We have recently updated the AMPDS dispatch system in Control. This piece of software is supposed to categorise all the calls into the three different priorities…
Cat A (Red)– High priority, life threatening injuries and illnesses.
Cat B (Amber)– Medium priority, chance for disability.
Cat C (Green)– Low priority, cut fingers, coughs, colds.
We had been hoping that the new update would cut the number of 'Cat A' calls we would be going to by better triage.
Unfortunately, the opposite seems to be true (for me at least).
For example, Maternataxis, which mainly used to be 'Cat B' and 'C' calls are coming out as 'Cat A' calls because it is often classed as “Bleeding from dangerous location”.
“Dangerous area” seems to be a new criteria with this 'upgrade', as it's the discriminating factor on a lot of the calls I go on.
I've just come back from a 'Cat A' call to a 16 year old boy who heard a crack in his neck as he got out of bed. No history of trauma, no neurological deficit, just the normal sound us old people make after waking up.
This was a 'Cat A' because it was a “Dangerous area”. I hate to say it, but pretty much every point on the body could be considered a “Dangerous area” depending on what had happened.
I understand that we have to over-triage in order to be safe, but our Call-takers aren't allowed to use any common sense or clinical judgement in deciding the category of a call. It's all very “ Computer says 'No'“, I'm afraid.
The flipside is that strokes (CVA) tend to be categorised as 'Cat B' calls, which is something that really needs to change if the National Service Framework is to be implemented. Road traffic accidents also tend towards being 'Cat B' calls.
Why am I mentioning this? Well I've just come back from the boy with the neck cracking, and after cracking my knuckles in front of him, the crew took him to hospital and the thing is, after being either cleaning my new flat, decorating it or at work for the past month, I'm starting to have a sense of humour failure.
So I may be a little 'terse' with some of my patients.
Which is good, because if you mollycoddle idiots they'll only think that what they have is serious.
Reynolds is moving on Tuesday, and has a lot of packing to do by then, he is tired, fed up and looking forward to the end of the week when it should all be finished and he can get back to the pursuit of joy…