I ran one the other day for a UTI. The patient did not wish to be transported, only for us to supply him with one of those flimsy plastic urinals for his use while his son (who was sitting in the car with the engine running) drove him to the hospital.

Not knowing what else we might do, we gave him the urinal and filed a cancellation.

Well done, much better than the alternative, having to send two ambulances - one for the fall off a chair, the other for a panic attack.

And at least she had a valid reason, unlike the silly old bat that pressed her medical alarm (then didn’t talk to us when we called it back, therefore getting a lights & sirens response) because her TV wasn’t working.

What a kind and pragmatic response to an elderly person’s distress. Makes me very proud to live somewhere that does things like that when they can.

Possibly also ought to be a SS flag to make sure that the sisters were generally getting the support they need?

well done

I’m curious why this counts as “Well, we may as well, because it doesn’t hurt anyone and makes people happy” and a woman in agony in labour counts as “Some daft cow who should have called a taxi”?

Because while the ambulance is dealing with the woman in labour, it wouldn’t be able to go to anyone else for at least an hour, and someone could die as a result. No one was endangered by the ambulance changing the lightbulb; if we’d needed them, we’d simply have phoned them and they’d have left straight away.

Of course, we could start sending to maternataxis with the proviso “if we get an emergency call, we’re going to turf you out and make you walk the rest of the way” but I don’t think that would go down too well!

Yep, congratulations to H702 for not thinking that basic patient care is merely medical.

Regards
Nick
http://nickhough.blogspot.com

These calls often frustrate me the most, not because they’re inappropriate but because there should be some better form of help for these people.

I doubt they ask for Police, since wasting Police time is a crime and these sort of people tend to be very law abiding. I doubt they call for Fire, because they’re all terribly busy being heroic and saving lives, but Ambulance are people who care and help in dire circumstance.

However while these people hold more of my respect than many of our callers, medically they come at the bottom of the pile and on a busy night we can’t go and help them at the cost of other emergencies. You can hear it in their voice that they’ve tried everything else and are desperate for anyone to help them! So this is where IMHO the social services are needed. A 24hr callout for vulnerable people in desperate need of anybody who can help them in a moment of need, and a simple straightforward number to call for help. Some councils are better than others, but usually only in office hours and if you fit the right criteria etc….etc…

The police have an “not quite emergecny” number, there needs to be a universal one that covers social services, NHS Direct and others. A Desperate number instead of an Emergency number.

You can’t buy goodwill like that. Thank you for having such a kind heart.

KJX - I think that’s the wrong track of argument to pursue. If you’ve lived for 80 years in the western world you probably do know that at some point, the lightbulbs in your home WILL blow - and probably this WILL happen during the hours of darkness, because that’s when you turn lightbulbs on. If they’re energy-saving bulbs, you get five *years* to plan what you will do when the lightbulb needs changing.

As a person who also can’t climb about to change lightbulbs, my contingency plan for illumination until I can get someone to change a blown bulb for me is simply having a tabletop lamp that I can easily move to any room as required. It’s not rocket science.

I’m not defending either misuse of the 999 service, and I feel that it’s perfectly acceptable that, since the crew weren’t busy, they helped out a vulnerable person in a non-medical way. But planning doesn’t come into it.

i changed a light bulb for a patient the other day.
we attended an elderly gentleman who’d fallen out of bed and while my crew mate gave him the once over, i changed the light bulb on the the stairs.

it’s often the little 2 second jobs that can make a big difference to the patient and as such i’d much rather be called out as a preventative measure like this than i would to the dozen patients a week i get that are healthier than i am.

our service is about care, not just saving lives.

I agree with uphilldowndale, we’re all going to be old one day (if you’re fortunate enough to make it that far) I’m sure the lady in question has changed many a lightbulb in her time but when you’re 80 even the most mundane of tasks can seem like climbing a mountain. I’m sure she’s enough to think about with her older, disabled sister, than worry about light bulbs and “planning ahead” on when they’re going to run out. You’ll find that the majority of health professionals couldn’t do more for the elderly. It’s the elderly that you often get appreciation and job satisfaction from helping. It’s the elderly with their failing health that have genuine reason to need an ambulance. Most of them have worked hard their whole lives and paid more than their share of taxes in this country - not like the majority that phone up demanding a taxi, I mean ambulance to hospital. I think the allocator and crew involved deserve a pat on the back.
As for the maternity argument. If you are in labour, yes it’s going to hurt, it should not be a surprise, child birth is painful! It is normal to be “in agony”
You DO NOT require an ambulance to transfer you to hospital. The crew can do nothing for you. It’s your responsibilty to get to the labour ward on time - and as has already been pointed out, you have ample time to arrange for this.

Anthea, I agree with you and I have never said that a woman in labour should NEVER call an ambulance. I have absolutely no problem with women calling for ambulances because they have gone into early labour, because things have happened quicker than they have expected or if the plans they have made for getting to the hospital have fallen apart at the crucial moment.

What I do have a problem with is women who are in *normal* labour and who haven’t bothered making arrangements to get themselves to hospital because they think the ambulance service will take care of it and that using an ambulance will save them a cab fare and not make them have to trouble their allotted driver. That, to me, is an abuse of the service and one that happens frequently enough to make my blood boil.

I don’t think anyone would blame you for calling an ambulance if you went into labour at 27 weeks, though, if only for the blue lights on the top. Someone like that would always be given priority compared with a women who was full term and just using us as a taxi service.

I can believe that. I have come across some awful midwives in my time. They give a bad name to the profession.

Ok, comment was a little on the ’sharp’ side.

I, like any sane person, would never expect a woman in labour and scared for any reason not to call an ambulance. I just don’t think we should expect one as a right - especially when for most of us it is a straightforward (if damn painful) experience and there are alternatives. Having had 2 myself I know it hurts and yada yada!

Apologies if I offended anyone.

Well, bravo for the brave dispatch supervisor that had enough sense to make the moral and humane choice. Here in the US if anyone found out about that in the general public there’d be an out-cry about ‘tax-payers dollars’ and rubbish like that. Of course there’d be an equally alarming out cry if she managed to hurt herself actually trying to change the bulb herself and anyone found out she’d called for help… damned if you do, damned if you don’t

Vic Fichman
Partner
http://www.firetraining.net

Sharon, well I was 37 weeks when I went into labour with my 2nd, my first was an undiagnosed breech and I ended up having a crash GA and a section….

I nearly had to drive myself (18 miles) to hospital as we couldn’t get hold of our pre-arranged carer for our 1st child - Oh the best laid plans! Son 2 arrived 2 days after christmas and at that point we lived in a rural area where taxis are unheard of. It takes abound 30 to 40 minutes to reach either of the two general hospitals with maternity units. My experience is that when you call the delivery unit, they tell you to stay at home - ‘well you might be in labour, you might not….’

I also have ’silent labours’ where I don’t actually get any pain with labour. The Specialist Reg who saw me when I arrived at hospital wrote in my notes that I wasn’t in labour as I could hold a perfectly coherant conversation. About 2 hours later, son 2 arrived, my second stage of labour (the pushing bit) taking a grand total of 6 mins.

Not everyone lives close to a hospital, as they do in London, however, everyone knows that they’ll need to change a light bulb sometime. As another poster pointed out having to do so is an absolute certainty.

I don’t disagree with the decision to help the old ladies, but if all the elderly population of London called an ambulance when they needed a bulb changing or a tap fixing, for instance, where would we be?

I noted that Mark says in his post about BBAs that they are a common occurance. Should LAS CHARGE these women for not making their own way to hosiptal in time - since they’ve had ‘a full 9 months to plan’ and are taking up not a small amount of resource in 2 Ambulances, inc Paramedic plus midwife and transort??? And what of those women who deliver in the hospital car park - tsk - what bad planning that was!

Mark - the point I’d like to make is that what sometimes *appears* to be a ‘normal’ labour can quickly turn into an emergency. When I had my first child we went to hospital as my waters had broken, they checked me out and sent me home (30 min drive) as they had no beds. Also with a 1st child I guess they figured it could be some time.

When I called the delivery suit early the next morning they were very relaxed (this is nearly 24 hrs since waters broke). However, when they examined me, they discovered that I was fully dialated and that the baby was breech. This hadn’t been picked up on before. Due to his presentation, which was slightly oblique, and the fact that my body started to push and baby’s heart beat wasn’t recovering, I had a crash GA and emergency section.

Therefore, having had a very bad experience, I am naturally very cautious. I could have sat at home longer, then taken 30 mins to get to hospital and ended up with a dead baby.

Presumably all those people who have a BBA have not made appropriate plans to get to hospital, or things progressed more quickly than ‘normal’ (whatever that is).

You say that it’s easy to tell the difference between someone who’s not in established labour and someone who is - the point that I’m making is that while this might be true some of the time, it’s not always the case. I sat in front of a Specialist Reg who didn’t think I was in labour, when I plainly was, so not everyone presents in the same way and people cope with pain in different ways.

In London I agree that circumstances are very different to rural areas and that in theory the journey to hospital shouldn’t take too long. I laughed when I read the BBC’s ‘Ethical Man’ story - the family dispensed with the car, so had to rely on public transport or walking. When the reporter’s wife had her 3rd child, they walked to hospital. However, the grandparents followed them along in the car ‘just in case’ - which kinda defeated the object IMO!!!

I certainly agree with other posters that elderly people need more support - unfortunately we don’t live in a society that operates under a ‘prevention is better than cure’ model and will always need those to ‘pick up the pieces’. The sad thing about London is that so many people live in isolation - the sense of community spirit is somewhat lacking, I say this as someone who lived in London for 11 years.

Anyway - if pregnant women abusing the ambulance service is such an issue then would it be worth the LAS going into partnership with one of the big London Black Cab companies to provide a service to these women? It would almost certainly be cheaper! The service could have priority over other customers (so women aren’t kept waiting for hours, which can happen).

Does the LAS keep stats on the number of maternataxis?

Hi Mark - in my case, I wouldn’t have known that it was an emergency. Things like the baby’s heart rate dropping and not recovering after a contraction are only picked up with foetal monitoring. I wasn’t suggesting that every pregnant woman in labour should have an ambulance! My experience has been that the Delivery Suite are quite laid back when you call them - they certainly don’t encourage you to go in too early.

The PCT next to us used (not sure if they still do) send a midwife around to check women to save them travelling to hospital before they should. However, I know of 2 women whose husbands delivered the second baby in this area, so not sure if this works! However, this model certainly has the potential for reducing the amount of abuse the ambulance service would suffer from. Not sure if this would work in London though, there probably aren’t enough community midwives.

Since I am still yet to pass my driving test, I would probably crash it and create a real emergency!

If the emergency happens when you’re in the taxi, then ask the taxi driver to call for an ambulance. Really, would you rather someone having a heart attack had to wait because you were scared of your waters breaking and staining the taxi floor? Because, seriously, that is what it comes to. People die.

I think the fundamental difference between this and attending a woman in labour is that we could have pulled the crew off the lightbulb call at any point if there was a proper call for them to go to. Perhaps I should be more sympathetic towards the maternataxis and, like you, assume they have called because they are scared, not because they are being ignorant/lazy/tightfisted, but it’s very difficult after the number of times I’ve seen life threatening calls held because we’ve sent our last vehicle out to a maternataxi (as I’m sure you have too)!

I see your point, but there is a difference between a false alarm situation (a lot of our “heart attack” patients turn out to be indigestion) and calling for an ambulance when you know you are just in normal labour. Of course, in an ideal world there would be enough ambulances so we could deal with maternities and renal colic patients too, but as you say, the powers that be have not provided enough money for that! The ambulance service has just started providing “green trucks” which are vehicles which only deal with non-emergency calls and provide basic pain relief, oxygen, carry chairs etc. You could have had one of these with your renal colic (although at the moment there aren’t nearly enough so you might have had a long wait, and sometimes we end up sending normal ambulances when there aren’t enough “green trucks”) but they are not suitable for maternities because the technicians haven’t been trained in childbirth. I’d quite like to see a dedicated maternity taxi service to help women in labour without putting pressure on the ambulance service!

there was talk of having a midwife in cta to ringback the maternity calls and adv as appropriate , which would be fantastic ,because its all well and good us in eoc saying theyre just in labour, theyve had 9 months etc ( even those of us who’ve had babies ) but what do we really know , the crews hate maternitys even more than we do coz of the lack of training they get for obstetrics emergencies , i mean it comes to something when the medical director says its ok for crews to ring eoc for medical advice on diff labours ( the good old saftey pin trick) so lets get a midwife or two on the team to help us decide what is a normal labour and tell those ladies with ten minute contractions , waters intact with a first baby that shes got bloody hours to go yet ( poor cow)

I think it would be best to define a ‘maternitaxi’ call. Picture the scene…..

A. 999 call complete with ‘the baby’s coming’ screamed down the line. Contractions apparently mere seconds apart.

B. Crew rock up to find Mum in pink T-shirt nightie wandering around the house looking grumpy. Contractions measured on a sundial.

C. Dad, Grandma, Grandpa, Neighbour all in attendance.

D. Mum loaded into Maternitaxi with Dad.

E. Grandma, Grandpa, Neighbour and dog get in Mondeo and follow…..

Mark, the CTA Midwife is a good idea but I think you’d find them so bound up by algorhythms and safeguards you might as well call NHSD.

SD

I am now feeling really embarassed! i had an ambulance for my third child and suspect the driver (it was just him) must have thought I was a complete time waster. My first and second babies were VERY slow to arrive so I’d thought I would have plenty of time with #3 and had arranged for my sister in law to look after the older two, thinking there would be loads of time for her to drive the 10 miles to my house…the best laid plans etc….#3 started coming much faster than I could have imagined, husband couldn’t get hold of his sister (the phone line to her house was down) so off I went in the maternataxi while husband tried to raise his sister’s neighbour (bless the neighbour, he not only woke sis-in-law up, he drove her to our house as well.
Meanwhile, I’m in the ambulance, stressed out so the contractions slowed down to five minutes apart. Aaarghhhh. Youngest took another 5 hours to arrive*
Got home later that day to be greeted by a shouty midwife who accused me of deliberately going to the wrong hospital - God knows how as there’s only one that does maternity for 60 miles in every direction….
*It was at this point I decided not to have any more babies as I was obviously Not Very Good At It!

I often wonder what makes them request ‘ambulance’ instead of ‘police’ or ‘fire’

Maybe you only get a third of them, the other two thirds split evenly between police and fire. Now there’s a scary thought.