The P.R.U. (Physician Response Unit) is a doctor and paramedic team who run from the Royal London hospital.  Their role is see patients who might not need a trip to hospital, and to treat them at home – thus saving the patient having to wait around in A&E for a couple of hours, and freeing up emergency services for more serious cases.  They also provide support for more serious incidents where a doctor on scene is a really good idea.

I’ve had a couple of jobs with them, normally it’s something simple like a patient with a chest infection, or other minor illness.  A lot of patients in our area don’t have a GP to see them, and so A&E and the ambulance service are their first, and only, port of call.

The P.R.U. is manned by a doctor, and a paramedic, they drive around in a blue Subaru which was donated by a firm of solicitors.

The last time I saw their statistics, they managed to treat a patient at home without needing an ambulance, or hospital visit, 30–40% of the time.

(They also wear the orange HEMS jumpsuits for some strange reason…)

I mention them because I had a job with them the other day.  I was called to a little old lady who’d collapsed in the street.  I got there first, and started my assessment – she was frail looking, but fully aware of what was happening to her.  Her pulse was on the low side of normal, and her blood pressure felt a little low (just off the pulse), then just as I’m about to check her blood pressure using out normal tools, the P.R.U. rolled up behind me, and three orange clad people jumped out.

I gave a quick handover to the doctor, and he continued assessing the patient while I measured her blood sugar.  Her blood sugar was normal, but her blood pressure was pretty low, a quick look at her heart rythmn didn’t show anything unusual, and neither did a further physical examination.

Meanwhile we were waiting for an ambulance.

I was asked if I wanted to cannulate the patient (put a needle in a vein so that drugs or fluids could be given), but as it’s been three years since I last cannulated someone, and she was a nice little old lady (instead of some stinky obnoxious drunk) I declined – I’m not that cruel to inflict my rusty skills on someone who is actually nice for a change…

There was still no ambulance to send, so it was decided to take the patient to the hospital in the back of the Subaru as the patient wasn’t getting the investigations she needed laying around the local market.

All I can say, is that she looked a lot healthier sitting in the back of the car, than laying on a market bench.

The P.R.U. (when it is running, manning the vehicle is apparently a bit of a nightmare) is a quality addition to the local NHS, and someone has definitely taught the doctors how to be nice to ambulance crews.  It’s just a shame that the Royal London doesn’t get any extra money to run this service that covers the gaps in local GP provisioning.

Just one more bit of the NHS being run on charity…

7 thoughts on “P.R.U.”

  1. sort of thing they should be doing all over the country, the numbers of chaff we get into A&E is crazy, and with the lack of GP's out-of-hours these days!why not catagorise calls so that they can be slung off the ambo's list and chucked onto a “nurse/doctor” list?

  2. Was a medical student and met one of the GP volunteers who helps with this service. He showed me around the car and all the kit in it. It's pretty impressive. Cool as it was, it didn't attract any interest from medical students in my group as it destroys your social life, has no financial rewards and in fact often results in you paying to upkeep it.The doctor on it was very cool though. He was Macgyver with a stethoscope.

  3. “Just one more bit of the NHS being run on charity”…like so many of our other 'statutory' services. Grrrr.

  4. You said it was three years since you last cannulated someone… Is cannulating the same thing as setting an IV? I can hardly understand how you've been 3 years on the street without doing it, i'm probably missing something…

  5. Paramedics can cannulate, EMTs (of which I am one) can't. Even though I could cannulate as a nurse, I can't when roaming around on the road because the LAS is a different trust.Just like I can't flush/replace blocked catheters, and have to take the patients into hospital…

    And before you ask…yes it can be annoying…

  6. When manning is alright up in control we do have a 'Telephone advice desk', which can send people towards GPs/walk in centres, but as manning is so poor, they tend to either not be running, or running at such a rate as to be (to us on the road at least) pretty pointless.Not their fault mind you, just a lack of manpower.

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