Monday 26 December 2011

Compu'er says No.......

"104 year old, fallen, no injury, very cold, can't get up"

Working at Christmas is generally a mixed bag. Your'e left feeling frustrated by people's apparent willingness to call an ambulance, when surely the last place in the world anyone would want to be at Christmas would be a hospital. On the other hand, others are reluctant to call 999 because it's Christmas and when they eventually do people are very sick. Most of the jobs we attend have houses full of family and the joy or sadness this brings makes the shift an emotional roller-coaster. At about 10pm a call came in from Gloria. A 104 year old lady who had fallen. It was about 15 miles away but we began. Within a minute or two we were cancelled for a higher priority call.

"21 male, ? # nose, post assault"

We attended this undeserving patient who had misinterpreted 'tis the season to be jolly' and taken it to mean 'let's go kick the crap out of each other'. Nothing spectacular, a quick bandage, a taxi ride to hospital and on to the next. Below are the following jobs I attended:

"47 year old female, SOB, abdo pain"

"14 month old male, not sleeping, feels hot"

"23 year old male, vomiting, has been drinking, collapsed at bus stop"

The 21 year old had been fighting outside a pub, the 47 year old had indigestion, the 14 month old had an ear infection and had seen the GP the day before and got antibiotics. The 23 year old was indeed drunk. None of them seriously ill at all. All could have coped with not going to hospital and all could have made their own way to hospital. Who am I to judge though? I'll just go where I'm sent. After leaving the drunken male at the hospital we greened up.

"104 year old, fallen, no injury, very cold, can't get up"

It was the same job from 10pm. It was now 3am. This job was now over 5 hours old. We called up to see if this was actually the case. Sadly it was. 4 ambulances had been cancelled for higher priority calls. Just like we were, and just like all the jobs we did since were. Apparently Gloria wasn't a priority. Apparently a 104 year old, lying on a cold kitchen floor, on her own on Christmas day wasn't worthy of an ambulance. The drunk people were worthy. Gloria was not. Is this the problem with computers making decisions? Or, is this a matter of ignorance? Who are making these decisions? For her to be left that long, someone consciously decided to send the resources elsewhere. Would they have done so if it was their mother or grandmother? Doubt it. Gloria didn't complain. In fact quite the opposite. She apologised. She explained how she fell over at 6pm, then waited 4 hours to call for help as she didn't want to be a burden. That means at 104, having survived both world wars, having paid tax for 66 years until her retirement at 80 and being self sufficient to the point of needing no benefits or care package she had laid for 9 hours waiting for help. Help she had earned. Help she was basically refused.

She didn't need to spend all of Christmas day in hospital. With the lack of Drs she would probably be in hospital for 3 days over the festive period now. She could have stayed at home. However, after the powers that be decided she didn't need an ambulance sooner than 5 hours, she had pressure sores and hypothermia.  We had to take her. But why wasn't she a priority? No apparent pain but surely a 104 year old won't feel pain like a 70 year old might. Alert. She was able to talk in clear sentences to the call taker and explain exactly what happened. It appears her lack of broken English and good grasp of symptoms had let her down. She denied chest pain and difficulty in breathing. Most people say they have one or the other just so they get an ambulance. In this instance, her willingness to tell the truth had caused her a long wait and a lot of distress. At what point are the fat cats in charge going to show some respect for the people most deserving? None of the jobs I did over the entire weekend were more deserving than her, yet none of them had to wait more than half an hour for an ambulance. I want to know why no one is accountable for this. If it was a member of my family I'd want blood. I have passed my concerns on to the powers that be but i'm sure i'll get a suitably political answer in reply basically saying "tough, get over it", but hey, bet they didn't spend christmas on the floor.


  1. Ella,

    I have read and re-read this posting.

    After witnessing the usual mass of Tooth abscesses, ear ache, uti's (mainly 18-30 yo females) and requests for voltarol/coedine over the last 3 days, I'm not surprised. Saddened, but not shocked.

    I am shocked though. Shocked that someone, somewhere did not have the gumption to add S.O.B or Chest Pain to Gloria's initial assessment.

    Shocked that Cameron's Family Values contrast so strongly with the Targets imposed on those who care.

    Tonight the system has beaten me, and I apologise for my negativity. Tomorrow I will pick myself up, dust myself down and do it all again.

    Knowing that someone else sees and feels what I sed and feel, well that is what gets me through. That & coffee.

    Cheers mate, keep it up !

  2. Bravo Ella! I have witnesses this first hand. I believe our trust send an ambo to all 65yr olds and over and won't stand down unless a Red1.
    That aside- go into politics!

  3. Bravo, good post. I got tasked to a R1 Cardiac Arrest the other night. The System downgraded the job then decided to cancel me. Fortunately a human kept me running. 73 year old lady with a broken arm.

  4. Triage is hard... conceptual real time triage even harder. The case above is what i call a "moral" emergency. There are to many of those... I take it she had no family.... and social services were not involved. Pressure sores are a risk... but the answer is ambulance services having roles defined for conditions rather than 1 role for all. IE Falls staff, wound care staff,medical, Critical Trauma Peads etc etc....As Paramedics we meed to embrace urgent care becuse like it or not it is seen as our responsibility. Therefore instead of how many Trucks available it would be.... We have 2 CCPs 2 Falls trucks, 5 Urgent Solos, 1 Blood taking solo, 8 urgent transport 2 Critical transport etc etc.... Its time for our profession to specialise we should define the role of the visiting clinician. S


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