Tuesday Morning  (I think)

Just how important is an ambulance, anyway?  Naturally we have our own ideas about that, and in most places the citizens agree with us because they buy and staff enough of them to take care of the community's needs. 

But in some places there are bureaucratic and managerial bunglers who are so intent on their own interests that the sick and injured are being left to suffer.  While these impeders are well-meaning, their actions filter through the system and degrade the EMS more than they help it.  We have documented here on several occasions how local medical directors in a few areas are so intent on upgrading patient care at the entry level (i.e. ambulance) that they drive away many potential first-aiders who could do good work in getting effective care to the emergency victim.  Those areas end up with scant ambulance service and even in some cases, untrained drivers who only do that … drive.

You may recall, if you're a long-time reader, that about 3 years ago I calculated that on a regular weekday the London (England) Ambulance Service has more desks in service at HQ than they have ambulances on the street.  Nationwide, many of the 12 National Health Trusts that operate the hospitals, ambulances, etc.,  have begun using more and more so-called Emergency Care Assistants (ECA's) who have nothing more than basic first-aid training and are supposed to be ambulance drivers and assist in loading and unloading the patients.  But the cash-strapped ambulance trusts have been using these lesser-paid workers more and more in place of paramedics.  The Telegraph reported last month  that half of the 12 Trusts have been at times sending out ambulances with nothing other than ECA's on board - no paramedics (even though the taxpayers are paying for them).  This is the end result of the intertwined actions of the bunglers in all levels of the organizations.

Some areas of Canada and Australia have been suffering from hospital mismanagement where the emergency rooms are literally unable to accept patients as the ambulances bring them (called "ramping").  Then you get this ridiculous situation where the hospital parking lot is filled with ambulances where the medics are maintaining patient care for 45 minutes and up to 2 hours while waiting for the disfunctioning hospital to make room for their patients.  During all that time there are no ambulances available to respond to fresh emergencies.  The Canadian provinces have apparently gotten their acts together and have largely eliminated the loading dock backups, but in some areas of Australia the situation has not improved at all.

"Ramping" at PA Hospital, Queensland, Australia

What brought this up today was the news from Down Under about a locally famous TV cooking show chef whose family home burned down Monday morning killing the mother and their three children and leaving Chef Matt Golinski in critical condition with 40% burn coverage.  Also making the headlines was that the ambulance dispatched on this most urgent call did not arrive until a half-hour after one was called for, and there was only one – one! – person on the unit, a paramedic / driver.  The Sydney Morning Herald reported yesterday:

The spokeswoman said an intensive care paramedic was dispatched from Maroochydore but confirmed only one person was in the ambulance, so a police officer then drove the vehicle from the scene to hospital while the paramedic tended to Mr Golinski.

She said there was nothing unusual about sending the first available ambulance, even if only one paramedic was able to attend, given other emergency response agencies were able to assist.

"If they're the closest vehicle then yes, it is standard operating procedure that other agencies would assist with driving the vehicle [to hospital]," she told this website.

You got that?  In the minds of the bunglers, there is "nothing unusual" about an ambulance showing up with only a driver.  They also further say that the delay and failure to send more than one ambulance was because all units were busy on other calls.  This was at 3:30 am.  The ambulance supervisor, by the way, didn't arrive until 45 minutes after dispatch.

I'm not deliberately picking on the Queensland Ambulance Service, but merely using this most recent example to point out just what is going on in the civilized world as the governmental bureaucracies grow and starve out the basic functions they are charged with.  And don't think it isn't happening in the U. S., too.  Just this past Saturday, on Christmas Eve the city manager of Pontiac, Michigan, handed out layoff notices to the entire fire department.  Every single FD employee.

Ok, watch your back and let's get started on this equipment check.  I'll head for the Bunn-O-Matic and get another pot started.

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