A man came on the line sounding as if someone had died.
“You need to send someone. We need someone here!”
“What’s the problem…” I began.
“She’s BROKEN HER TOE!”
I sighed inwardly. As you know, we’re not allowed to comment on the appropriateness of a call, so I ploughed through the questions in a monotone, being careful to emphasise words like “conscious” and “breathing” in an attempt to bring home the point that ambulances are generally for people who have problems in one of these areas, not those who have BROKEN THEIR TOE.
This didn’t faze our lovely caller, who answered every question with “No, but she’s in pain!” Well, yes, it generally is painful when you’ve broken your toe. The call, unsurprisingly, came out as a Green 2, the lowest of the low.
His piece de resistance was his answer to “And when did this happen?” The toe had been broken yesterday, when the patient had stubbed it against the door.
I tried to bring the call to a close, but the caller was going on and on: “Are you sending someone? Are they on their way? She is in pain!” and wouldn’t take the stock ambulance service fob-off of “help will be with you as soon as possible” as an answer. I was going to just say goodbye and hung up, but felt this man would be ringing up every five seconds if I didn’t say something to him. If the QA office are reading this, please accept my apologies.
“The 999 service is for serious and life threatening emergencies,” I said. “We prioritise all our calls, and yours is the lowest priority. Do you really consider this to be a life threatening emergency?”
“Yes!” said the caller. “She’s in pain!”
Well, I tried.
I checked on the call a bit later and there was a message from the Telephone Advice people upstairs: “Already spoken to this patient - no send policy invoked - self care advice was given, patient to make own way to hospital if needed. Will ring back and advise.”
I thought that was the last of it. But it wasn’t.
Five minutes later the caller was back on the phone, and this time, he had the bright idea of answering every question with the opposite of what he’d said earlier. Is she conscious? No. Breathing? Struggling! Quick, quick, send us an ambulance. Didn’t you call earlier for a patient with a broken toe? No, no, that wasn’t me. Just send the ambulance.
As it was now a category A emergency, we not only had to send an ambulance, but a FRU (first response car) as well. The FRU was a lot closer to the call than the ambulance, and the FRU desk asked the FRU to report on arrival due to the nature of the earlier calls to this address.
FRU arrives, finds a fully conscious and well patient with a broken toe. He rings us straight away and tells us to cancel the ambulance. I don’t know what he said to them, but he was on scene for a grand total of six minutes, including doing his paperwork.
It’s a shame there isn’t a law against wasting ambulance time like there is for the police.
October 27th, 2006 at 2:36 pm
If there ever is a law against wasting EMS time and resources, it should be punishable with “The Toe Tax”
October 27th, 2006 at 4:44 pm
I suppose there isn’t a law against it because it’s more likely to put off responsible but worried sick/ injured people than idiots with a sense of entitlement like the one in the post.
October 27th, 2006 at 5:03 pm
Argh! AAAAAAAARRRRRGHHHHHHHHHHH!!!!!!!!!!!!
People. They blow my mind, but sometimes, I wish they’d blow their own out.
October 27th, 2006 at 8:09 pm
whats the address?
i’ll get the ambulance fire-arms unit right on it.
is there a direct line of sight from the snipers nest at the top of the gherkin?
if not i can get the guys on HEMS to sort us out. i’m sure we can find someone with the right attitude: “ANYONE WHO RUNS IS V.C. ANYONE WHO STANDS STILL IS WELL DISCIPLINED V.C…!”
October 27th, 2006 at 10:43 pm
The Ambulance service must have rights to fine time-wasters like this.
I was told a story by a tech who was sent to an elderly gentleman, history of MI’s, complaining of chest pains. when they arrive at scene, they found out it was just toothache.
October 28th, 2006 at 3:31 am
Having a partial charge system **might** help…but a legislatively enforceable fine system would be far better. If they (politicians) can legislate to protect emergency service workers then they can surely legislate a fine system for obviously fraudulent time wasters.
What about charging any time wasters with attempted manslaughter if by not telling the truth they result in a resource being made unavailable for a subsequent cardiac arrest (resulting in death)?
We can introduce AMPDS/ProQA like systems until we are blue in the face, but they fail on one key point - in accuracy. If any question is answered in accurately or untruthfully the whole triage feature becomes pointless.
October 28th, 2006 at 3:39 am
This behaviour is completely outrageous. It has mad me so mad. Tell me where they live and I’ll go and break the other nine toes.
October 28th, 2006 at 11:24 am
Hoax calls should be applicable for mansluaghter in the worst cases. Misguided/selfish people should be fined heavily.
False Call Good Intention is just a fact of life and the people are usually quite nice, but panicy.
The inherant problem with AMPDS is as a telephone system you can’t see whats happening, and visual clues make up a large part of triage. So it eres on the side of caution. By following the answers given by the caller any outcome is covered by the system and blame cannot be shown to be with the EMD.
I personally feel that Judges should be able to impose fines on stupid law suits and lawyers, so we can end the litigational society we’re growing into. Then AMPDS can dare risk to do what it’s supposed to do.
October 28th, 2006 at 11:49 am
These are the kind of things you never see on the fly-on-the-wall reality shows on TV. Maybe people would get the hint if they did show someone being berated by an ambo for wasting their time every now and then.
October 28th, 2006 at 2:00 pm
Come to Scotland! We can batter them with the EW(S) Act which covers EXACTLY this sort of pish!
October 28th, 2006 at 10:19 pm
Hi,
Although misusing the ambulance service sadly isn’t a criminal offence, misusing the 999 service is.
Some our most persistant idiots have gone away after a couple of £80 fixed penalty tickets delivered to the door by a nice unsmiling copper.
Advice? Use your ECPs, get them round to the local nick and talking to the Duty Sergeant.
Have fun, we do
October 29th, 2006 at 12:24 am
@Kai
Aye, but in Scotland it’s customary to batter and then deep fry everything!
October 29th, 2006 at 10:23 am
The good old ‘London Big White Taxi Service’…
October 29th, 2006 at 4:19 pm
Off the top of my head (without checking all the legal references) this person could likely be dealt with under s127(2) of the Communications Act 2003, which says:
127 Improper use of public electronic communications network
(2) A person is guilty of an offence if, for the purpose of causing annoyance, inconvenience or needless anxiety to another, he-
(a) sends by means of a public electronic communications network, a message that he knows to be false,
(b) causes such a message to be sent; or
(c) persistently makes use of a public electronic communications network…
This is punishable by a fine and/or up to six months inside.
If it was clear that they had had explained to them the reason why an ambulance wasn’t being sent, and they then phoned up deliberately lying in answer to the triage questions then it might well fit the bill of “for the purpose of causing annoyance, inconvenience or needless anxiety to another”.
If the facts you related were properly explained to a police officer they’d certainly want to be interviewing the person to establish exactly what the intent of the caller was.
I know we’re *all* busy, but part of the reason for this is that all emergency responders have to respond to sh*t like this. If we deal with it effectively it might ultimately free up our time to deal with the things we are really here for.
October 29th, 2006 at 4:34 pm
Over here (NL) I’m pretty sure he wouldn’t have gotten a fine, but he would have received the bill for the actual costs… likely to be a good deal higher than a fine. It seems to work for us…
October 29th, 2006 at 10:45 pm
Over here in Canada, you have to pay for the ambulance regardless. Crew’s wages are excepted if the ambulance was necessary, but in a clear cut case like this the caller could be hit with the cost of the ambulance, the cost of the FRU, the wages of all the crews involved AND a fine.
Puts the bogus callers off somewhat.
October 30th, 2006 at 1:36 pm
I would like a Police Officer to do “third man” runs with some crews. Any prosecutions resulting in this exercise should be well publicised so it would get around that the Ambulance Service is an “Emergency” Service. Crews take note that EMDs try their best to stop this dribble but we can not go on instinct and experience, we have to follow AMPDS. We do “get rid” of a lot though.
October 30th, 2006 at 7:31 pm
I’ll say it again folks.
Use your ECPs, use your ECPs, use your ECPs.
We’ve done it and it works.
Rich
An ECP isn’t just for OOH.
October 30th, 2006 at 8:00 pm
I think that people that call for a non emergency such as described should be sent a bill for the costs involved this would soon get through and make people think first.
October 30th, 2006 at 8:36 pm
In NZ we are charged for Ambulance call outs. It really does make you think twice before calling.
On another note, we are now being urged to call the Emergency Services for anything suspicious looking, apparently we don’t use it enough. Turns out we’re more hesitant than dial-happy now.
Take a leaf out of our books and charge for emergency services!!
October 31st, 2006 at 9:28 am
Out of interest… are you charged if you are unconscious on the ground and someone else calls the ambulance?
October 31st, 2006 at 1:35 pm
Jeeez - if I’d have been the FRU attending that incident I’d have been inclined to “accidentally” stand on the broken foot the show them some real pain.
I’d welcome a system where you can report time wasters to the Police, but then haven’t they already got enough on their plate already? It’s not like they’ll get around to deal with such cases with much urgency since they’ve their own priority system haven’t they?
You just can’t win.
October 31st, 2006 at 7:09 pm
I get the impression that the diagnosis of a ‘broken’ toe was self-made. It would be interesting to know whether it really was broken or just painful. Most of the patients I see who tell you they have broken something haven’t.
And for those who are not familiar with the work of ambulance/A&E this kind of behaviour is far from the isolated case you may think. We find that such calls are only too common.
November 1st, 2006 at 11:08 am
Laina, trust me charging makes no difference we still send ambulances to jobs that are more than a waste of time, painfull knee at 3 am “when did this start”– “oh about 2 weeks ago”, and ” i need an ambulance urgently i’ve stood on a tooth pick, it’s out now but send them quick”- NO they did not get an ambulance but they called. good old NZ ah
November 1st, 2006 at 9:23 pm
Does anyone out there actively manage their inappropriate callers?
November 4th, 2006 at 1:08 am
What a pain, can’t believe he wasted LASs time like that.
But, I have to say, what about those who ring for an ambulance and really need one and it never turns up?
I have a friend, a psych patient and a prolific self harmer. Some nights ago she cut her arm very badly, down to the muscle infact. She staggered to a bus stop to try and get to the local hospital. It was 3am. The next bus wasn’t for another hour. Although the wound was not bleeding as badly as it had been, she had lost a lot of blood and was in a lot of pain and felt weak and faint. She questioned if she could remain conscious till the next bus turned up (couple all the medical stuff with the fact it was -2 dgree c and she could get hypothermia- wearing only a t-shirt and jeans) and concluded that she didn’t think she could. She rang an ambulance. The woman said help was on its way. 30 minutes later they hadn’t come. She rang again- same woman, she checked the status and said they were very busy but a crew had been assigned my friends call and she would tell them that my friend felt worse; the lady also appologised for the delay and insisted my friend call again if she deteriorated further. Another 25 mins elapsed, no sign of LAS. But, a bus came, my friend staggered onto it, confused, in agony, weak, and psychologically distressed. 10 minutes later she staggered into A and E, checked in. Her phone rang, LAS, “where are you?” my friend replied that a bus had come and she was at A and E. LAS ” you should have told us, we have could have used this ambulance for another call, you wasted our time”. My friend, not really with and shocked started to explain that she’d been waiting nearly an hour and was feeling really quite unwell and that she had rung twice and assumed they weren’t coming- LAS hung up on her. My friend passed out 5 minutes later. Two bags of fluids, a bag of blood, and 36 stitches later she was feeling a little more perky.
You could argue that she had survived an hour, and managed to make her own way to the hospital and therefore didn’t need an ambulance. But, after an hour she wasn’t to know that they would turn up and had she sat there waiting any longer and LAS hadn’t turned up, she would be dead.
And yet they got shirty and hung up on her.
Maybe they thought she was like stubbed toe man- merely wasting LASs time.
November 4th, 2006 at 11:59 am
Hi Bick
I can see both sides of that one. If there’s a long wait for an ambulance, there is always a good reason for it. If it was a very busy night maybe there just wasn’t an ambulance available for her. (Also, if she gave any indication that she might be violent towards other people, we’d arrange the police to attend with us, which can cause a delay). While your friend was waiting at the bus stop, us in control would be broadcasting the call, trying to get an ambulance to take it. If she hadn’t called us, we would have called her back every fifteen minutes to half an hour to see how she is and apologise for the delay. We wouldn’t think she was wasting time - we’d be looking at the call on the screen thinking “god, that poor girl has been waiting for ages, I hope we get someone for her soon”.
And if she was waiting an hour, it’s likely that she wasn’ t the only one. When we finally found an ambulance for her, we could have sent it to another call - maybe an old person lying on the floor with a broken bone, a diabetic with low blood sugar, a child who has had a fit, a woman having a miscarriage. The ambulance crew would have thoroughly searched the area around the bus stop before contacting us to ring your friend back, using precious time that they could have used getting to another call.
Now I hope you can imagine the frustration of the allocator with a screen full of calls waiting for ambulances when she rings your friend back and find she has made her own way to hospital and didn’t think to let us know…
On the other hand, with your friend alone, cold and not in the greatest of mental states, it is understandable that she forgot to ring back. The person who rang her back and was “shirty” and hung up was totally in the wrong, and while I understand how frustrated she was, she could have had a bit more compassion.
If anyone calls an ambulance and then decides they don’t need it, PLEASE call back and let us know!
I should probably do a post about this. Thanks for the thought-provoking comment.
November 4th, 2006 at 3:38 pm
TomDimmock said,
on October 27th, 2006 at 10:43 pm
The Ambulance service must have rights to fine time-wasters like this.
I was told a story by a tech who was sent to an elderly gentleman, history of MI’s, complaining of chest pains. when they arrive at scene, they found out it was just toothache.
And Mr Dimmock, you would undoubtably be aware that sometimes angina and coronary syndrome present only with pain in the jaw.
Hence the problem with invoking laws in this area. With the guy described in the post - he was a time waster. He called it in, and when he didn’t get priority, he called back and lied. But what about people presented with a problem where they don’t know the importance, the priority? You ight call it time wasting to call in a person with bad abdo pain, but what about that person who turns out to have an AAA. I certainly came across someone on the ward where the ambulance crew had made an ‘executive’ decision that it wasn’t serious. An hour later he was being rushed in his son’s car to A&E with a ruptured AAA.
Educating the public, and giving a much better non-emergency services (for thoe low priority things) are the answer, not persecuting the lay people.
[again though, i agree liars should be done. you can be charged with wasting police time, why not paramedic time?]
November 4th, 2006 at 4:53 pm
Sorry,but the original caller who had the FRU responding should take into consideration the risks the driver has taken en route on blues to look at her manky stinky toe.
The reply about the self harmer?Does a burglar moan if he gets caught and goes to jail?No.Do the crime,do the time.
You want to slice yourself open,do it on a+e steps so you can walk in or save up for a cab.My bucket of sympathy runs very dry very quick on a shift when its fool after fool.Self harm?You did it,you fix it.
Regulars like this are a drain on resources.
November 5th, 2006 at 2:04 am
Merseyboy,
I think your comments are rather harsh towards self harmers. Sure, she did it to herself, but she is mentally ill- she didn’t do that to herself. Nor do people give themselves abdominal pain, make themselves stop breathing etc. It is still an illness. And, awfully, it is still so taboo. Thank you so much for confirming that some of society is still completely ignorant towards this subject. Would you argue that a twenty stone man who has eaten junk food for the last ten years and thus furred up his arteries and induced a heart attack should not receive treatment? You could argue he had brought on the problem through chosing to eat that diet. Gosh, heaven forbid you ever become one of the one in four of the population who gets a mental illness and needs help..
Mark, thank you very much for your response and enlightenment on such a situation.
LAS had asked if she felt violent to others and she had assured them that she didn’t. When she rang back after 25/30 minutes the lady (ironically the same one who took my friends initial call) was stunned she hadn’t received help yet and had to double check the progress of the request. She said she wasn’t sure why she had not got an ambulance yet but did say they were very busy (it was a wednesday night- are they always busy?). My friend was indeed not in the best frame of mind and had lost a lot of blood, she had also come to the conlcusion that LAS had either forgotten about her or thought that she was not worthy of help because she had DSH’d. I much agree she should have rung back, but she actually said to me that she thought that if she dialled 999 again to say she would take the bus that she thought she might block someone elses more urgent call.
I agree , it might be useful for you to do a post about rinigng up if you don’t need LAS to attend afterall. Keep writing, it’s great to read. And thank you for showing that you are more compassionate towards DSHers than Merseyboy is. Maybe you should think about being a paramedic! Lord knows why Merseyboy is one if he treats/regards a large part of society with such derision!
November 5th, 2006 at 3:10 am
When to call is a tricky one. As a layperson, my criteria is when you definitely need some help, it can’t wait until morning and you absolutely can’t get to the hospital (or a walk in clinic) by taxi.
On the other hand, I’ve called 999 for migraine headaches, when my husband was away and couldn’t drive me down there, I’d taken everything I have at hand for it, I was headbutting the wall for a change of pain and obssessively contemplating blood-letting, overdose or even suicide to get it to stop.
(I’ve had near-fatal gallstones and the migraines can get just as painful, 10 on the pain scale, but less easy to cope with because the brain itself is affected, so I make more of a fuss because trying to be stoical makes the pain much, much worse).
Arguably, the migraine is not life-threatening, it’s only pain. I don’t know. I usually grab the phone rather than a knife and no one has given me any stick for it yet. I certainly couldn’t get a taxi, at one pointon one occasion all I could manage for two minutes was ‘my head hurts’ in answer to any question.
Since a doc took the time to explain I could safely double dose the tramadol, I haven’t been back, but even then, I don’t think I was really timewasting - just too out of focus to read fine print on safe dosage and make a decision to risk more. Even when they can’t give me more pain relief, they can at least, hopefully, stop me doing anything pain-crazed.
Are migraineurs timewasters? Did I do a bad thing? I don’t know. Certainly, my I-think-it’s-broken hand caused me to get a book and a taxi and expect to sit cheerfully around at the bottom of the queue for a while.
I’d be more likely to call an ambulance for a ‘drunk’ than someone with a clearly broken but not bleeding hand.
November 5th, 2006 at 6:27 am
To be honest, I don’t think a migraine - if you’re sure that’s what it is - is something you should be calling 999 for. It isn’t a life threatening emergency even if it feels like one. That said, the state you were in, it’s understandable that you did call us. In fact, the suicidal thoughts you were having because of the pain would be reason to call, but the migraine itself wouldn’t.
A GP visit might have been a better option than an ambulance, although I’m not sure you could have waited for one to turn up. It’s a tricky situation.
bick: Yes, we are always busy, but it sounds like your friend was unlucky to have such a long wait on a Wednesday night. It always gets a bit busy around pub closing time, but not usually *that* busy. Perhaps there was football on TV on something…
November 5th, 2006 at 8:24 pm
Mary - I think the basic idea is that you are charged, but if the crew decides it was life threatening or whatever and did require an ambulance then they wave the fee. It’s about $70 I think.
Angry Medic - of course charging won’t stop everyone, but I’d certainly expect it to help. We’ve had instances where we have rung an ambulance, “just incase”, and happily paid up the fee - better than guessing wrong, calling a taxi, and losing a friend. The general public do not know as much as you about Medical Situations - so give them a break.
November 6th, 2006 at 10:58 pm
There would be nothing to prevent the LAS from making a complaint to the local police if someone did this sort of thing maliciously. There are exemptions to the Data Protection Act that apply. In practical terms, it would probably only work well if both the Met and LAS had policies on how to deal with these cases.
In the mean time, I hope the FRU paramedic gave the strongest possible words of advice!
November 13th, 2006 at 6:27 am
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Jessica
November 20th, 2006 at 5:19 pm
…. … Arrrghh!!!
And poor lil me (all 110 kgs
just ordered a taxi when I had a broken ankle (although I did think it was just a sprain).. and when I had a painful AC-joint displacement (ie. tore all the ligaments holding my clavicle in place), I bloody _walked_ to hospital (about 1 km away)… And someone calls an ambulance for a “broken toe”?!? Claiming it’s life-threatening?!? WTF!?!
The first call could be put on plain stupidity and panic (although, why call the next morning?!?), the following one is just mind-bogglingly, idiotically narcissic.. The FRU should’ve called cops to give the guy a nice lecture..
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