The staffing of ambulances at the moment is…to put it bluntly… poor.
Working on the FRU/RRU means that I often get to a call within minutes (yes, within 8 minutes) of that emergency call being made. Unfortunately with so few ambulances on the road, the patient and I are often left staring at each other for long periods of time. Up to an hour in a couple of cases.
I was sent to a young man having an asthma attack. It was late at night, and he had been queuing to get into a nightclub, had started to feel his breathing getting tight, so had headed to a taxi office in order to go home. Unfortunately his asthma progressed and so an ambulance was called. What he got was me.
After dealing with the drunk group of teenage girls that were waiting for a cab, loudly ’caring’ for my patient, I started my assessment. It was a cold night so I sat the young man in the taxi office, and listened to his chest. I could hear a nice loud wheezing from his lungs, so I started him on the first dose of our asthma medication. I got his details and vital signs, and waited for the ambulance to turn up.
It takes between five and ten minutes for the asthma medication to finish, and by the end of it there was still no ambulance.
I listened to his chest again, still an audible wheeze, so I gave him a second dose of the medicine. So there he was, sitting in a cab office at three in the morning with a mask over his face, ‘smoke’ pouring from it, and all around us were intoxicated people getting cabs home.
Not very dignified.
We started chatting, and I was impressed by this polite young man with manners and common sense. The second medication finished and so we continued to wait, and wait, and wait for the ambulance. I phoned up my Control and asked them if there was an ambulance assigned.
“Sorry EC50, we are still holding calls in that area”.
So I was on my own with this patient for the foreseeable future.
Sometimes I can transport a patient myself to hospital, it’s not technically allowed. Actually we’ve been told that we shouldn’t do it at all, but in some cases I think I’m doing the right thing for the patient. So I will load them into the car (which only has the front passenger seat, the rest of the car is taken up by equipment) and nip into the nearest hospital. Control are often happy for me to do this, as it means one less job that they need to send a proper ambulance to.
I couldn’t transport this patient though, he wanted to go to his local hospital, which would mean driving past two other emergency departments and out of my area. I couldn’t see Control, or my bosses being to happy with that.
So the patient got a cab to hospital. At his insistence. The double dose of medicine had cleared his lungs up nicely, but he would probably need some short-term steroid treatment. I rechecked my assessment of him, and was happy that his physical condition was well enough to get a cab to hospital. But I wasn’t happy that there was no ambulance for this patient who actually warranted an ambulance.
As I write this I wonder what would have happened if he hadn’t responded to the medicine that I gave him.