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 ? 🥹

Complain to the ambulance service. That paramedic is a dangerous set of hands. Also talk with PALS about how your daughter was received and how she would be in the future - do you have open access?

As for the guff about learning to drive - ignore it. They don’t understand and have made it clear they don’t intend to try so there’s no point engaging with it.

How is your daughter now OP?

No, YWNBU to call an ambulance; she is clearly clinically complex and was seriously unwell.

Alongside that, I think there are probably also steps you can take to help yourself (and her) going forwards, especially give the current state of the NHS and ambulance response times etc:

I think perhaps if you have no partner / can’t drive I would be talking to my neighbours, explaining the situation and asking if they’d be willing to drive while you looked after her, if the situation ever arose again.

I also think you should talk to her clinical team about best protocol- is there a card she/you could carry, or a letter from the Consultant perhaps, to explain that a pre-alert to resus should always be made?

And lastly, the reality is probably that you will need to advocate loudly for what she needs on arrival, if this happens again, and present said card/letter.

I hope she’s doing better now.

Christ that's terrible, it wasn't trivial it was bloody serious, I'm not one for complaining but I would in this case, that's so bad.

I phoned for an ambulance for the first time ever last year. I'd been unable to walk and had severe pain for two days. When I got to the hospital, literally the first thing I was asked was why I had called an ambulance. It turned out I had leukaemia and also had to have an emergency splenectomy. I believe I was fairly close to dying.

It still rankles that that was the first thing I got asked. You totally did the right thing OP and like others have said, you should put a complaint in. I had so much going on at the time that I didn't, but it still bugs me a bit and I feel I've left it too late to do so now. It was a traumatic time and that wasn't a question that I felt needed to be asked at the start. When you phone for emergency services, you shouldn't be treated like an inconvenience.

I hope your DD is doing better now.

Agree it was a right call.

It became a medical emergency as you could not organise transport when you knew she needed hospital treatment.

And as @NewUserName2244 suggests contact pals.

This is a problem
“ 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 “
because they could have given the staff more time to organise if they has called ahead.

I am not suggesting the timing would have worked out any differently but my first question would be why did he change the process. And its careless remarks like that which trouble people long after the situation is resolved as you begin to double guess yourself

Hope everything is sorted now

I don't drive and my nearest hospital is an hour bus ride or seven minute train ride away (plus walking to the train station or bus stop, then another bus from the bus station or walking from the train station.) I used to live a 15 minute walk from said hospital, it's a shame I had to move!

Meanwhile, @Sweetandsour11 you did the right thing, I'm sorry your DD was so poorly. 💐 I hope she's recovering well.

Wow, how insensitive and judgemental are you. You have no idea why the mother wasn't able to drive. She might have a medical condition that prevents her from driving for all you know. It's stressful enough supporting someone who has a severe chronic condition without you insinuating she's a shit mum for not having a car on hand. Plus you can't support a severely ill person and drive safely at the same time, so it's irrelevant to the situation. This is exactly why ambulances are needed, they do a lot more than just transport people to hospital and they can be the difference between life and death.

You did make the right call. You know your daughter and she is known at the hospital.

This incident requires a full investigation and my advice would be for you to complain to the ambulance service. Someone has clearly made a wrong decision in respect of your daughter’s care requirements.

Hope she is improving OP 💐

Crazy posts on here. It's not a reasonable ask of a neighbour to be on standby to take a very sick child to hospital. I wouldn't be prepared to do this for a neighbour as I have my own responsibilities (work, children) I couldn't drop at any moment. I certainly wouldn't ask my own neighbours to do this - I barely know them.

As for driving, you want op to pay £1000s to learn to drive and run a car because there's a chance she might need an ambulance every 5 years? Any one of us could need an ambulance at any time but about 1/3 of the country doesn't drive. That's not a reasonable solution.

My point wasn’t about using an ambulance , the point I was trying to make was your daughter would get there quicker if you got her there by some other means and obviously Uber isn’t reliable either . In the 40 + minutes you were waiting on calls / waiting on an ambulance you could already have been in the dept getting treatment .

As @RosesAndHellebores says. Don’t complain to the hospital PALS, you need to complain directly to the ambulance service.

We are in a similar position to you. Following a complaint, we now have a system in place to prevent future problems. I’m obviously not going to state what they are.

Unless you have a chronically ill dependent, I don’t think you can imagine how difficult life can be. It’s impossible to drive to the hospital as one carer, since you have to keep their airway maintained.

Going straight into resus definitely speeds up treatment as the patient is seen immediately rather than waiting in a side room for triage.

@Sweetandsour11 i hope your daughter gets well soon, and continues to have good health.

yes, this is the correct use of emergency services

It was a clinical decision to call the ambulance not yours.

so don’t feel any guilt over this.

Awful behaviour. These people are supposed to be professionals.
Make a complaint

Biggest load of horseshit I have read in a long time. If that paramedic is so jaded that they put at risk a clinical outcome then they need management intervention to improve or get out. Yes the Service is at critical levels, yes the system is broken and putting huge pressure on all, but that does not excuse clinical negligence and dereliction of duty. Yes there are absolutely shit Paramedics out there and it looks like you got one of them.

OP - complaint to Ambulance Service individually and specifically about the crew conduct and decision making. Speak to PALS on the wider issues of the clinical management pathway and ways that you can escalate the call when there is a sudden deterioration. I think this constitues a near miss event and should be investigated to prevent any repeat that could potentially result in an even worse outcome.

Don’t think it was U as such. But you should be driving. So you can get her there quicker in such situations and not rely on the ambulances, for the sake of your DC as much as anything. You’d be there quicker.

Don't blame yourself. It wasn't your fault. You are doing you best in a very difficult situation.
I hope your daughter is ok

Did you not read the post? OPs daughter was vomiting uncontrollably

How exactly can someone simultaneously drive, make sure the PICC line is not obstructed or compromised, AND prevent their child from choking on their own vomit?

This isn't helpful and you have no idea why OP doesn't drive /have a car she can use.
But even if she could surely it would have been dangerous with a child as ill as OPs daughter she could have inhaled her vomit and choked

Oh but some parents are just so much better parents they could do all that simultaneously whilst driving, learning French and making a chicken stretch to 5 dinners. It's all so easy when you've never done it.

That paramedic is a serious risk to the public

Except she wouldn't. Because by the tien she'd got her kid into the car, sorted with bowls etc, stopped and started every few minutes to check on her, had to find somewhere to park whilst still trying to check on her, then potentially carry / drag her easily 10-15 minutes to A&E and join a queue.... Not to mention if she choked on vomit at home op can do something. If she needs resuscitation at home, op can do something. How good do you think it lbe for anyone if op is negotiating traffic and her kid starts choking?

and some people are ignorant of how having this situation unfold, it would be dangerous to drive.

I would complain about the attitude of the Paramedic but I would also speak to your DDs Consultant or Specialist nurse and ask them what to say if this situation ever arises again. After a very difficult situation with my frequent flier DD (and A&E junior doctor problem, not paramedic), we drew up a personal protocol which was signed by the Consultant, which I laminated and which went everywhere with DD, so that in the event that she needed to go to hospital, this could be handed to paramedics and then the attending A& E staff, so that everyone knew what to do.
Would something like that be possible for the future?