WWYD heart attack and no ambulance?

[1wokeuplikethis]

This is what happened to our family today. My dad had a heart attack, I phoned 999 and I was put on hold. I’ve heard about this but never thought it actually happens. When I finally got through they said an ambulance would take 2hrs so I can wait or take him myself. Nearest hospital is 30mins away, so I needed my husband to drive so I could be there if dad went unconscious but seriously, WHAT DO YOU DO? I thought, the shop nearby has a defibrillator outside, should I take that? But I don’t know if you can take them. It was busy A roads the whole journey with speed cameras and every light was red- do you go through them? If dad had gone unconscious in the car, do you stop and pull him out on the wet road to do CPR? Carry on to hospital?

I felt so helpless. You always think an ambulance is round the corner but what if it isn’t and you’re just an average joe with no medical knowledge?

Please please tell me, what would you do in that circumstance? I was not prepared.

@LakieLady to be fair a sprained ankle can be managed at home with worsening advice given

It is dire but there are common sense practical issues that are structural and need to be dealt with. For example where I live people who need emergency surgery are taken first to the district hospital that has no emergency surgery facilities. After a long trolley wait because they can't help a second ambulance is required to transfer them to the bigger hospital which does have emergency surgery facilities. The two hospitals are five miles apart. But it is the protocol. A protocol which uses two ambulances unnecessarily and the time of two A&E departments unnecessarily. It is a complete joke and those in charge need to be held accountable. However major trauma, and a heart attack falls under that definition is taken directly to the major trauma centre 10 miles away.

I had a ridiculous situation in August. I fell badly severely breaking my wrist and a vertebra. The call handler refused to triage me because I couldn’t categorise which was the worst injury. I'm not sure how I could do that without an XRay machine. I was on the pavement in the rain for two hours. There were three calls in total. On one I wasntold to take paracetamol and I unproven but to get a pharmacist's advice first when I asked how that was possible I was told tongoogle on my smart phone and telephone them. On the third call the call handler said "so it will be 4 hours, is that OK". Thankfully through my pain I twigged and having said yes first, managed to interject that it was not OK, so then a clinician call was arranged. The clinician told me sarcastically that he would send my free ambulance that would be with me in an hour. I could not get up.

The ED was an absolute disorganised shambles, carrying out procedures in contravention of Nice Guidelines. Staff were rude and it was like the third world. When eventually after 6 hours and no pain assessment, I got through to cubicles, there were more staff than patients.

This arises because the NHS is not fit for purpose and because of public worship has been used as a political football for years. The Blair Government wrapped it up in shiny plastic by extending PFI and introducing the PCTs as an additional layer of very expensive bureaucracy, notwithstanding the new GP contract. There are far too many managers, producing almost worthless data but not addressing the structural and practical issues.

The most effective thing that could be done is to reintroduce the nursing bursary and make it non repayable providing the nurses benefitting provide a minimum of 10 years' service to the NHS and to ensure that nurses are re-equipped with actual nursing skills.

The second most effective thing would be for the British public to stop being congenital grateful for a system that is not fit for purpose and which is free only at the point of delivery.

The delays in handing over patients is a huge issue if there is between 3 or 10 ambulances queueing ahead then people will die.
A triage would help hand patients quicker.

Wait time for a heart attack round here is 6 hours. NHS is on its knees. I had to drive to A&E with my relative

@saltinesandcoffeecups

2 hours for a heart attack… that is ridiculous. I’m sorry you had to go through that I hope your dad is ok.

I’m not sure why bother spending money on an ambulance service with that kind of response time. You’d be better off paying taxis.

COVID is out there that is decimating workforces. It’s having a massive effect on staffing the ambulance service as well as other services. At the moment the best thing we can do to keep these services running is the old hands face space and vaccines for all.

This is the bigger danger with omicron it seems, rather than direct hospitalisation and deaths. Sick NHS workers can’t treat NHS patients, whatever is wrong with them. This is the fall out of COVID deniers and anti vaxxers in action (alongside Tory austerity legacies)

@saltinesandcoffeecups

The operator didn’t stay on the line- she said wait or go

That’s damn near criminal. In my area if something like this can be proven, at a minimum that dispatch would have been fired.

When the number of incoming calls reaches a certain level the call takers are not allowed to stay on the line once the triage tool is finished. It's so busy at the moment when you call 999 for an ambulance you may be kept on hold for a minute or 2 before they answer you. It's quite sensible that once instructions are delivered to hang up the phone

@ifonly4

OP, I really feel for you. My Dad had a heart attack and actually had a GP with him in the house. Things turned from bad to worse and GP told my Mum to get on the phone immediately to basically tell them they had to send the delayed ambulance now. She was told the ambulance assigned to him was currently on an emergency call out to a child. This is going back years ago to a labour government - seems like nothing has changed.

My dad had this. I was told there'd be a delay for an ambulance for my poor old dad with chest pain (82, unstable angina diagnosed but went on to have a CABG the next month) so he was bundled into my car and I drove like a nutter through town to the hospital. Once my dad was being assessed in Majors, I asked one of the paramedics (accompanying a 10ish yr old boy in his school uniform wearing a sling with his mum) if they could cancel the ambulance...he said my dad was his next pick-up he'd been diverted to collect the child.

It's the lack of GP appointments and the inaccessibility of minor out of hours services.

Also, the grey economy, where hundredd of thousands are not even registered with a GP and go to A&E because that's the only place where it's no questions asked.

The most effective thing that could be done is to reintroduce the nursing bursary and make it non repayable providing the nurses benefitting provide a minimum of 10 years' service to the NHS and to ensure that nurses are re-equipped with actual nursing skills.

Why should nurses be made the subject of indentured service in what’s supposed to be a free country?

I agree with returning - returning, remember - to free training for jobs that are required by society. Someone upthread mentioned the lack of childcare that blocks women too. The culture of long hours, unreliable shifts and low wages for “heroes” all needs to stop. All the ‘reforms’ of the last two decades have led to this. Surely we can all see that we’re staring straight at a failed state with no healthcare?

Hope your dad is ok, op.

Just a reminder that Alexa can talk you through CPR if you need it (I assume the others do too)

Postman

"The most effective thing that could be done is to reintroduce the nursing bursary and make it non repayable providing the nurses benefitting provide a minimum of 10 years' service to the NHS and to ensure that nurses are re-equipped with actual nursing skills."

I fully agree.

They also need to re-introduce bursaries for other Allied Health Professionals, such as Physiotherapists, Dieticians, Podiatrists, Occupational Therapists, Orthoptists, Osteopaths, Speech and Language Therapists etc.

These professionals can reduce hospital stay times and/or support patients in the community, thus reducing delayed discharges.

@ChardonnaysPetDragon

It's the lack of GP appointments and the inaccessibility of minor out of hours services.

Also, the grey economy, where hundredd of thousands are not even registered with a GP and go to A&E because that's the only place where it's no questions asked.

Agreed about the lack of GP accessiblity - the GPs trying to defend the inexcusable is very telling.

@ParsleySageRosemary because they would be getting their training free. If they want to move to something else, they could convert it to a student loan and repay it. Like every other graduate has to. I think similar should be introduced for doctors and teachers too.

I would make my own way at the moment, if you think you're having a heart attack then you're probably too sick to wait for an ambulance. I was working last night, my first job was for a patient who'd had a seizure, job was 12 hours old! When I arrived they were just returning from hospital having made their own way. Response times are madness at the moment, around 15minutes for a cardiac arrest (for a realistic chance of a good outcome we know this needs to be less than 4minutes), 2-6 hours typical for chest pain/severe difficulty breathing/unresponsive but breathing. Only call 999 for a life threatening emergency for which you are too unwell/unable to make own way.

Some talk on the thread of what services should be used for various circumstances. Was recently sent this document, think it went out to all households in Scotland, which is very useful

@ParsleySageRosemary I am currently doing my training through the open university as it is classed as part time and there is more flexibility than a brick uni nurse training. Most placements have been brilliant letting me work what I had childcare for but have come across some that were awful and basically said I’d work when I was told, it’s such a barrier to people

I was in this situation a few years ago, although it was severe chest pain, so didn't actually know if it was a heart attack at the time.
I stuck my dad in the car and raced to the nearest hospital which was half an hour away.
I remember how scary it was though, I had Google maps up on my phone in case I needed to tell 999 my location if I needed to pull over

[quote PostMenPatWithACat]@ParsleySageRosemary because they would be getting their training free. If they want to move to something else, they could convert it to a student loan and repay it. Like every other graduate has to. I think similar should be introduced for doctors and teachers too.[/quote]
The idea that training has to require a huge debt is one of the pieces that has led us to this point.

Staff are isolating when they aren’t even Ill so that isn’t helping things either

I have found this thread to be terrifying, thank goodness OP it had a good outcome.

I think the reality is that we all need to make plans in the event we cannot get medical attention. Our local hospital has had numerous periods now where people have been turned away.

I for sure am going to book myself on a course to brush up on first aid skills. I have just had a look and unfortunately St Johns don't seem to be doing anything in England. Has anyone any recommendations where else to look? Lots of places doing courses but not sure of the calibre.

[quote PostMenPatWithACat]@ParsleySageRosemary because they would be getting their training free. If they want to move to something else, they could convert it to a student loan and repay it. Like every other graduate has to. I think similar should be introduced for doctors and teachers too.[/quote]
Would be better to make the job less crap with better work life balance to help retention rather than try yet more incentives to encourage people to start training.

St Johns don't seem to be doing [First Aid training] in England.

Ironically, St Johns is a major part of the vaccination programme, one way or another: a lot of their people are vaccinators.

@AlternativePerspective

id rather have a reformed nhs along the french / german model even if it meant we payed into it more ,for a service thats fit for purpose the thing is that people don’t actually want a reformed nhs. They want the exact nhs that they already have. Where everything should be treated and paid for despite the fact the number of treatments available for various conditions is going up, thus meaning the amount of resource and money is going down.

Stop offering treatments like bloody IVF on the NHS, and free up some of that money to improve the emergency responses and treatments. Just to use one example. But everyone thinks their situation is unique and should be treated. Well perhaps sometimes the less life-threatening things shouldn’t be.

NO!

Stopping offering ivf on the nhs is not the answer. The cost of ivf acrually is relatively low and is artificially inflated by a private market. In most areas in England it’s a post code lottery as to what you get and if you even qualify. Where I am you had to have no other children (you or partner) be under 35, no existing health conditions, been trying 2 years before referral, and then3 year list, one round and one fresh embryo transfer then that’s it.

The solution is adequate funding not further cutting the service offered. Defunding ivf also further stigmatises infertility.

OP I'm not going to go down the "ethics of the delay/state of the health service route", I'll cut straight to the important bit.

You and your husband's swift action getting him to hospital almost certainly saved his life. Well done. What you're dealing with now is the need to decompress after a highly traumatic situation. When I was young and working as cabin crew, we has an automatic "grounded for a week" rule for crews involved in a medical incident because it is so stressful - and even more so in your case as it was your dad.

You've done amazingly, you really, really should be so proud of yourself ❤

I think this is a good time to also think about getting yourself on a first aid course too. You've clearly coped well (even if you don't feel it right now as you're still in shock) and you never know who may need your help in the future.

Love to your family

The solution is adequate funding not further cutting the service offered. Defunding ivf also further stigmatises infertility.

It's a bottomless pit, it will swallow all you throw at it and ask for more.