Monday, 6 February 2012

Passers-by



"Male, unknown age, ? unconscious, ? intoxicated, caller no longer on scene"

This call with be all to familiar ambulance crews the world over. It's a bread and butter job at the weekend but puts a huge strain on the ambulance service. The patients are often abusive, extremely drunk, possibly incontinent, often covered in vomit and don't want any help. Why would they? They didn't call us nor did they want us called! The problem for us lies in the 'duty of care'. I have no doubt that left to their own devices most people in that state would eventually find their way home. It's just how it works when people (myself included) get drunk. No matter how bad you are, the homing pigeon in you always gets home. However, we can't be sure and having that 'duty of care' we have to ensure they get to a place of safety.

The reason we are there, more often than not though is not because of the dear passer-by. Someone who has walked past / driving past / heard about / think they saw, a person who was collapsed / asleep / fallen or dead without checking. I don't have a problem with people calling an ambulance for someone who needs one but I do have a problem when someone calls an ambulance without even seeing if they need / want one. It's as bad a bus and tube drivers calling for people who are merely asleep because they are 'not allowed' to wake them up. So many resources are wasted every day attending to drunk people, homeless people & non-existent people because a good Samaritan has phoned 999. Below are 4 of the jobs I've attended on a recent weekend phoned by a passer-by.

"Male u/k age, cardiac arrest. Patient is lying by phone box. Caller was driving,  not on scene"
On arrival at the location given the was no phone box, let alone a patient. An extensive search of the area was unfruitful. No patient was found. A witness 1/2 mile from the location given said a man fell on the floor, got up and walked off.
Category:                         Red 1 - within 8 minutes
Vehicles dispatched:         2 x Ambulances 1 x FRU
Location:                          Not as given. 
Caller on scene:                No
Outcome:                          No trace
Time taken:                      38 minutes
Total cost:                        £1250


"Male u/k age, unconscious, life status not known. Caller not willing to approach"
On arrival the patient was lying on a bench, I woke him up. He was an alcoholic. He was verbally abusive and refused all treatment. The called had left before we arrived.
Category:                         Red 2 - within 8 minutes
Vehicles dispatched:        1 x Ambulances 1 x FRU
Location:                         As given 
Caller on scene:               No
Outcome:                         Declined aid
Time taken:                     46 minutes
Total cost:                       £750


"25 year old female, unconscious, lying on pavement, called states thinks patient is drunk"
After driving up and down the road given for 10 minutes we eventually found the patient in the road parallel, sitting / slumped at the bus stop. She spat at us and was verbally abusive. Said she was waiting for a bus. Refused treatment. The bus came and she got on.
Category:                         Red 2 - within 8 minutes
Vehicles dispatched:        1 x Ambulances 1 x FRU
Location:                          Not as given. 
Caller on scene:               No
Outcome:                         Declined aid
Time taken:                     41 minutes
Total cost:                       £750



"35 year old male, collapsed. Patient is lying at bus stop. Caller no longer on scene"
On arrival at the location the patient was lying on the floor. We woke him up and he agreed to be checked over on the truck. He walked on. He vomited on the bed, floor, cupboards and crew. Patient declined hospital.
Category:                         Red 2 - within 8 minutes
Vehicles dispatched:        1 x Ambulances 1 x FRU
Location:                          As given
Caller on scene:                No
Outcome:                          Declined aid
Time taken:                      29 minutes on scene. 32 minutes back to station. 48 minute
                                        cleaning and changing uniform. Total time: 1 hour 49 minutes
Total cost:                        £750 + cost of new uniform 



As you can see over £3500 and almost 4 hours downtime of 5 ambulance and 4 FRU's was spent of calls where simply asking the patient if they needed an ambulance would have prevented a wasted call. Once we make patient contact, we are required to fill out a full PRF form for each of them which is time consuming. I don't want to discourage people from phoning 999, far from it. Where there is a doubt CALL 999 but I would urge people to check 'life status' before deciding to call where practically possible. We want to be there for the people who want and need us but as alcohol becomes more and more of a problem in this country instances of passers-by phoning in for 'collapsed' patients is ever increasing, putting a costly, unnecessary and avoidable strain on the ambulance service. Please think before you dial.


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