Should I call an ambulance for this?

[MisunderstoodNettles]

i unfortunately take SVT attacks which can be very nasty and stubborn to convert out of. I’m very familiar with the symptoms when it starts and know exactly when I’m in SVT.

usually I just make my own way to a&e- I’ve previously walked over, called a taxi, got a bus etc. it feels awful, absolutely awful, but my logic has always been that SVT isn’t life threatening so it’s never occurred to me to call an ambulance no matter how bad it feels

Unfortunately I had an episode recently whilst in a different unrelated medical setting and they insisted on calling an ambulance, despite me saying I was more than happy to make my own way to a&e. I understand thought they were helping and im NOT complaining about that. The ambulance came, took me to hospital- the paramedics were lovely but I deep down was mortified that they had been called out to help me for something that isn’t life threatening

Usually I just make my own way to hospital, but after a recent attack a few months ago a nurse told me I categorically must call an ambulance next time and if I’m in SVT then I should never risk going on a bus or taxi to hospital myself etc. But I’ve got this inbuilt fear of being a time waster and wasting resources especially when people wait 10+ hours for ambulances already. And I’ve also been told by other staff before that it’s fine to make my own way to hospital so it’s a bit confusing

just wondered if any paramedics etc on here could advise- is this something that would warrant an ambulance call in future? Or is it something I should make my own way to a&e with if I can and deep down you’d be thinking I’m a bit of a timewaster if you got called out to it since it’s not immediately life threatening? I don’t want to waste anyone’s time but equally if it’s unwise to make my own way to hospital then I don’t want to do that either! And I’ve always felt so, so guilty about that ambulance which was called out to me and potentially someone else had to wait longer because of it x

It’s no unreasonable to phone an ambulance for this BUT given the current state of the ambulance service you’d potentially be waiting a few hours for an ambulance so unless anything felt different to normal or chest pain, etc then i’d probably just phone a taxi/friend instead and be there within 20-30minutes.

Things have got so bad that my sister was advised by the ambulance service not to wait for an ambulance but to take her FIL to hospital straight away because it was going to be min 4 hours.

Please don’t worry about wasting anyone’s time and definitely don’t be mortified about having to get an ambulance. This is what we all pay our taxes for, just because the politicians have messed up the NHS, doesn’t mean you should feel bad about using it. Don’t mess around with heart problems, get an ambulance if you need one.

Usually I just make my own way to hospital, but after a recent attack a few months ago a nurse told me I categorically must call an ambulance next time and if I’m in SVT then I should never risk going on a bus or taxi to hospital myself etc

I'd say the decision has been made for you. Listen to the experts. Theyre not going to tell someone to call an ambulance unless it's essential

Remember too, calling an ambulance doesn't always mean they'll send one. Your call is triaged so if they think you dont need one they'll tell you to make your own way.

They'll reinforce that you make the right decision calling them

I'm a Paramedic.
For what it's worth my opinion is that if you are experiencing an episode of suspected SVT which is lasting 5 minutes beyond what you experience as a 'normal' episode/doesn't cease with the typical manoeuvres OR you feel unwell in the episode then I would advise being seen in hospital.

I would only advise calling 999 if you're too unwell/unable to make your own way. Honestly all the flow charts/advice you'll get officially will say call 999 - but essentially if you can make your own way is saying you're happy to wait 1-2 hours (typical cat2 response time) in your house alone/without any medical supervision whilst you wait for that ambulance.

Then what do we actually do that's of benefit - yep we'll be polite and nice, we'll do an ECG (to tell you that yup you have and SVT) and take your history (which you'll only then have to repeat again at triage in A&E), walk you out to the ambulance, drive you upto the A&E - you will actually get medical care and supervision quicker if you someone can drive you up.

We're actually really only of any meaningful use if it's actually not an SVT you're in, but actually a VT (instead of a fast narrow complex tachycardia it's a fast wide complex tachycardia - this is a rhythm that the ambulance service has treatment for, it's also a rhythm that can become pulseless/cardiac arrest).

It's your health, when ever you experience an episode of illness it's for you to assess that particular situation and decide do you need an ambulance or is there an alternative.

Actually when people give on the record advice it's defensive to say 'call 999 and wait for an ambulance' - because there is no risk for the person giving this advice to a patient should they come to harm. I.e. if that patient comes to harm waiting for an ambulance because they sat at home for x hours when they could have been at hospital hours earlier and had their life saved then nobody gets in any trouble at all/everyone is fine (other than the patient).

Yet if an individual formally tells you that it might be fine to goto A&E in a car driven by your partner because you only live x minutes away and you should come to harm during that journey then they could then be asked to defend that advice/why they thought that was ok.

OP is asking advice from paramedics or other people who know about the condition. If you don't know what it means you are not likely to be able to advise her. You could look it up on Google.

Yet if an individual formally tells you that it might be fine to goto A&E in a car driven by your partner because you only live x minutes away and you should come to harm during that journey then they could then be asked to defend that advice/why they thought that was ok

Presumably they'll have been trained in risk assessment etc, and will be able to Ambulance control are pushing back more now, rightly so, and telling people to make their own way into A&E. In some cases they're even sending taxis if people are calling for an ambulance because they have no way of getting to hospital

Unless it's life & death it seems to be down more to a clinician at ambulance control to make the decisions. I would expect they're highly trained to be allowed to say yes or no

I was referring to the people who tell you to call 999 if x symptom/situation occurs. It's just defensive/something to say that's protective for the person saying it and can't come back on them.

I'm actually one of the people who runs through the calls seeing if people can make their own way (we rotate through different roles). The training for that particular side of the service was a 2 day course on how to use a particular piece of software (that bizarrely we don't actually use in the role), there was no training about anything patient safety, just how to word the request so that the responsibility falls on the patient if anything goes wrong - it's all defensive practice.

I've said it a few times before on here - absolutely a taxi is a safer service then the ambulance service for most life threatening emergencies. But if you thought your life was at eminent risk, why on earth would you want to wait an hour for the call back "we're working to be with you as soon as we can but due to unprecedented demand it could be another 1-2 hours. If YOU agree, if YOU think you could safely make your way in a taxi, I can book one to be with you in 20mins, there wouldn't be any charge, you should be triaged by the medical team shortly after arrival".

Clearly an elderly fall on floor cant get up, a broken leg, sepsis confused - isn't ever going to be able to get in a taxi. But a child with an appendicitis or meningitis, new onset crushing chest pain, thunderclap headache - all could be put in a car. All imminently life threatening emergencies with a clock counting down - but if they can be picked up and put in a car seat/driven to the hospital why on Earth would you wait the hour for us to call you back just to get a free taxi - if you were that worried you wouldn't wait you'd get to hospital the quickest way.

Thanks for your insight though.

Pretty much anything can be life-threatening.
"Supraventricular tachycardia (SVT) is a condition where your heart suddenly beats much faster than normal. It's not usually serious, but some people may need treatment."

https://www.nhs.uk/conditions/supraventricular-tachycardia-svt/

@SleepyRich Youre singing to the choir. I dont know how often I phone from work for an ambulance.

But as you know s many callers fall into one of 2 categories. Call 999 cos they've broken a finger nail. Or debate 'being a nusiance' and thinking the bleeding will stop/the chest pain will go away. Its the latter ones that need the encouragement to call & if necessary let ambulance control make the decision for them. The people that just think ambulances are for people so much worse off than them. At least if they make the call, the ball is rolling

Can I just suggest, and I'm not gonna even deny that I have not RTFT in future please ring 111?

I work for the ambulance service and the 111 staff will absolutely direct you to what you need based on your symptoms and medical history. I hope you're feeling okay now.

Excellent advice

@MisunderstoodNettles how are you?

I’m absolutely fine thanks (and very grateful to everyone for all the advice!)

hopefully no more SVTs until I get my procedure but I definitely feel better about calling an ambulance if I ever needed to (although hopefully I won’t need to!)

@MisunderstoodNettles well the fact that you feel fine is all that matters and you've got some great advice for the future if you ever need it which hopefully you won't!!

It is quite serious, and although not as serious as ventricular tachycardia, it can cause symptoms if very fast, prolonged, low Bp etc.
Definitely ambulance is appropriate- unfortunately they are slow atm

My husband has AF (usually around 200 bpm too) and they’ve also advised him to go back to a&e every time he has an episode lasting a few minutes or more. They said he should be calling an ambulance as it’s safer than making his own way there, however every time it’s happened so far he’s been close by so I’ve driven him there and they take him straight through

Of course the advice is to call an ambulance. It’s the same for my daughter. But it takes them 45 mins to rock up by which time I’ve already called ahead, parked up and she’s in resus with an iv in.

they always tell me we should have gone by ambulance because it’s arse covering. But the reality is it’s much quicker for me to drive

now if she had episodes of syncope with it then I would wait for an an ambulance

I would think the very opposite. You don't mess around with heart, or anything immediately life threatening and don't have the luxury of hours waiting for an ambulance, you get to hospital ASAP. The ambulance service has become a glorified taxi for people who can wait for hours.

OP I have SVT. It absolutely CAN be life threatening, I have no idea why no one's told you that it isn't?

I've had to be put back into a normal sinus rhythm via cardioversion when adenosine didn't work. My heart also stopped (rare) when I had an SVT run that ended in a VT.

It's rare, but if left to its own decides there's a risk of ventricular tachycardia and then VF. Then you're on deaths door.

I have an implant in my heart now and I'm on meds for life. I also have a second heart condition called prolonged QT and the two although separate heart conditions, can aggravate each other. I normally manage at home but probably once a year I have a bad SVT run and my husband calls 999. If your SVT is anything like mine (up to 300bpm) then 999 is absolutely the right way to go.

Yes also this, my cardiologist says the 3 minute rule too.

It's there for a reason OP.

but the other way round - if you drive yourself in a medical emergency and have an accident you will be in deep shit with the insurance.

I don't believe many would ask a patient to drive themselves in, normally we'd ask if there's any family/friends or a taxi that could take you.

If a patient is alone/so sick they cannot stand or they're unconscious etc they'll just have to wait their turn. Many of these patients unfortunately die before we arrive (or the excessive delay means they arrive too late at hospital for the treatment window - stroke window for treatment is 4.5hours, heart attack about 12hours - but every minute means more brain or heart will die). That's why the pressure is on to get the ?heart attack patient to hospital whilst they're still walking/talking and get the tests/treatment before things progress.

To highlight how bad it is/why people need to call 999 'just in case' we go on escalation once or twice a week now where hospitals are told they have just 45minutes to take a handover from ambulance staff after this the patient gets left in the front of the nurses station without any handover regardless of how sick they are - we are not allowed to clinically override the plan - so the confused patient whos had a stroke, waited the 1-2 hours at home for the ambulance, waited in the carpark for 45mins, then gets left in front of the nurses station without any handover to hospital staff. It's only done when demand is at an extreme level but clearly with demand increasing it's going to become more of the new normal.