Tag Archives: ambulance

A desperate state of affairs

Today I read the incredibly sad story of Bella Hellings.  Bella was a three month baby who died after suffering a seizure in March.

Unfortunately it took 26 minutes for paramedics to arrive on scene due to a number of wholly preventable issues.  The fault of these issues lies squarely at the feet of the trust rather than the individual paramedics.

The first issue is that Bella lived on a new build estate, so new in fact that her address didn’t feature on trust vehicles sat navs. Unfortunately for Bella, as is so very common, the houses all look so very similar so the detail her fraught parents gave as a distinguishing feature wasn’t unusual.  What I ask of you the reader is tonight, when it’s dusk, step outside your house.  Go to the side of the road and see if you can clearly see your house number?  I can pretty much guarantee that it’s not clearly visible.  For your own sake please find a much larger house number than the one you have and make sure it can be seen from the road.  Yes I know you know where you live, as does the postman but the emergency services don’t and unless it’s clearly visible from the road there will be a completely preventable delay in finding you when you need help at your most vulnerable time.  I have no idea if this was the case at Bella’s house but it is at pretty much every other house I’ve ever had to visit and is a point worth mentioning.

The next issue was that an ambulance had to stop for fuel.  How have we got to the state that we run our ambulances so ragged that there is insufficient time to refuel them other than when they’re on an emergency call? Now I don’t know what vehicles East of England run and I don’t know their range but I’m pretty sure, like everywhere else in the country, the crews get called out seconds after they log on and are constantly run until they finish.  I also know that WMAS has staff called Ambulance Fleet Assistants.  Their job essentially consists of ensuring the vehicles are ready to go out at the start of each shift, part of this is to refuel them from their own diesel tanks they have at some of their ambulance hubs.  I would suggest that East of England need to do similar to ensure their vehicles start the shift fully fueled.  While this wont fix the problem of having ambulances run constantly it will prevent issues like this from happening again, additionally it will deliver cost savings which will enable more money to be put into frontline vehicles and crews.

The key issue on the refueling of the double crewed ambulance (DCA) is there isn’t enough of them.  There simply aren’t enough DCAs to go around.  Any paramedic who crews a car will be able to tell you of horrendous waits for very sick patients, I’m personally aware that in at least one county the amount of DCAs available on a Friday/Saturday night is regularly less than the digits on one hand.  This leads to delays, the DCAs are constantly working their entire shift and their journey times are now longer as EDs have been shut and downgraded.  Unfortunately this means there is no resilience within the system and it’s not beyond the realm of imagination to imagine that one day, somewhere in the country all the ambulances will be held up outside one hospital and something terrible happen leading to a horrendous wait for DCAs to arrive on scene.

I’m very suprised that no-one has every submitted an FOI request for one specific night and asked for DCA crewing levels across the country – I would be astounded if there wasn’t a sea change after if this is undertaken.  Cars have their place in the ambulance service but with services chasing a government imposed arbitrary target of 8 minutes, with their entire worth measured on this one target, it appears services are crewing more and more cars at the expense of DCAs.

There shouldn’t be a choice between DCAs and cars, there needs to be a dramatic uplift in funding for ambulance services across the country, until this happens there will be incidents like this up and down the land and more people will die.  I implore the government to give ambulance services more cash for vehicles and crews as they are so desperately needed.

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It appears some journalists don’t know what they want.

I’m writing today about an article in Saturdays Daily Express, “Health and safety rules have turned into a sick joke”.  It’s confusing as it appears that the Stephen Pollard, who wrote the article, isn’t really sure about what he’s writing about nor what he actually wants.

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The article starts with a mention to an unrelated case of which I have no knowledge nor expertise so cannot comment with any authority – however to ensure that you can read the entire article I’ve copied it, you also know I haven’t missed anything out.

 

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The article talks about Godfrey Smith, a former Community First Responder who broke the law while responding in a service marked vehicle responding to a call.  The marked vehicle is pictured here, in an article published on 11th September in the Metro.  You will note that although it has green and yellow retro-reflective ‘battenburg’ markings it possesses neither blue lights and therefore it will also not have a siren.  The Daily Express article concentrates on the fact that Mr. Smith exceeded the speed limit by 50% as the sole factor, whereas the Metro article shows that Mr. Smith not only exceeded the speed limit, but also ignored a ‘keep left’ bollard in order to circumvent a red traffic light.  It is worth repeating that Mr. Smith did not, as he had neither, activate blue lights and sirens both of which are essential equipment for claiming those exemptions, exemptions he is not entitled to.  

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The article then states that no-one was injured as a result of Mr. Smiths actions, this is irrelevant.  He broke the law, and according to the Metro article he broke the law three times (excess speed, fail to obey keep left bollard, crossing a stop line when a red light is shown).  Apparently the SatNav on the vehicle required updating, again this is irrelevant.  Anyone who has done any further driver training knows that observation of road conditions and signs trumps whatever the little plastic box tells you, if the road sign says 20 then that is the maximum permissible speed by law.

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The article then moves onto the tragic case of Mr. Simon Burgess who the coroner recorded died in accidental circumstances.  It is factually incorrect to suggest, as this article does, that a delay in sending in help to Mr. Burgess directly caused his death as the coroner informed the court that the delay in waiting for specialist teams “was not a significant factor in his death”.

The article then moves onto the tragic event of Shannon Powell.  A young girl who first had a seizure and then went into respiratory arrest.  This article fails to mention the fact that Miss Powell was having a seizure, this makes carrying her virtually impossible for any length of time and depending on the method used it can be impossible to manage a persons airway – without this airway management death would have been inevitable.  

As a quick breakdown I’ll list the available options to carrying a person so you, the reader can establish why Miss Powell would have been left on the ground until the ambulance could be brought closer

  • Carry chair – only possible to use with someone who is conscious enough to protect their own airway.  Carrying over rough ground is possible, but only if the patient remains still
  • Longboard – Requires the patient to be strapped onto the board, depending on the nature of the seizure this would be impossible, furthermore movement dramatically changes the center of gravity which makes carrying a seizing patient virtually impossible
  • Scoop – see longboard for explanation
  • Carry sheet (only some ambulance trusts carry these) it is impossible to manage a persons airway when in a carry sheet, meaning your patient may asphyxiate prior to reaching the ambulance

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This article then moves onto what can only be described as a rant.  Furthermore it incorrectly describes Mr. Smith as an ‘ambulance driver’.  This ambiguous term means nothing in law – does the journalist mean paramedic? Or does he mean someone who, as in this case, drives a vehicle provided by the ambulance service?  I’ve yet to meet an ‘ambulance driver’ anyone who is ambulance crew, regardless of their training, does far more than just drive the ambulance.  It is worth remembering that Mr. Smith is not ambulance crew.  He has training only slightly above that of a first aider and is limited on his treatment options, especially when compared to a paramedic or an ambulance technician. 

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What really bugs me about this article, and I mean really bugs me is that the journalist links to one of his previous articles, titled ‘Too many people killed by speeding emergency vehicles’ an ill informed article describing paramedics as ‘stretcher bearers’.  The opening paragraph of this linked article is as follows

“Those at the wheel of emergency response vehicles can never be excused from driving responsibly.  After all, far too many people are injured and killed on the roads by police cars, ambulances or fire engines going at breakneck speed.”

This is incredibly hypocrisy, in one article he defends a volunteer driver, who has no exemptions under the Road Traffic Regulation Act 1984 or the Traffic Signs Regulations & General Directions 2002 , who failed to adhere to basic driving standards.  In the other he calls for a reduction in road traffic casualties from irresponsible driving by emergency service vehicles, which it is worth remembering Mr. Smiths vehicle was not.

Unfortunately for Mr. Smith, as he has admitted to driving past stationary vehicles in excess of the speed limit and failed to obey traffic signs while in a marked service vehicle when not entitled to do so, I have no sympathy for him.  It was his choice to break the law and he must accept the consequences.  He placed significant numbers of the public at risk and that is indefensible.