Nee Naw - Quick Quiz

Quick Quiz

Okay, a quick quiz for you. The four jobs that I wrote about on my observation shift with Steve - what do they all have in common. Just a quick recap, there was:
* An old lady on the floor with a broken hip who was in very severe pain.
* A man who’d swallowed a fish bone and thought it might be stuck in his throat, who was alert and standing round chatting when we arrived.
* A rather perplexing depressed man who refused all help from us and sent us away.
* A prisoner with a potentially life threatening arterial bleed after being slashed in the face.

Published May 20, 2008 -

Comments on “Quick Quiz”

laputain Says:
May 20th, 2008 at 10:00 pm

oooh, I’ll be guessing that the call taking software categorised them all as Cat A-get-there-in-8-minutes calls….
Dullahan_999 Says:
May 21st, 2008 at 12:35 am

Well, it should go, B,C,C,A … I have a feeling it didn’t though.
elm Says:
May 21st, 2008 at 2:25 am

They were all ‘genuine’ calls, and no time wasters
DavidWaldock Says:
May 21st, 2008 at 6:05 am

They all actually needed an ambulance!
Jenny Says:
May 21st, 2008 at 7:33 am

None of them were looking for a big white Taxi! and were grateful for your help.
red Says:
May 21st, 2008 at 8:52 am

They were all relatively pleasant. No abusive people in sight.
Commonpeople Says:
May 21st, 2008 at 11:47 am

They were all fans of Leyton Orient!
Mart Says:
May 21st, 2008 at 1:47 pm

“* A rather perplexing depressed man who refused all help from us and sent us away.”

And people are guessing that they were all genuine jobs that needed an ambulance?!?
swast nick Says:
May 21st, 2008 at 6:14 pm

they were all grossly miss-triaged by ProQa?
Mart Says:
May 21st, 2008 at 7:21 pm

Nah that could never happen…… ;o)
Martin Says:
May 22nd, 2008 at 5:01 am

They all received an inappropriate response.
M's way Says:
May 22nd, 2008 at 10:32 am

Hmmm they were all blogged about ;D
Emily Says:
May 22nd, 2008 at 12:08 pm

None of them were drunk!
Amypops Says:
May 22nd, 2008 at 4:08 pm

They were all classified as B or whatever it is on AMPDS.
Mark Myers Says:
May 22nd, 2008 at 4:17 pm

Ping! And the points go to Amypops! All of these calls were an Amber 1, or a category B. Which should tell you what I think of AMPDS…
Paul Says:
May 22nd, 2008 at 7:09 pm

How can arterial bleed possibly be CatB???

Surely the prison nurses realised how serious this was and passed it onto the control room?!?
Mark Myers Says:
May 22nd, 2008 at 9:39 pm

Because AMPDS is rubbish. Sometimes, even if the caller gives the call taker all the necessary information, and the call taker enters it all correctly, it still churns out a wildly inappropriate category. It’s more common for it to over prioritise than under prioritise, but as you can see it does happen.

I should add that under prioritising doesn’t compromise the response at all - dispatch staff just ignore AMPDS and do what is necessary. (In this case, immediate dispatch of an ambulance and activation of HEMS. The only reason no FRU was sent was because none was available) Over prioritising is far more dangerous, because while we are allowed to say “I don’t think that should be a green, let’s treat it as a red” we are not allowed to say “that shouldn’t be a red, let’s treat it as a green”. Which results in a lot of wasted resources…
bugg Says:
May 24th, 2008 at 6:53 am

I was going to say that they were all actual calls…but was beat to it.
Georgia Says:
May 25th, 2008 at 7:13 pm

over prioritising, yeah, that happens everywhere. yesterday, i gave myself a nasty electric shock, but felt fine, just some tingling in my fingers and a sore elbow where i banged it off somethign when it jerked back. i called nhs 24 (scotland’s nhs direct) and asked for advice. they sent an ambulance and a FRU. i was breathign okay, walking, talking, feeling fine. only wanted to know did i HAVE to go to hospital? if i did, i’d have made my own way there. but, they decided this over the top response was needed, wasting both an ambulance crew and an FRU’s time. the ambulance crew did an ECG and told me i didnt NEED to go to hospital, but i could if i wanted. i chose not to. if i didnt need to be there, i didnt want to be there
crazy nurse Says:
May 28th, 2008 at 7:38 am

What exactly does AMPDS stand for? Do all ambulance servces use it; or is there a rival product?
EMD999 Says:
May 28th, 2008 at 11:52 pm

“Advanced Medical Priority Dispatch System”

Funny how all RTA’s are cat B’s even if you type in a plane crash with 200 casualties, chemical spillage, entrapments etc…

I was happy to see on the “One Show” this evening that a man got fined £5000 and jailed for making hoax calls to police, fire and ambulance. He was jailed for 4 years i think, but they had about 4 years worth of calls before they could get to that stage. What is this world coming to when anyone let alone adults feel they have to call hoax calls for attention? I must admit i was a bit disappointed though, at the “One Show” for putting fire and police in the spotlight and not ambulance service, always forgotten!
Matt Says:
May 30th, 2008 at 7:36 pm

I prefer good old “Common Sense” to AMPDS.
I’ve seen a blue request for transfer AMPDS go down as low priority, simply because AMPDS does not handle the extra information relating to a casualty that controllers would think “shit, this needs to happen kinda nowish”…

Matt.
xxx
Claire Says:
May 30th, 2008 at 8:31 pm

I guess NHS direct has something similar. I called them and had a hard time convincing the call taker that I did not need an ambulance. Eventually she let me speak to a nurse who agreed with me. I suppose the dreaded words “Chest pain” struck fear into her heart.

Apart from that NHS direct was great that time. I was a little scared. I spoke to a doctor within an hour and found out that the tissue between my sternum and ribs was inflamed. Thank you!
Nigiri Says:
June 4th, 2008 at 5:53 pm

We use MPDS in British Columbia Canada. Our dispatchers all have PCP (Primary Care Paramedic) liscences. I find it very interesting that we have exactly the same problems with MPDS that I am reading about here - over prioritizing and inability to add to the assessment except in very specific ways. I am all for giving the caller the benefit of the doubt since we can’t physically assess a patient, but it’s getting silly.
grumpy NHS spouse Says:
June 18th, 2008 at 2:00 pm

No, No, NO! NHS24 in Scotland is NOT the same as NHS direct - it is the out-of-hours triage set-up. It is for emergency use, not for a chat about what jags (sorry, jabs for the English speakers) you need for your holiday or what to do about that cough that you’ve had for a week where a normal GP visit is what is wanted. And if the magic words “chest pain” or “difficulty in breathing” crop up in the responses to the call-handler’s questions - part of an algorithm designed by people with experience in emergency care, used in loads of other places too - the computer goes “ping” and an ambulance should be allocated. Of course, it works 2 ways - the people who know how to work the system can swing it very neatly by using the magic words. Unfortunately, you can’t SEE the caller, you might be able to hear what’s going on, but until it’s all done with videophones, there are limitations to what telephone triage can do. So, which side do you err on? The people who really need the yellow taxi for their MI are the ones most likely to say “I don’t want to make a fuss, I’m sorry to be a bother …” The great general public need to learn to take responsibility - they’ve lost the plot somewhere, but they certainly know their “rights”. I blame the nanny state myself - but there we are.
grumpy NHS spouse Says:
June 18th, 2008 at 2:01 pm

No, No, NO! NHS24 in Scotland is NOT the same as NHS direct - it is the out-of-hours triage set-up. It is for emergency use, not for a chat about what jags (sorry, jabs for the English speakers) you need for your holiday or what to do about that cough that you’ve had for a week where a normal GP visit is what is wanted. And if the magic words “chest pain” or “difficulty in breathing” crop up in the responses to the call-handler’s questions - part of an algorithm designed by people with experience in emergency care, used in loads of other places too - the computer goes “ping” and an ambulance should be allocated. Of course, it works 2 ways - the people who know how to work the system can swing it very neatly by using the magic words. Unfortunately, you can’t SEE the caller, you might be able to hear what’s going on, but until it’s all done with videophones, there are limitations to what telephone triage can do. So, which side do you err on? The people who really need the yellow taxi for their MI are the ones most likely to say “I don’t want to make a fuss, I’m sorry to be a bother …” The great general public need to learn to take responsibility - they’ve lost the plot somewhere, but they certainly know their “rights”. I blame the nanny state myself - but there we are.
grumpy NHS spouse Says:
June 18th, 2008 at 2:08 pm

Oops! Sorry - wanted to make the point but not that emphatically!!! Seems it might be a problem with your submit box though as I’m not the first to send something twice!!
The Driving Instructor Says:
June 23rd, 2008 at 3:17 pm

I won’t have guessed that they would all be classified the same category since to me as a lame man, they don’t seem to be in the same amount of danger. Good thing the whole world isn’t run completely by computers!

Shola UK Driving School
Steven Says:
June 24th, 2008 at 9:20 pm

Grumpy NHS Spouse,

I disagree with your first point. NHS 24 is NOT for emergency use, that is what 999 is for.

According to NHS 24’s website it (NHS24) is “an online and telephone-based service. We can answer your questions about your health and offer advice.”

I do, however, agree with the rest of your comment. If the caller mentions chest pain or difficulty in breathing then of course an ambulance has to be allocated, even if it annoys us ambulance crews to discover that there is no chest pain or DIB.

As you say, NHS 24 can’t see the patient, so what they say has to be taken at face value. Perhaps it’s the system at fault, but certainly not the staff.
Promoo Says:
July 29th, 2008 at 1:34 pm

/cheer
I get to use CBD
/cry
We are changing to AMPDS

I am going to have a punt that AMPDS gave them all the same Cat
Lauren Says:
August 5th, 2008 at 8:50 pm

NHS24 gets awfully confusing sometimes (and I work there!)

We are a service for people who feel they need to see a gp/district nurse/speak to a cpn/have minor surgery outside their normal surgery hours. If this is why they are calling then they get assessed (by a very experienced nurse in most cases) and a decision is made as to what is most appropriate for them at this time. Unlike NHSDirect we are the main way of accessing out of hours health practitioners - we refer patients to them directly - right down to getting their appointment time for them if they live in lothian.

However we are also an online and telephone based service who can answer your questions about your health and offer advice. This means giving advice on medication, travel health, how to register with a dentist/dr, where your nearest gum clinic and how to get help with health costs and so forth. These people only speak to a nurse if they are symptomatic, in most cases they speak to a Health Information Advisor who deals with their questions and gives them the most appropriate advice.

As to the not seeing them problem I agree, I do very little patient assessment as a lowly handler. I basically deal with people who really should have called an ambulance because someone is unconscious or has stopped breathing or has classic cardiac/stroke symptoms but even then it’s sometimes a bit tricky as you never can tell.

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Nee Naw

Nee Naw is a blog about life in the London Ambulance Service control room. It is written by Suzi Brent.

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