulty breathing was as bad as it got, surely there's nothing more urgent?

of course there is, one who has stopped breathing!

I would imagine that the call taker also has to distinguish what "breathing difficulties" means

It's very subjective

some people will say this for being a little wheezy/bit of a cough, but able to speak in between

Or it could mean turning blue, grasping at throat, flailing about etc.

"breathing difficulties" won't always have the same priority, depends on how the questions are answered

Of course this was an emergency - breathing problems and loss of conscious following RTA could indicate extremely serious problems.
Some years ago a client of mine fell off his motorcycle in what seemed to be a relatively minor incident. Reluctantly he agreed to be checked over in hospital but when he got there he collapsed and died from internal bleeding. Trauma injuries need immediate attention.

There are higher priorities (a few) than unconscious with difficulty breathing
Depends if he was unconscious at the time of the call as well
But even it was a high category, if there's nobody to attend, they can't go

You know, stop it deteriorating to that point?

If the situation changes, you ring back and your priority changes.

Of course someone who has already stopped breathing and has pretty much only got minutes to get help if they're going to live is prioritised over someone who is breathing and death isn't imminent

any of us could deteriate as we type..

also the call taker will probably have asked questions to assess whether stopping breathing imminently was likely: grasping, blueness etc

Very surprised at this, OP. Breathing problems in children seem to be taken very seriously.

In the last year I've twice had a problem with DS2's (9) breathing - in my mind his condition was worrying but not critical. In both cases 111 triaged an ambulance response. In the first one, 999 said they had no ambulances available and could I take him to A&E. In the second the ambulance arrived within 10 minutes and treated him on the spot.

DIB is different though. As opposed to falling over and then having difficulty. It could be because you have pain when you breathe (which isn't difficulty breathing) or simply winded or shaken

I'm surprised, but not shocked. I'd expect an unconscious child with breathing difficulties to be a priority. The fact that it wasn't a car involved is not relevant, my DH's old boss was killed a few weekends ago, falling down the stairs in his own house. A head injury can be equally serious from the most unlikely things.

On the other hand, I've waited 40+ minutes for an ambulance and I'm a brittle asthmatic who's supposed to be a priority call every time. Last time I had a random policeman sitting on the stairs holding my hand whilst we waited. No idea why he was there, DH found him in the drive

head injury and breathing difficulty is an emergency and you should have had an ambulance right away

Not really surprised. There are not enough.
A man collapsed right in the town center when i was visiting my mother few months back. We could see him from the coffee shop. We were there an hour and he was still there when we left. Worse thing is the hospital is a minute away..
I had an accident as a child and knocked myself out. ( so over 20 years ago now!)
My parents took me too a&e as i'd been out for over 5 minutes and was throwing up. We were waiting in A&e for hours. I think my mom lost hair that day
It's hard, there could be someone who is in a more desperate condition who needs it more.
I was shocked though that the man was kept waiting for so long.
Other times when i've needed to call an ambulance they've arrived pretty quickly.

My dh is a paramedic. The whole system needs a complete overhaul. Starting with giving them powers to refuse jobs when they get there and are clearly not needed. A cough, cold, knee that's been sore recently, being pissed, broken toe ( but I said chest pain in the phone as I knew you would come fast!???) are not ambulance needing jobs.
Often they don't get a break at all due to being so very busy. At least 12 hour shifts mostly running into 13+
I believe they should be running courses in every school that teach common sense about what warrants a 999 call.

Also that going in a ambulance will not get you to miss the waiting room. In fact I know that if they deem someone a time waster ( he says about 75 percent) they will make sure they have to wait in the waiting room like everyone else.

I had to have an ambulance called to work for me recently, as I was in SVT (v fast heart rate), and not stopping. I have been told by GP, and A&E doctors that after 20 minutes I must call paramedics, as oxygen deficiency is dangerous.
They took 40 mins, first time it's been that long tbh. My colleagues were shocked at the length of wait, and I actually had to have oxygen, which I've never needed before.
The crew were fab, but I think they're so stretched atm.

The amount of people who phone ambulances when not needed - in general, no judgment on the situation in the op at all - is a massive drain on the system and the speed they can respond to an emergency sadly. If people took the time to think before calling 999 it would help a lot.

I was in a and e with Ds last week and someone came in with their child via ambulance because the child had a cut on his neck that wouldn't stop bleeding - the cut was covered with a normal, small plaster so not some massive arterial bleed! They then complained they had to wait in the waiting room!

One big benefit of arriving at hospital in an ambulance is that you skip initial triage and go straight into the system

I never heard that, tbh. Big disadvantage of arriving in ambulance is that if you are stable upon arrival, A&E keep you in the ambulance until they are ready to let you in & start their 4 hr clock. 20 minute waits in the ambulance at our local A&E are minimum, up to 2 hrs not unheard of.

It's sad but not surprising to me.

I work as a nurse in an environment with a lot of older people (but no emergency care facilities on site) and have done for a number of years. I've had to call 999 ambulances many times for falls, suspected heart attacks, strokes and such forth. The wait times vary massively depending on how many higher priority calls are in front of you and how many crews are working that day. I have had to wait nearly an hour before for a woman who had a heart attack (and sadly later died) and recently had a several hour wait for someone who wasn't assessed as being urgent (elderly lady had a nasty fall but was conscious and breathing). The ambulance staff, in my opinion, do a bloody amazing job but they are massively over-stretched, and they deal with a ridiculous amount of time-wasters (drunks / people who have relatively minor injuries but just don't want to pay for a taxi). In my opinion we need to start fining people who call out ambulances inappropriately.