Speaking as part of the LAS, we routinely monitor all the timing data of
every call, so a transfer would be picked up. We are not set up to monitor
where a patient would have been on a drip as we could not pick up from where
the drip was stopped and then restarted, this would only ever come to light
from a retrospective study of patient notes, and potential outcome studies
by the Trust. London does not have a high proportion of technician only
crews, although this does occur. At the time the request for transport is
made we have no idea which crew mix would be available for transport. The
urgency of the transfer is decided by the doctor ordering, we are aiming for
this to be clinically evidenced based and not a convenience time. With over
2500 responses per day (4000 calls +) of all types some triaging is
inevitable. If the drip is clinically necessary, then if we were to supply a
technician only crew we might reasonably expect the drip to be shut down for
safety at pickup, or an escort to maintain the efficacy of the treatment on
route. We unfortunately cannot normally guarantee to return the escort, not
part of the SLA.

-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Helen Deborah Vecht
Sent: Monday, June 06, 2005 7:31 PM
To: [log in to unmask]
Subject: Re: Drips and transfers, was Re: Assessment tool for transfer of
medical patients

Maurice <[log in to unmask]>typed


> Can you describe what is mediocre about the care, are referring to the 
> cessation of the drip or that technicians are not authorised / trained 
> to administer them!

No criticism of ambulance technicians is intended in any way.

It is my fear (possibly ungrounded) that discontinuing a drip for transfer
might result in a 2-3 hour interruption of an infusion. It is this
interruption I see as 'mediocre'.

I envisage that the cannula gets capped as soon as transport is booked
(maybe this does not happen) I envisage a 'non-urgent' transfer waiting
around 90 minutes. (Maybe this does not happen) I envisage it taking up to
an hour for a new ward arrival to start treatment, like a drip, simply
because there will be other things happening on a ward.

Perhaps things have changed enormously in the past few years. Perhaps not. I
am sure it is possible to arrange only brief interruptions on transfer. I
suspect that the reality, especially in non-urgent patients, is that such
interruptions might be uncomfortably long.

Are these transfers to be audited?

--
Helen D. Vecht: [log in to unmask]
Edgware.

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