Gautam Ray wrote:
> It may sound perverse, but I think keeping reasonably long waits, allied
> with good triage by experienced staff to make sure the genuinely needy
> are attended to expediently, has some place in disuading the "wasters"
> from staying.
Agreed. But how many of these patients came in by 999 ambulance. There
is still the perception, amongst some users of the service, that they
will be seen quicker if they come in by ambulance. The ambulance
services, DoH and A&E's should be educating the public about this.
> Kent police have today announced that frequent (3 occasions) misusers of
> the 999 call to Police will be disconnected by BT (with appropriate
> written and personal warnings, and presumably attempted re-education).
I think this is possibly an idle threat. Imagine the outcry when these
'disconnecteds' (in more than one sense) are unable to dail 999 for a
medical problem and the worst happens. Who will get the backlash then?
> Having heard from a Paramedic colleague recently about a 2O year old
> bloke who dialled 999 for an Ambulance more than 24-hours after
> sustaining a sprained wrist
We had a 24 year old female yesterday who called for ambulance as she
had an abdo pain for 4 weeks. She lived less than a minute away from the
hospital.
> Only last week, one ambulance service (was
> it Essex?) announced that it was looking at not attending all calls > for help with a fully crewed ambulance. Instead, a 'phone triage officer
> will despatch a paramedic practitioner or GP (don't flame me, its not my
> idea) to deal with those that clearly didn't need A&E attention.
Yes, this will be for the Catergory 'C' calls. Currently, London has
about 17% of 999 calls falling into this category. This equates to about
100,000 calls a year and I am sure that this figure will rise after we
fully implement AMPDS within the next 2 years.
Telephone Advice lines operate in a number of regions around the country
including a trial/study in London Ambulance Service. My experience of
offering telephone advice is that the caller/patient seem reluctant in
some cases to accept advice and still insist on an ambulance attending.
Conveyance direct to a Minor Injuries Unit may be of assistance here, or
simply treatment at home. This will probably require adherance to quite
strict assessment protocols to ensure the correct disposal of the
patient. Either way I somehow can't see many paramedics rushing to
answer the vacancy bulletin to attend these calls on a response vehicle
as recommended by the Audit Commision!
John Warwick
Paramedic
London
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