PARAMEDICS WITH THE SCOTTISH AMBULANCE SERVICE (SAS) are claiming that the pressure to meet mandated response times is resulting in ambulances not being properly disinfected.

Not only are they not being give time to perform the daily and weekly cleaning, but they are seldom allowed to give proper cleansing after individual transports.  Requests for time to do “deep” cleaning after a patient has vomited or defecated are being refused in order to get the unit available for the next call more quickly.

One paramedic told the Dumferline Press:

“The only thing that seems to matters these days is reaching target figures on response times.

“The standard of hygiene is very basic. Whereas in other areas they have cleaners, in Fife it is down to the crews.  We wipe down surfaces at the start of the shift and that’s it. Sometimes if jobs are already piling up when you’re starting, it doesn’t even get that.”

Jonathan Fox from the Association of Professional Ambulance Personnel said: “The fight against superbugs cannot stop at the hospital door. The ambulance service is part of the total patient care package and nobody should have to be transported or work in a dirty ambulance. The issue of ambulance cleanliness is simply not being taken seriously enough.”

The Dumferline Press has the STORY.

AN ALBUQUERQUE, NEW MEXICO, CITY COUNCILOR is concerned about emergency response times.  Councilor Don Harris believes that roadway impediments such as speed bumps and traffic circles are hindering timely responses for emergency calls and he wants to consider removing them.

Harris will be proposing that the city council spent $9,000 for a study to see if it would be worthwhile to ban these obstructions on primary response routes in the city.

TV station KOB, Channel 4 has this video report on what Councilor Harris wants to do:

AFTER A 3-MONTH TRIAL PERIOD IN QUEENS, the New York City fire department will be introducing new dispatch guidelines for the other boroughs.

The upgraded practice calls for dispatching the companies immediately before taking the time to collect the ancillary information.  Dispatchers will keep the callers on the line and continue to get information and then relay it to the responding companies.

Brooklyn dispatch photo by Britton Crosby

The new procedure was instituted as a means to reduce response times and it proved successful in the Queens trial.

The New York Times has an article describing it HERE.
Firegeezer notes:  Maybe the article is leaving something out, or perhaps I’m missing something.  But departments throughout the country have been doing this for 30 or 40 years already.  What’s new?

IN THE PAST FOUR YEARS, OVER 430 PEOPLE HAVE DIED IN SAN FRANCISCO, CALIFORNIA, while waiting for an ambulance that was late in arriving.

Even though the city’s standard for response times is not as stringent as the nationally recommended standards, they are still missing the target response time in 27% of the high-priority medical calls.

Image supplied by FreeFoto.com

The San Francisco Chronicle did an in-depth study of all 439 delayed calls and have reported their findings in today’s paper.

While there are several reasons why the times are not being met, the Chronicle found that the biggest obstacle is in the dispatching center:

The 911 call center, plagued with problems from low morale to a proliferation of calls from people who don’t speak English, is the weakest part of San Francisco’s emergency medical response system, according to The Chronicle’s analysis of city dispatch logs from Nov. 1, 2003, through Dec. 31, 2007.

Fifty-seven percent of the time, the call center has failed to meet the city’s goal of dispatching urgent medical calls within 2 minutes, records show.

The Chronicle’s staff writer Jim Doyle has put together a very thorough and interesting report.  Take the time to read the entire story HERE.

IN GENNESSEE COUNTY, MICHIGAN (FLINT), THE EMERGENCY ambulance service is provided by Regional EMS, a private not-for-profit company.

Yesterday (Monday) a 7-yr.-old boy was riding a dirt bike in an indoor motocross track in Fenton when he lost control of his bike and crashed into a steel pole.  An ambulance was called for the obviously injured boy and one was dispatched from the nearest station 6 miles away at 5:09 pm.  Three minutes later the ambulance radioed back for directions to the address on Thompson Street, which is a main thorofare in Fenton.  Eleven minutes after that transmission, the ambulance radioed again that it had broken down and could not complete the call.  A second ambulance was then dispatched and it arrived on the scene 22 minutes after the original call.

A sheriff’s dept. paramedic arrived on the scene five minutes after the intial call and tended to the boy while waiting for the ambulance.  Three hours later the boy died at the hospital.

Regional EMS photo

This lengthy response time is not unique for Regional EMS, however.  The Flint Journal explains:

Until January, Regional EMS was on probation because of what regulators called a “pattern of delayed responses” to emergency calls and because of other problems.

Regional was allowed to operate while on probation but was required to give its dispatchers more training, show that it was using updated map books of Genesee County, and to turn over its dispatching policies and procedures to the county Medical Control Authority.

Regional’s probation came after Medical Control said it saw a “pattern of delayed responses” to calls for help for more than two years.

Medical Control claimed at the time that 15 of 17 allegations against the company for delayed responses and dispatching trouble were valid.

Read the entire story in the Flint Journal HERE.
Regional EMS company WEBSITE.

Firegeezer wants to know:
The only reports on this say that the boy was on a “dirt bike.”  Was this just a simple bicycle with those knobby tires, or was it a motorbike?  I just cannot imagine parents sending a child that young out to play on a motorcycle.  But it happens, I know.

Whether it was motor- or pedal-powered, why was this arena allowing someone that young and irresponsible to ride on a hazardous course like that?

And what gives with this ambulance company?  After being on probation for, among other reasons, employing drivers who get lost, why are they still sending out people who cannot find the main highways?  (and don’t have sense enough to know where they are going before they leave the station).

There are a whole lot of people who have a share of the responsibility for this debacle.

A SCOTTISH AIR AMBULANCE OPERATED BY the Gama Aviation firm was delayed from responding to an emergency call for two hours Sunday because they couldn’t get anyone to refuel the aircraft.

The call came from the Orkney Islands around 2:30 am that a child with a suspected case of meningitis needed immediate transport to a mainland hospital.  The air ambulance based in Glasgow had just returned from another flight when the call came in and they needed refueling before leaving on the next mission.  The plane had a pilot, a paramedic, and a specialist team from the hospital consisting of a doctor, a nurse and a load of equipment on board during the delay.

Gama’s fuel contract is with Signature Flight Support at Glasgow Airport, but when they called for a fuel truck, none was to be had.  Signature couldn’t produce a driver for the truck, claiming that their duty driver had changed his cell phone number without telling them and there was no one else readily available.

Gama next tried to get fuel from the BP terminal which is constantly open at the airport, but BP refused to drive a truck across the airport because they don’t have a contract with the Scottish Ambulance Service.  Gama offered to taxi over to the BP terminal, but they still refused to service the plane. 

Finally after nearly two hours, Signature got a driver to the terminal and the twin-engine Beech King was fueled.  The plane completed its mission and the last word from the hospital was that the child is doing “just fine.”

Naturally, politicians are outraged and are demanding investigations and “answers.”

You can read more in the Glasgow Daily Record HERE.
The Evening Times has MORE.

IN THE UK, THE FEARS GENERATED BY DISPATCH CONSOLIDATION are coming true.

18 months ago the counties’ ambulance services were combined into large, regional services and lately the local dispatch centers have been shut down in favor of distant facilities serving a much larger area.  People have been complaining that somebody 100 miles away cannot possibly be familiar enough with the territory to dispatch adequately.

The most recent example of this occurred in Oxford when a 14-yr.-old girl collapsed at a skate park in Grove.  But when someone called 9-9-9 for an ambulance, it was dispatched to a skate park in Grove, Bedfordshire, more than 50 miles away.

While waiting for an ambulance that wasn’t coming, the girl went into respiratory failure and had to be rescusitated by a police officer that was on the scene.  After 45 minutes went by, the police called once again for an ambulance.  One finally arrived one hour and eight minutes after the initial call was placed.

Police Officer Sue Harris
The girl’s guardian angel (Mail photo)

Thanks to the presence of the trained police officer, the young girl did survive.  But the citizens are now doubly worried about what will happen when the regional fire dispatch center begins operating later this year in Hampshire.  It will be responsible for dispatching fire calls for an 8-county region.

The Oxford Mail has the STORY.

WHEN A LADY IN WENTWORTH, NOVA SCOTIA, GOT HOME from a trip early Friday morning, she found her house filled with smoke.

At first she ran down to the basement to check her furnace and saw that the smoke was coming from her flue and no flames were visible.

The Halifax Herald tells Leah Palmer’s story:

The 911 operator took her information and stayed on the line with her until she was turned over to the Amherst dispatcher.

“She asked the same questions as the 911 lady did. When I hung up I expected her to call out the Wentworth fire department, which is about a 10-minute drive.”

“We waited and waited. My sister just got finished saying that it was taking the fire department a long time to get here when I got a call back from the Amherst (dispatcher).

“I couldn’t believe it. It was 1:04 a.m. and the dispatcher was calling me to see if everything was OK. I told her it wasn’t. She asked if I wanted her to call the fire department and I told her, ‘Of course I want you to call the fire department.’

“I couldn’t believe that 29 minutes had gone by and that she hadn’t called the fire department yet.”

After confirming that she positively, absolutely needed the fire department, they were dispatched at 1:06 and arrived at her home at 1:15.  Fortunately the fire never got out of the flue pipe and they were able to extinguish it and clear the smoke out of the house in a couple of hours.

The dispatcher claims that she forgot to dispatch fire because she was busy sending a police officer after a drunk driver.

Miss Palmer wraps it up nicely:  “This should never have happened. It makes me think that maybe it was better back in the days when the fire call went directly to the fire chief’s house and he called out his firefighters.”

You can read the full story HERE.

IN NORTHAMPTONSHIRE, ENGLAND, paramedics with the East Midlands Ambulance Service are complaining that they are under so much pressure to return to service after a call that they are not given enough time to exchange depleted oxygen cylinders when they get low.

Even though the hospitals have refilling stations, the crews say that they are not being given the time to replenish their cylinders before they are sent on another call.  In what has become a familiar refrain lately, one paramedic is quoted:

“When we see a patient in their home, we often want to make them stable where they are before taking them to the ambulance, but we are sometimes not getting the option.

“You are always thinking about whether to hold a bit back in case someone later on will have to go without. The point is that patient care is not the priority; getting to jobs within the 18-minute target time is the only thing that seems to matter.”

The Northampton Chronicle & Echo has the STORY.

Firegeezer wonders if this is more of a labor ploy.  How much time does it really take to refill a portable bottle?  Why can’t they operate an exchange system like we do here, where you just leave off the empty bottle and grab a full one?  This newspaper should have asked some more questions.

Addendum:  According to their WEBSITE:
“The East Midlands Ambulance Service (EMAS) provides Unscheduled Care and Patient Transport for 4.6 million people in an area covering approximately 6,425 square miles across the six counties of Derbyshire, Nottinghamshire, Lincolnshire, Northamptonshire, Leicestershire and Rutland.

“We employ over 3,000 staff at more than 70 locations and operate a fleet of 850 vehicles. Each year, we respond to more than half-a-million 999 calls and provide 1.25 million journeys for non emergency patients. Our overall annual budget is £125 million.”

THE NORTHERN IRELAND AMBULANCE SERVICE has confirmed that it has suspended two employees at the Regional Emergency Medical Despatch Centre based in Belfast for altering response-time records.

The Transport and General Workers Union spokesman Albert Mills confirmed the suspensions followed allegations of logging incorrect response times to emergency call-outs - a serious disciplinary offence.

BBC News has the early report HERE.