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?

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

That doesn't happen here. I went to hospital in an ambulance with an elderly neighbour around Christmas. She had fallen and broken her hip. Not only did she have to go through the triage system, but the ambulance crew had to stay with her until she did. The ambulance crew were stood in A&E with us for over an hour. At one point there were six crews waiting to hand over patients and as one paramedic said "Here's hoping nobody was dying and needing them".

Also I'm very surprised at such a wait for an unconscious child with difficulty breathing, but it all depends what gets said on the phone. The child calling the ambulance may not have been made aware of all of the details.

My DS had a fit and despite living 10 mins from the hospital we called an ambulance because he was rigid and we couldn't get him in the car seat. It took an hour.
The next time we took him in the buggy (15 mins walk, road is less direct). The reception staff were s a bit panicked ("erm he's having a fit right now? Oh erm... Quick this way")

Presumably the dispatcher asked questions about what is meant by unconscious and for how long? And what is meant by difficulty breathing?
Difficulty breathing can describe a critical situation, or something not nearly so worrying.
Although of course he should be seen and checked out. But I just doubt he would have waited in A&E for 3 hours, if this was serious. IME children especially with serious conditions, get seen quickly.

Triaging is surprising to the lay person!
I have now taken 2 people to a&e with dislocated fingers and I was surprised they seem to go right to the front of the queue infront of people with seemingly much more serious injuries/conditions!

I'm not surprised at the wait either.My DD has epilepsy and has gone into status on many occasions. The last time we called an ambulance when she was in status even after I had administered rescue medication, we waited 40 minutes for an ambulance to arrive and the didn't even send a paramedic/first responder. They told us there was a defibrilator at the sports club near my house - as if that made everything OK

This was not the 1st time we have waited that long - and we live 30 mins drive from the hospital in an ambulance on a blue light or 45 mins if we went by car. Consequently DD has had many seizures lasting over 2 hours. I have been told never to attempt to take DD to the hospital in the car when she is having a seizure so have no choice but to wait for an ambulance. We used to have an ambulance station 5 miles away but since they closed it the repsonse times have been appalling around here - even for life threatening high priority calls.

I believe a false fire engine call can warrant a fine so why not ambulances?

Because choccy, people will plead ignorance or simply are ignorant. They don't understand what an ambulance is actually for and what constitutes an emergency, or they know how to play the system and what words will guarantee an ambulance coming to them. And ultimately if a ambulance crew refused to take someone to the hospital and that person then died, the shit would hit the fan. So better safe than sorry.

I spent an afternoon working in A+E today, I'm usually in another dept but they were stretched and needed all the help they could get. I counted 8 ambulance crews with patients on trolleys waiting for bays to become available. 8 ambulances off the road for an exceeding amount of time. Further ambulances bought in patients via wheelchair who were able to sit in the waiting area. Not one of these patients required any intervention with oxygen, nebulisers, pain killers, immediate tests etc.

In the few hours I was there only one patient came in who needed immediate help.

That's where all the ambulances are!

That's just not true about skipping the q and really obnoxious people believe it.

I called my first ever ambulance not long ago for toddler DC3, she was shaking, gasping and went blue, they were here within 20 minutes (we live quite far out) and you could tell the poor responder on the phone was juggling as they made us stay on the line to check status all the time.

But when we got there they had her stable and we were sent by triage nurse into the q and normal waiting room. We jumped no q's.

She was wrong as 10 minutes into waiting DD started shaking and developed a rash, she was then admitted for 2 days with an infection. But the point being you don't get to jump the q and the poor buggers are massively overworked and take a load of flack from Idiots who shouldn't be there anyway.

Sadly in a previous life working with the Elderly I found some families would constantly call 999 to deal with any form of incontinence on their parents part, one family then wanted the district nurse to strip, wash and remake the bedding before they would 'allow' the hospital to discharge!

Part of the issue is that people say they have chest pain which gives them priority when it might be chest pain from a viral cough that needs a GP appt, at best.

In the few hours I was there only one patient came in who needed immediate help.

That's where all the ambulances are!

Where I live there are numerous different ambulance companies, the one that would bring GP admissions to A&E just because they were less able or willing to get themselves to A&E are a TOTALLY different company to he emergency life and death ambulances, and as they staff for the less urgent ambulances aren't actually paramedics, "freeing them up" wouldn't make more emergency ambulances available.

The emergency ambulances with paramedic crews are available but reserved for people who really need them

The other ambulances take up to 6 hours max to arrive, and people complain bitterly about the delay, usually saying "what if I'ld been having a heart attack" (and not just waiting for a lift to hospital because unable to drive. Not getting the irony that being able to complain is exactly the reason why they were on the longer window wait

Hmmm, the way I read this he was uhconscious for a minute or so and then regained consciousness but had difficulty breathing like an asthma attack? If he regained consciousness relatively quickly that is a very reassuring sign. A head injury from a pushbike is also reassuring and the fact that there was no vomiting means this would not have been high priority. His difficulty in breathing would have been looked at seperately and I assume they would have asked you questions relating to his asthma.

It must have been a very scary situation and you were understandably concerned. I have a feeling that if the above was the situation you wouldnt have been triaged that high and that would be why the ambulance took a while.

I have heard dispatchers say that many say someone has major trouble breathing, but when the paramedics get there the person is sitting talking normally.

Hmm, to be fair I am surprised that the operator didn't keep them on the line when they called.

I had to call an ambulance for DH last week. He has kidney stones and had been to the GP that morning for a mild water infection, was prescribed penicillin. Took one when he got in from work and within minutes had been sick, come up in hives, gone purple in the face and was struggling to breathe. Obvious bad allergic reaction (he'd never had one before) so I thought fleetingly about putting him in the car but his breathing convinced me 999 was the way to go. The despatcher kept me talking til the first responder arrived (within a few minutes) and he then spoke to the actual ambulance crew as they were on their way.

They then took him into the ambulance to stabilise him, and didn't leave here for another 25 minutes. I was going to follow them to hospital so was a bit fraught as they were in there with the doors shut, but they were giving him oxygen, adrenaline and antihistamines and it was probably this that saved his life. Had I driven him, it may have taken the same time to get him to A& E (traffic here is dreadful) and he might have been in real trouble.

Can't praise the paramedics enough, they were great!

While, of course, it's not acceptable to wait that long, I do question why the OP waited so long?

I am a paramedic. As soon as we are tasked with a case, we make every effort to get to the address as quickly and safely as we are able. Unfortunately, we are chronically understaffed and underfunded. Demand for ambulances far outstrips supply and every month experienced and highly skilled clinicians leave the ambulance service because morale is rock bottom, we are verbally and physically abused, our pensions are threatened and we are now expected to work until the age of 67 in a physically demanding job. It takes time to train new staff, and so there is always a shortfall.
None of this helps with the situation you find yourself in, but it may go some way to explaining it. As pp have said, it does seem that A&E triage were in agreement that rhe symptoms were not time critical, and that could well be why the case was not prioritised when resources are very scarce.

OP, I hope your son if feeling better now and you are ok, must have been really worrying x

The whole system is under major pressure. Call-outs to people who are drunk and want a lift home, people requiring paracetamol who could have quite easily sent their husband/wife who is just sat there to the local shop, pregnant woman ringing for sickness at 11 weeks, women in labour at term with their husband waiting to follow behind in the car, people ringing 111 for advice on sleeping tablets and ending up with an paramedic on their doorstep. All actual jobs I have heard of recently.

12 hour shifts, one half an hour break. Seriously. They don't choose the calls they go to, they sign off from one job and get sent the next. There isn't a list of jobs they may fancy going to. Crossing counties, driving 4 hours or more to London/Bristol and then getting calls on the way back to areas they aren't even familiar with, 12 hour shifts turning into 14/15 hours, still with only one half hour break.

So to the person saying 'they took their own sweet time to get to me'. Fuck off.

Surely ambulances are for those whose medical need is so urgent they can't wait until they arrive at hospital for treatment? Ie the paramedics will need to start treatment immediately and continue on the journey? If you can get there yourself then that doesn't really fit the need

I don't think it's particularly uncommon for children to be knocked out briefly, it's probably not that urgent

This happened to a family member recently, life threatening injuries yet the ambulance took 1.5hrs to arrive! Obviously they are very over stretched but these were very serious injuries which needed emergency surgery right away.

Deliberately misleading callers should be fined for repeat offences.
Ambulance crews should absolutely have the power to refuse to stay at an address to treat someone with a painful knee ( but who has told the 999 operator that they can't breath)

The general public love to slate our NHS but they are the ones bringing it to it's knees by the absolutely unreasonable demands they place on it.

Fining is easy. Collecting the fines is quite another matter. It would take an enormous amount of admin and many people you couldn't collect from anyway (no income etc)

Before my last child, I was a paramedic.

What Frankie says is spot on. (I won't get into a rant about timewasters as I'd be here all night.) In my trust, there was a 9 min target on priority calls.

As is spiderlight. More often than not, we'd get the call, head there and receive updates along the way. The dispatch operatives use a computerised triage system with lots of questions on it.

Why did you wait so long before calling back, OP ?? If you really believed you needed emergency assistance, then why would you wait 1.5 hours for help?

Oh and One big benefit of arriving at hospital in an ambulance is that you skip initial triage and go straight into the system is Utter rubbish. In fact I used to take great delight in wheeling these people round to the waiting room to join the others!

Ambulance crews should absolutely have the power to refuse to stay at an address to treat someone with a painful knee ( but who has told the 999 operator that they can't breath)

We do, Lello ....then we sit and wait for the complaint.

Unfortunately, also too many are scared that they might have missed something, so take them in anyway (arse covering essentially). Plus there is also the view, that if the system allows it, then why not? It's certainly a lot easier waiting in the corridor at A & E with a poorly knee or a drunk. Yep, we have to stay with them (and thus an ambulance is out of action) until they get handed over at the hospital.

The system is so broken.