Was I unreasonable to call an ambulance / was it my fault.

[Sweetandsour11]

anbir of background : DD12 has a long standing medical history and has spent a lot of time in hospital. Although chronically ill she has done really well the last few years and avoided critical situations for a substantial time. We have a protocol that if she spikes a fever she has to attend A&E and be put on IVabs and bloods taken etc

on Sunday DD was fine her usual self and we had been out during the day. Nothing out of the character. Sunday evening she spiked a fever and as I always do I booked an uber to go to a&e which is around a 10 minute drive away.
DD started vomiting pretty severely and the uber refused to take her. I called 999 as she was rigouring vomiting a lot and was clearly not well at all. I explained to them about the situation and that she had an IV Hickman line in situ. They said that they would have to get a clinical person to call back who will then decided on clinical emergency.
40 minutes later they rang and sent an ambulance fast at this point.
when the paramedic arrived one of them seemed annoyed that they were sent to us. Kept repeating how close we were to the hospital but the issue is she couldn’t stand - he was soo rude and uninterested the entire time.
they took her obs and I knew they were bad. We were in the ambulance and the paramedic in the front asked the one in back if they do a pre alert to recuss and he said no.
he then said to me that “ when we have situations like this usually they would pre alert the hospital for recuss but because she was known there they will just turn up “
whrn we got there they just turned up with her in to normal treatment area. They know her but there wasn’t any indication given that she more poorly than previous times with a spiked fever as the paramedics didn’t do a pre alert and rolled her in to a normal cubicle asked the nurse who saw us if they knew her she said yes and they basically rushed off.
there was no indication she needed more help and it took a bit of time for it to be realised once in a&e. She deteriorated quite quickly and ended up in picu ventilated for 4 days.

surely the was the correct use of an ambulance ? 🥹

Of course it was. The clinical person at 999 decided to send one.

It sounds a very stressful situation for you and your DD. I’m not sure what else you were expected to do if the taxi refused to take you - I’m presuming you don’t drive/know anyone who does drive and would have been willing to take you?

The paramedics not providing a pre-alert just sounds lazy on their part tbh - how long would that have taken them?

You made the right call, as did the second paramedic who wanted his colleague to call ahead.

I would contact pals, explain that you don’t want to cause a huge fuss, but that you do want someone senior to sit down with the dismissive paramedic and ensure that he understands the consequences of his actions.

Over the last few years there has been a big push in the NHS to listening to parents more, especially for kids with serious long term conditions, because in many cases (like this one!) the parents know more than the medical professional who comes newly into the situation.

This

Of course it was ok, hope your DD is doing better now

100% correct - well done, you did everything right.

Yes correct thing to do my DS is the same if he has ketones & vomiting hes to go straight to hospital. Usually I drive, but one time he was very unwell and I couldn’t focus on driving and called an ambulance.
Ambulance was pissed off despite his ketones being 4mmol (which is very dangerous for a diabetic) hostipal told me not to worry and to ignore them as done the right thing!

It was. And you’d be well within your right to raise a complaint about the medic that treated you & your daughter with contempt.

Could you or someone else not driven to hospital? If not, no, yanbu

100% correct and I would certainly be contacting PALS.

However I think as a parent I would have insisted they called ahead and when we got to A&E I would have voiced she was more unwell than usual and you knew her obs were not good. Although we rely on medics sometimes you have to shout from the rooftops and challenge their views!

Hope she feels better soon.

the lack of pre-alert won't have made any difference really though will it - the person they spoke to on arrival knew her and made a sensible plan quickly by the sound of it. There wouldn't have been a pre-alert from an Uber would there? Doesn't sound like great communication in front of you, but probably didn't make a material difference to how things ended up.

100% right use. Ignore the dickhead. Or put in a complaint if you have the energy.

You followed the protocols that you have been given (by real experts) and it's not for him to decide.

I would complain about this paramedic-wannabee doctor. He needs to wind his neck in and do his job.

Definitely complain to PALS.

You 100% did exactly the right thing. You need to complain about the paramedic. In my experience, they are usually absolutely wonderful, but this one clearly wasn't and I doubt it will be his first complaint. Please don't doubt yourself.

This. And please please contact PALS. You’re not complaining per se but this behaviour does need to be highlighted.

In all seriousness you should complain about the paramedic - they clearly didn't make the right call, and for a child with longstanding severe health problems they should have pre-alerted ED - which might have significantly benefited her and avoided a PUCU admission. They need feedback on their mistake and possibly more training.

I am sorry to hear this.

I am in a situation where I have to call an ambulance several times a year for myself because of a heart problem. I have found them unfailingly wonderful. They always err on the side of caution and are very supportive indeed, even when between us we decide for me to stay home on some occasions - they always stress that calling for them was the right thing so that they can do definitive observations on which to make a reasoned decision. On the occasions when I have needed to go in they have gone out of their way to get me to a situation where I will be seen as quickly as possible.

MInd you once in A&E and the initial crisis is past there are long long waits in unacceptable surroundings - not the fault of the staff of course.

I have always found the paramedics to be more efficient than the A&E team really!

Your reason for calling an ambulance makes total sense. Please do not let this experience pout you off from doing the right thing in the future. Can your DD have a medi-alert bracelet which makes it clear what the parameters are for going to hospital and her medical history? I have one with information about my pacemeker etc.

If you actually read the OP you'll see she tried to call an Uber. Why would she do that if she had a car on the drive that she could just get into? Have a think. 🤔

You totally did the right thing. I once called an ambulance for my mum who had woken up extremely weak and pale and was peeing blood. I would not have been able to get her out the house and in the car myself so we called an ambulance. One of the paramedics seemed to heartily disapprove of this action and suggested it could be a water infection. However her BP was low so they took her in. Turned out she had a big internal bleed and had lost 3 pints of blood. She needed emergency surgery and was extremely poorly for a long time afterwards. I’m very glad at the time that we followed our instincts.

RTFT. The OP said the taxi refused to take them as DD was vomiting severely.

On another tack - I think you should feedback to PALS at the hospital so that the process can be scrutinised. Unfortunately they will only do this in the form of a complaint, which feels a bit uncomfortable. I had cause to do this in relation to serious mistakes made when I was taken to A&E with my heart problems. The outcome was 100% positive - no-one tried to cover up and they initiated an enquiry which resulted in new protocols form that A&E and extra training based on what had happened. I was given the full papers chronicling all of this.

It may be that concerns about ambulance staff do not go through PALS but they will be able to point you in the right direction. It may save someone else going through the same problem as your DD.

You were absolutely right and I would also complain , however it sounds like your daughter deteriorates quite quickly and it would be worth working out how to get to A&E on your own ( friend / relative) if this situation arises again .

Yes I know a comment above said it would have made no difference and I did ask him to - but it does make a differences it’s a big deference if time if they are pre alerted to a situation in recuse they have everything ready to go.

Put in a complaint, that was very poor of the ambulance staff.