“Call a hambulance! I’ve eaten too many Percy Pigs and now I think I’ve got swine flu!”

I’ve just come back from three weeks’ leave and found the service absolutely inundated with calls from people who think they have swine flu. No one seems to have taken any notice whatsoever of the NHS’s advice, which is to ring your GP if you are worried that you may have a touch of hamthrax. (The only expection is if someone develops life threatening symptoms as a result of the flu, which is extremely rare and usually only seen in people who had poor health to start with). No, the general public have cleverly decided that they want to take their piggy germs to a hospital where they can spread it to thousands of sick and pregnant people and on their way infect a poor ambulance crew who will then go off sick for a week, leaving our resources even more stretched.

As usual, we are not allowed to refuse anyone an ambulance, so the crews have no option but to mask up and go in. Once they arrive and confirm that the situation is a non life threatening case of suspected swine flu, the crews just have to arrange a GP for the patients like they should have done themselves in the first place. Our protocol is that all GP requests are made via Control, because our phone lines are recorded and crews’ mobiles aren’t, so we have been run off our feet calling GPs this weekend. While we are used to making the odd call to GPs whilst getting on with our job, it is extremely dangerous to have allocators and radio ops tied up on these calls when they are supposed to be allocating and operating radios.

Personally, I’d like to see a blanket no send policy on all calls to patients with flu symptoms only unless the call has been authorised by a doctor. Call takers should just be able to say “Are you worried you have swine flu? Well, you shouldn’t be calling us. Call a GP instead.” and the patient would go away and sort out their own GP without tying us up. I can’t see that happening, though.

It is all very stressful. I never want to see another pig again. I am even off my Percy Pigs though I am sure that will pass. I just hope no one in the control room catches it, because I’m sure if they do we will all go down with it and then there will be a huge staffing crisis and I will have to do lots of overtime.

Published Jul 12, 2009 - 116 Comments and counting

116 Comments on “Swine Flu”
  1. Phoenix Says:

    Had a patient today who had rang her GP originally, who then decided to call us! Ended up coming down the MDT as ?swine flu/?meningitis from the doctor…so off on blues and twos for someone who had a curly tail and pointy ears. I hope I don't catch the flu before my hols, let alone catch it and spread it to the sick people I deal with every day.

  2. Nee Naw - Swine Flu | Swine Flu Blog on Updates Outbreaks and Cure Says:

    [...] Nee Naw – Swine Flu [...]

  3. MarkUK Says:

    I work in a school as H&S Officer (p/t until I take over two more schools in September) and first aid leader. We've not yet (as of 16.00 9/7/09) had any swine flu, but we've come close, so it's only a matter of time. The First Aiders will be the ones who have to look after the suspected patients until parents arrive.

    Can you tell me what kind of masks you are using? I can't get any guidance. Our local ambulance service have been told to put the mask on the patient (makes sense as it keeps the bugs to the infected person) but I still can't find out the type of masks I need. I'm quite willing to hit the budget for a couple of hundred. In the meantime, all we have are gloves, aprons and alcohol gel (to be kept well away from our "students" as they'll drink/eat it).

    Adults are supposedly not infectious until they are symptomatic, but that doesn't apply to kids. Unfortunately, we don't know when a child becomes an adult in this context. 12? 14? 16?

  4. Met CO Says:

    I work at the met police control room and I'm also worried in case someone comes in with it (we have a really unlogical sickness policy, so loadsa people come in when they should be at home)…because the whole centre will go down with it!

    Are you able to give friendly advice to the caller and say "you really should call your GP" or is it a case of being a robot and just asking the questions and passing for an ambulance?

  5. Met CO Says:

    I work at the met police control room and I'm also worried in case someone comes in with it (we have a really unlogical sickness policy, so loadsa people come in when they should be at home)…because the whole centre will go down with it!

  6. bbpsi Says:

    MarkUK, I am officially a completely unqualified person, but I just happen to have this link here from the CDC in the US with recommendations on the use of face masks:

    http://www.cdc.gov/h1n1flu/masks.htm

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  9. Ceeej Says:

    Hamthrax? I am so stealing and using that word..

  10. Andy Says:

    Isn't this the government's fault for that stupid tv/radio/leaflet campaign they did telling everyone that it was entirely possible that they might have swine flu. We know people don't read the details – from that point on, any illness will be swine flu regardless of the symptoms.

  11. Amanda Says:

    I had flu – badly – last Christmas. Followed the usual advice…went to bed, and was eventually woken up three days later with worried relatives suggesting that perhaps they should call a doctor. I had developed bacterial pneumonia and took weeks to recover.

    Two acquaintances, one in Scotland and one in Hampshire, also followed the usual advice, didn't bother the doctor or emergency services and died of total organ failure. One was 38 and the other 43 years old. Both left partners and children.

    On the strength of the sentiments above, they'd probably have died from misdiagnosis/neglect had they bothered contacting their local hospital (doctors' surgeries tend to close during the holidays and at weekends).

    If you find dealing with members of the public such an inconvenient chore, perhaps you need to rethink your choice of "career".

  12. Nick Hough Says:

    Hamthrax? Love that term!

    I'm also very sorry to hear about the death of a GP from Swine Flu. Sadly, I fear that Dr Michael Day won't be the last health care worker to die from it.

  13. JoePublic Says:

    Well said Amanda! Although you have to feel for Suzi, 3 Weeks leave, poor thing and having to come back to all this, how will she find the time to blog and twit. As I write this, waiting to see if my babies fever will worsen, I fear that I will soon have to trust in the advice of a suzi, unless I am lucky enough to find someone who still takes pride in what they do.
    Suzi, I believe a crisis can bring out the best in people, I suggest you take your own advice and stay at home before you infect people who take pride in the service they provide!

  14. Victor Bates Says:

    I am concerned. There does appear to be much emotion with this wine flu and so it is almost impossible to get a real information about what is the real problem. Some who are healthy are dying. Not only the people with other health problems.
    I would be very grateful for any real information. How bad is this?
    Thank you for providing this blog.

  15. Ed-Doc Says:

    Amanda, whilst I truly do sympathise with your loss, we must remember that even with relatively 'minor' ailments such as flu there comes a point where the emergency services do need to get involved. I'm sure nobody from the ambulance calltaker right through to the hospital staff would grumble about treating a person with genuinely life-threatening flu symptoms such as a very high fever or genuine DIB.

    From what I've gathered from the article, what Suzi (and the rest of us) are getting irritated by are the seemingly endless people calling 999 and coming to A&E with coughing and sneezing, in the belief they have swine fever only to infect everyone they come into contact with.

    JoePublic, I strongly believe Suzi does take a pride in what she does! Hence her annoyance when she sees a system being destroyed by what, frankly, is nothing more than stupidity and bureaucracy. I hope your baby has made a full recovery and can assure you that it is not people in need of genuine help who we are grumbling about – we want to be able to help people like you which is why we get so annoyed at people who should know better than to abuse the emergency care services for convenience/attention.

    JoePulic's mention of a crisis made me look on the bright side – maybe if emergency care becomes inundated with silly flu calls, we will get more 'common sense' powers… yeah right.

    Keep writing Suzi, I'm glad to see that you're doing so well with all of it and I apologise in advance if my views seem strong but I feel I have to make my point. Thanks for reading if you've lasted this long!

  16. Suzi Brent Says:

    I am sorry to hear of what happened, but you said yourself that neither you nor your acquiantances contacted a doctor. As I said in my post, contacting a doctor is the right thing to do. Going to A+E, especially by ambulance, is the wrong thing because it endangers others. You could give flu to a weak person who goes on to die from it or a paramedic or doctor.

    I am very annoyed by your remark that I find dealing with the public an inconvenient chore. Perhaps if you were trying to deal with calls to road traffic accidents, cardiac arrests, etc and had a constant stream of calls to make to GPs for people with flu distracting you, you'd be happy about it?

  17. Suzi Brent Says:

    What a load of nonsense. I blog and tweet in my own time (we don't even have internet access at work except on breaks), and you seem to be implying that I've done something wrong with me taking leave? I take immense pride in what I do – and what I do is dealing with emergencies. I hope your baby is okay and that his/her fever gets better – but if he/she gets worse and you really need us, you'd better pray that all the ambulances and control staff aren't tied up arranging GPs for people who couldn't be bothered to do it themselves.

  18. Suzi Brent Says:

    The NHS Choices website has some useful info: http://www.nhs.uk/Conditions/Pandemic-flu/Pages/Q… Hope that helps.

  19. Suzi Brent Says:

    Thanks and well said.

  20. lou lou Says:

    Christ there's some stupid people about! Swine Flu is contagious! Lets all call an ambulance, infect that, its crew and every other poor sick person in A&E because you're too bloody lazy or dumb to listen to the correct advice. STAY AT HOME, CALL YOUR GP – simples!
    Yes people have been dying from regular flu. Amanda you seem to be taking it out here on Suzi because you was ill and left it too late to call a doctor – who's fault is that? Suzi's? Your friends both died because they didn't contact a doctor… I'm sorry whos fault is that!? I imagine even in Scotland and Hampshire they have out of hours GP services? People don't take repsonsiblity for themselves and when the shit hits the fan it's always somebody elses fault! Yes I personally find it a chore when people simply don't want to inconvenience themselves. The advice for flu is not to take to your bed and shut down and hope it will go away!

  21. swine flu | Nee Naw – Swine Flu Says:

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  22. Kathryn Says:

    Suzi, i think you do a truly amazing job – one that not many other people would be able to handle – good on you girl and keep it up – your country needs you!!!

    I really feel for those people that have posted about their ill or deceased loved ones or aquaintances but as was so succinclty put peviously NO ONE is complaining about treating ill people, merely about treating idiots with a sniffle! Lets be nice to the kind lady who saves lives daily and remember what a hard job these poeple have to do – and hope one day we are lucky enough to have someone like Suzi around when we need her!!

  23. JoeGeneralisedPublic Says:

    There are quite obvious and excusable frustrations being demonstrated here, and despite my own rants I hope that something positive can come out of this kind of discussion for Suzi and the service.

  24. DrShroom Says:

    In defence of the public, most have never really had the flu – "I've got a touch of the 'flu" invariably means common cold – so this really does seem like the coming of the Aporkolypse; also, if services are anything like they were on South Coast last night, NHS direct wasn't answering, and neither was the Swine Flu hotline, and GPs weren't coming out, leaving many worried, well or not, with nowhere else to turn.
    That having said, I think it is disingenuous to interpret comments born of frustration as indicative of not caring. Sadly, resources to formally assess everyone with 'flu like symptoms just aren't there, and inevitably some people will get missed / misdiagnosed. This isn't because we don't care.

    Slainte

  25. salari Says:

    well, I'm now recovering from hamthax (great name, must remember to use it). I followed NHS advice, rang Dr, told to stay home, drink plenty, call if you get worse. To be honest, it was no worse then regular flu (had it once before about 4 years ago – ick). I wouldn't have thought of ringing an ambulance for either strain of flu – after all, it's not an accident or (hopefully) an emergency – I might feel like poo, but I'm not activly dying there and then. People need to have some sense when accessing HNS services – mind you, I wonder if the choices now available are a bit bewildering???

  26. meninyellow Says:

    salari, I think you have hit the nail on the head. There are too many choices and all those who know their rights, but not their responsibilities take the easiest option and don't even think (or care) if it is the appropriate option. I find it hard to think of any situation where a viral infection can constitute an emergency, which is what 999 is for.

  27. Flora Gardens Says:

    As a member of LAS road staff [ie working in ambulances] I have to say that a large number of the public have absolutely NO common sense whatsoever. ____We are being called to entire FAMILIES – four or five people – with swine flu symptoms. What is worse is not only being called when these people have had these symptoms for several days, but also that they decide to call at 3 o'clock in the morning on a Sunday!!! ____No blame attaches to either the sector staff who dispatch us, or the call takers – both have no choice in what they do. The public are – as a rule – completely incapable of self-help. Furthermore, GPs who recommend patients call an ambulance whe it's totally unnecessary do not help one little bit!!!

  28. gandalfranks Says:

    just getting over my little stint of hamfraxs not so bad!!!!!! FLU IS FLU H1.N1 IS ONLY A FLU!!!! WHY YOU PEAPS HAVING A BOP AT THE PERSON THAT GAVE YOU THE FORUM TO BITCH LEAVE THE LASS ALOE…..

  29. jac Says:

    Hi like the site would just like to say having looked at the nhs direct website the final advice given says call 999 ask for an ambulance perhaps government services should commuincate with each other!

  30. Suzi Brent Says:

    Where does it say that? I had a look and can't find it. The advice I found was:

    " What should I do today if I think I have swine flu?

    * Read up on swine flu symptoms then use the NHS Direct swine flu symptom checker
    * If you are still concerned, stay at home and call your GP who will be able to provide a diagnosis over the phone. Use our service search to find contact details
    * If swine flu is confirmed, ask a healthy friend or relative to visit your GP to pick up a document entitling you to antiviral medication
    * They will then need to pick the medication up at a collection point your GP will advise on (a local pharmacy or similar) "

  31. someone Says:

    mmm So many people tying up the ambualnces I had to go without today when I wanted one… Please listen to Suzi when she says stop calling us with flu!

  32. padpaws Says:

    Absolutely, I work in a school and I love my kids (most of the time) and we have had an out break, and I am shocked at some parents who will still send thier child into a public place when th e child has suspected swine flu, get a doctior involved for advice and monitoring is a definate, having realistic preventive methods is also essentilal…sorry to hear about acquaintances, but suggesting that they should not get ambuances to places where people are sick and are at most risk of swine flu is irersponsible.

  33. Ed-Doc Says:

    Hi Again,

    Just out of interest Suzi, is there anything that you can see LAS are effectively doing to combat the difficulties caused by the influx of calls? Or is it just business as usual? If not, can you see any way of easing the situation? Clearly educating the public won't work as there will always be some who for whatever reason will call 999 regardless (don't intend to be judgemental with that comment, it's just a fact of life) so is there anything else you can see would work?

    It would be interesting to hear everyone's views (sorry if it seems I'm hijacking your forum Suzi!!)

    Ed-Doc

  34. Suzi Brent Says:

    Personally, I'd like to see a "just say no" approach – we could kindly and politely say to callers that we are not sending to people with flu of any variety unless there are immediately life threatening conversations. We could also help them by repeating the advise from the NHS website and giving them GP numbers to call. I don't think the LAS would ever do this, though.

  35. WWo Says:

    Tonight on BBC told , that 500 people will die in UK every day of Swine flu

  36. Andy Says:

    if I may dare to suggest – if you "had to go without an ambulance", then perhaps the reason you wanted is wasn't life-threatening?

    If it had been, an ambulance would most definitely have been sent.

  37. Andy Says:

    if I may dare to suggest – if you "had to go without an ambulance", then perhaps the reason you wanted is wasn't life-threatening?

    If it had been, an ambulance would most definitely have been sent.

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  39. Ed-Doc Says:

    Yeah, sounds like a brilliant idea. The only thing I can see working (as I very much doubt LAS would introduce a no send policy) is to have dedicated practitioners (of some sort ie. Not necessarily the already stretched ambulance service) sent to suspect flu cases for a spot of sympathy, and to check that nothing worse is going on.

    At our end of things, I can only suggest a similar thing: dedicated flu clinics for suspected cases so they aren't infecting more people than absolutely necessary. This could hope to reduce the effect on EDs so they aren't suddenly inundated with swine flu cases and will reduce the number of seriously ill people the infected come into contact with.

    Easy to say these things I'm sure but I'd hate to be the one to implement them!!!

  40. Tom Says:

    Love the reference to hamthrax. Excellent.

    My wife and I, several years ago endured an unpleasent bout of flu. Naturally, my wife had the normal strain, while I was struck down with man-flu (a combination of flu, rabies, dengue fever, and a sprinkling of cancer) which was very nasty.

    I think that the stoicism prevelent just a generation or so ago is gone, and the population is being, what? I-rasher-nal in their expectations of the emergency services.

    Keep up the blog and good work Suzi.

  41. George Says:

    I have mild to moderate COPD. I live alone, and have no friends or relatives that would be able to fetch and carry prescriptions, medicine, oxygen or anything else for me in case of illness.

    What am I supposed to do if I get the flu, accept that as a COPD sufferer my chances are minimal anyway, and so can expect to be triaged straight to a mass grave?

  42. Ellie Says:

    I would imagine that you would be, with the elderly and underlying health issues type people and to whom Suze and any other ambo staff would dispatch to as people who deal with illness on a daily basis tend to have a more appropriate veiw on what is severe and requires immediate care and what they can 'sleep off'.
    i have to say that this is not always the case though.
    people are scared because of all the press ive even heard it related in a similar vein to The Black Death!! i mean come on peoples. Even if you think you have it and really feel the need to call an ambulance stop and think – if there is a baby somewhere who could die if an amublance comes to me instead decide if you could live with that and then if you still feel the need for an amulance call one. They are not a taxi service people! i have been to A&E many times with anaphylaxis. broken limbs and a brusied (felt like broken) spine only once via ambulance as i live less than 10 minutes away – i still feel really bad for taking up the ambulance when they found that i would be ok with bed rest anbd painkillers.

  43. ED-Doc Says:

    My advice would be to follow the standard instructions (from the NHS Direct website). The stage you have highlighted as being difficult would be the collection of a certificate of illness and the collection of medication as you have nobody to do this for you. A doctor would be able to visit your home if you are housebound and should be able to give you the certificate there and then. I have read that the Red Cross may deliver medication to you if necessary and I know that many pharmacies offer a delivery service.

    All I would stress is that you would be left with many of the same problems if you called 999. The only reason we ask people not to collect medication in person is so that they do not infect others: such as those you will be packed into an ED waiting room with!

    Obviously, as a COPD sufferer you will need to be far more cautious with 'treating it lightly' as the pandemic so far appears to have far more serious consequences in those patients with underlying medical conditions. My rule of thumb would be only to call an ambulance when you would under normal circumstances e.g. serious chest pain, difficulty in breathing etc etc. I also suggest that if you are unfortunate enough to need the emergency services that you let them know first that you possibly have swine flu!! No need to infect more health workers than necessary!

    Hope this has helped and if you have any further questions, I would be happy for you to post a reply, or you could call your GP and arrange a chat with him/her to discuss your concerns.

  44. lou lou Says:

    I imagine George a Dr or district nurse would be arranged to drop you around your meds. So if it happens, which I hope it doesn't, the advice for you is the same as for everyone else, contact your GP. A GP would of course review your COPD and if you have an acute exacerbation you may need to be admitted to hospital, in which case the GP would arrange an ambulance. I wouldn't have thought there was any need to panic or be thinking about mass graves…

  45. Suzi Brent Says:

    Some good replies already – I agree, if you get the flu, phone the doctor like everyone else. If your breathing gets bad and it becomes an immediately life threatening emergency, call 999 and get the ambulance you need. I hope you are okay.

  46. Suzi Brent Says:

    Way to make everyone panic! It's nowhere near that bad yet and I doubt it ever will be. Also, remember that thousands of people die from flu every winter anyway.

  47. Suzi Brent Says:

    I agree with Andy. It *could* get to the stage where people die because of inappropriate swine flu calls taking up the ambulances, but at the moment all appropriate calls are getting ambulances.

  48. Tom Says:

    George

    I meant no offence, and belive that you fall into the category of htting the 9's.

    If you reside in Ashford in Kent, consider yourself armed with a helper, as I will gladly fetch and carry for you should you need it.

    My name is Tom, and if you live in Ashford, my number is 01233-331913.

  49. jac Says:

    Hi please don't be negative, curosity was on my mind as a good friend's husband and child have 'suspect swine flu' quoted by a gp.i went to the nhs direct site completed the questionaire to the worst of my ability and to my shock horror it alerted me to saying call 999 ask for an ambulance, i personally wouldn't dream of doing that as i have many friends doing great jobs within the government services, it would be a waste of resources. However media coverage of calling your gp has really only come to the forefront in the last week. I'm perfectly capable of making a realistic decision of when i may require 999 assistance. thanks suzi.

  50. Suzi Brent Says:

    Sorry, didn't mean to be negative, was genuinely confused as to where you'd found that information. I've noticed before that NHS Direct have several trigger questions which end up with you getting an ambulance, so I am guessing when you filled the questionaire you said yes to one of them and that's why it recommended an ambulance. Not because of the swine flu itself.

  51. Central medic Says:

    George, as a COPD sufferer who is calling up with DIB, or pretty much any other unusual symptom, you will receive not only an ambulance, but almost certainly also (in London at least) a firts responder within minutes, to assess you and start any necessary treatment before the ambulance arrives. I hope this reassures you.

    As some others have mentioned (but I'd like to get it off my chest too), it is highly frustrating (me ambo man too) to hare across town on blue lights and sirens, to a normally healthy person who feels a bit shivery, and has a bit of a temperature (and is possibly under two duvets, in a greenhouse), who didn't think to have any paracetomol, but called us instead. This effectively prevents us from being any use whatsoever to the heart attack or car crash that's happening around the corner for a bit.

  52. loopyloola Says:

    There is a specific MPDS protocol that allows for reduced response in the case of pandemic flu. My understanding is that LAS are waiting for the DoH to declare a pandemic and the medical director to authorise the usage of this protocol. Been off for 2 weeks so it may be in place now or very soon

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  55. Hammo Says:

    I understand what you are all saying, but i rang my doctor because my husband baby and I have it too, we were told we could not have Tamiflu though because it was for high risk patience, and I have to wait until my baby is really really ill, he already has a high temperature, not eating, looking dazed, but he said for him to get Tamiflu for a 5 month old was a lot of work because he would have to seek permission from the medical council, then cut down the amount of Tamiful and administer it himself, I got the feeling he couldn't be bothered. He told me to wait until his temperature was over 39, but also said when the practice closes as 6pm after that I need to call NHS direct but they have a 7 hour waiting list because of everyone calling them. So please tell me what am I supposed to do just leave my baby and hope he is ok, or call for help. Its ok saying all these idiots ringing in with a cold, but with the people who have already died from it, do you think they thought they were going to die, no they didn't. People are only being concerned for the welfare of there loved ones and the welfare of themselves. I understand what your saying and that you get frustrated, but if someone is too ill to get to the hospital then they need your help. They may not be going to die from it, but they may be in agony with it and with all the reported deaths they are obviously worried.

  56. Suzi Brent Says:

    I understand your frustration – but please, please don't call 999 or go to A+E just because there is a long wait for the GP or NHS Direct. People should not be going to the hospital unless a GP tells them to or they have developed immediately life threatening symptoms. I know just watching your baby and waiting for him to recover must seem like you're not doing enough, but it really is the right thing. Imagine how you'd feel if you took him to A+E and there happened to be a weak, disabled baby in there at the same time for something else, and she caught swine flu and died from it. No, the people who died from it didn't think they were going to die, but you must also remember there have only been two cases of previously healthy people under sixty dying from it and try not to panic. Also remember that in a real emergency (like if your baby is unconscious, turning blue, or heaven forbid stops breathing) we will be there to help you like a shot. But we're there for emergencies that have actually happened, not to prevent them happening.

  57. lou lou Says:

    People who call for an ambulance with swine flu will usually have a ring back arranged through NHSD anyway. All you've managed to do is tie up the emergency services arranging NHSD for you when you could have done so yourself. If a GP or NHSD feel it warrants it – they will arrange an ambulance. Again even though you get an ambulance, if your symptoms are non life threatening I imagine you will be left at home where you can not go on and infect other people. People are panicking. Thousands die every year from illnesses related to regular seasonal flu you know! Hospitals do not need people spreading their germs to others with serious health problems.

  58. Anon Says:

    Up here in northern Scotland the out-of-hours GP service is often not staffed, which means you get transferred to NHS Direct.

    Depending how you answer their questions, you either get told to see your GP during surgery hours or you get the ambulance—if it's available, which it's often not as it covers a large geographic area.

    And that's not as sensible as it might sound—the scripts NHS Direct work from are a bit daft so you can be seriously ill and get no help, or have something minor and get the ambulance.

  59. photo Says:

    at least you arent a pregnant woman with swine flu :)

  60. AmdEMD Says:

    SECAmb are still waiting for the go ahead too.

    I cant see us telling people they wont be getting an ambulance, I think we will just work our way back up the REAP Levels.

  61. loopyloola Says:

    It is in use in West Midlands, would be interesting to hear how their staff are finding it.

  62. MarkUK Says:

    And if you are, who do you believe? The midwives and the NHS website, or the minister?

  63. metal-bijou Says:

    @ Flora Gardens: To be fair, you will only see either the ones requiring real aid or the "NO common sense whatsoever" families as us sensible individuals won't cross your path. And frankly I'm insulted to be branded as no common sense as I'm a member of the public.

  64. metal-bijou Says:

    @ Flora Gardens: To be fair, you will only see either the ones requiring real aid or the "NO common sense whatsoever" families as us sensible individuals won't cross your path. And frankly I'm insulted to be branded as no common sense as I'm a member of the public.

  65. chris Says:

    Your cynicism, for a suposedly caring service, is astounding.

  66. Suzi Brent Says:

    I was far less cynical when I started the job. Five years of being confronted with the world's most selfish, stupid and rude people wore me down.

  67. Promoo Says:

    Ahhh the joys of swine calls. We in our control room are very very very happy that to have an ECP hanging around to erhumm advise callers of the whole “call your Gp thing” ….. and as we have a bit more scope with our callers we can question further and “suggest” they contact OOH GP.

    /me hugs CBD .. not looking forward to AMPDS

  68. Promoo Says:

    Ohh just to add to that ..anyone who appears to be “at risk” will *always* be sent an ambo

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  70. Cameron Says:

    Lots of interesting comments here… Just one question – so what does one do if one has absolutely NO confidence whatsoever with your GP?

    I ask because a close relative who has recently had surgery for lung cancer had a heart value replaced around a week ago wanted to see his GP as he was showing signs of heart failure – fluid retention around his legs and middle and SOB. GP didn't want to come out – relative has no transport. Had to ask a neighbour to run him down to GP who just told him to increase his duiretic medication and 'come back tomorrow'. Result – a 2am 999 call as his breathing had become worse and a 3 night stay in hospital whilst they addressed the fluid retention.

    Result – no confidence in GP who had previously diagnosed his lung cancer as 'asthma'; and don't get me started on the Out of Hours GP service – now THERE'S a story…..

  71. Michael Says:

    If you don't have any confidence in your GP – change your GP. Whether there's an outbreak of swine flu around or not. I work in A+E, and there are plenty of things that a GP can arrange and co-ordinate that we can't. The ambulance service and A+E are not alternatives to primary care!

  72. Cameron Says:

    That's fine if you have a choice. We've already changed surgeries once – and there's not a huge choice.

    The relative I refer to could change but I suspect he won't (more out of habit than anything else given that he's in his 70's) and would still get saddled with the same OOH service, so not alot to be gained there.

    Michael – are you suggesting that at 2am, when a pt has decompensatory heart failure (which has nearly killed them once already – 3 days in ITU and 3 weeks in hospital) they should be calling the OOH service rather than using 999?

    All you health professionals out there might think patients are 'stupid' for using the Ambulance service rather than a GP or OOH service, but when you nearly lost your life because one of them didn't act appropriately, it does change things. When I spoke to the Ambulance service in the relative's area after the incident where he nearly died, I was told that it was OK to call and that if it wasn't appropriate, they would tell us.

  73. Suzi Brent Says:

    if it wasn't appropriate, they would tell us

    Sadly, this isn't true. I think it *should* be the case, but in fact we are not allowed to refuse anyone an ambulance or tell them that their call is inappropriate.

    I think Michael meant that people should be calling the OOH for swine flu, not for heart failure! Of course if you think it is a life threatening emergency, you should call 999. There is a world of difference between making an "inappropriate" call that you genuinely believed to be appropriate and making one because you're not satisfied with your GP.

    A lot of the time when people call us instead of calling a GP, we end up referring them to the GP anyway, because what they really need is a prescription or long term care, and ambulances can't help with that.

  74. Andy Says:

    Best one today was a woman who'd gone through the swine flu checklist on the internet. At the end of it, it told her to call 999 – which she did, saying she didn't want an ambulance, she'd only called cos the system had said to, and wanted to know where she could get better advice…..so she was sent an ambulance that she didn't want (it was an Amber call)

  75. Hammo Says:

    Just wanted to update mine, i kept ringing the NHS helpline like it says and there was a 7 hour waiting time, i waited and they said there was nothing they could do for my month old baby, just ride it out. i then called my doctors and demanded he see a doctor and he was looking/ acting ill. We went and the doctor just made snide remarks "Little Benjamin is wandering what all the fuss is about", I felt like saying no he isnt he's thinking im in pain and need help. She told us nothing wrong with him, go home. We did and later that night he all limp and we couldnt wake him, we immediatley called 999. After a 4 day hospital stay and many tests and swabs, it was confirmed as Swine Flu and almost Hyperfirmia. I followed eveything by the book at the beginning, rang the GP times, rang NHS Direct twice, WE WERE TURNED AWAY FROM THEM ALL….. So for you to say the ambulances should think about turning people away just amazes me.

  76. Hammo Says:

    Suzi you seem to have misread what i was saying, i wasnt saying i was going to ring an ambulance etc because i could not speak with NHS direct, i actually did everything by the book, i spoke to them twice.What i am trying to say is that if the doctors had done there job at the beginning by giving my son medication we would not have had a terrible night when my son failed to wake and went completely limp and unresponsive. I tried and tried but got no where, so because they were not doing there jobs, my son became really ill, his temp went from raging high down to 34 and under, he was freezing to touch and sweating badly. In the hospital they had to give him 10 blankets to try and get his temp up. he has been on antibiotics and tamiflu for 5 days, So if doctors had helped when we asked them we would not have needed the help of an ambulance. There to blame not us.

  77. Hammo Says:

    Ive never written on a so called blog before but really felt the need to when i came across this site. I can see both sides, but if an ambulance had not turned up the othernight i dont know what we would have done, and dread to think what would have happened to my beloved baby. Im just so glad they sent one.

  78. Suzi Brent Says:

    So glad your baby was okay. I'm sorry you didn't have a good experience with the GP. To be fair, they had no way of knowing that his condition would get worse and they can't send everyone to hospital who has swine flu because of overcrowding and risk of spreading the infection further. It sounds like you rang 999 at just the right time. Just to clarify, I was not saying they should turn *everyone* with swine flu away – a limp, unresponsive baby should ALWAYS receive an ambulance (whatever the cause) but they should, in my opinion, start turning away those who just have a regular case of the flu and no life threatening symptoms.

  79. Suzi Brent Says:

    So glad your baby was okay. I'm sorry you didn't have a good experience with the GP. To be fair, they had no way of knowing that his condition would get worse and they can't send everyone to hospital who has swine flu because of overcrowding and risk of spreading the infection further. It sounds like you rang 999 at just the right time. Just to clarify, I was not saying they should turn *everyone* with swine flu away – a limp, unresponsive baby should ALWAYS receive an ambulance (whatever the cause) but they should, in my opinion, start turning away those who just have a regular case of the flu and no life threatening symptoms.

  80. Sewmouse Says:

    As usual, the folks who NEED to hear that they're abusing the system aren't concerned in the least and don't think this post applies to them. The folks who have legitimate need for immediate medical care, on the other hand, take the caution personally. Seems this is a universal problem. Happens here where I work too, albeit not in a medical sense.

    While it certainly is your right to healthcare – a bit of personal responsibility can go a long way. Having driven myself to the hospital twice while in severe distress (once having chest pains as a gallstone passed while 6 months pregnant, once with a blood clot in my lung (pulmonary embolism) and in my leg (deep veinous thrombosis)), I find it amazing in the extreme that folks over there will call an ambulance for a broken toe or a case of the sniffles.

  81. Cameron Says:

    Maybe the way this Ambulance Service is different to the way in which LAS works?

    If you can't trust a GP to recognise the symptoms of heart failure and act appropriately, then it's a pretty sad state of affairs! I know that these people aren't happy with the GP service they've received and frankly it sounds pretty dangerous to me….

    I guess what needs to be tackled is the REASON why people choose the Ambulance service rather than the GP for minor problems, long term care etc etc?? Until this happens, then you'll continue to be frustrated and p'd off. If ALL primary care was of high quality and met patients' needs then they wouldn't be calling 999 – would they??? ;-)

  82. Cameron Says:

    How awful for you – as a parent I know that these experiences dent your confidence in the GP service. Personally I would complain. There's no excuse for patronising comments and bad advice.

  83. ED-Doc Says:

    Hi Again,

    I think the (justified, in my opinion) anger of some of the posters here needs to be used for good rather than ranting at medical staff (such as myself and Suzi) who always have the best interests of our patients at heart, whatever you might believe.

    Hammo, I'm also so glad that your baby is OK. I'm just wondering (and certainly not criticising so don't get me wrong) what was your child's temperature before his episode in the night? Were his symptoms being treated? (ie. with ibuprofen/paracetamol for temperature and close monitoring of temperature to prevent hyper/hypothermia)

    Andy, I think your relative's GP reacted entirely appropriately. The symptoms you describe of fluid retention and shortness of breath are (in short) caused by an increased blood pressure affecting the way the kidneys work, thus causing fluid retention. The difficulty in breathing was likely caused by fluid being retained on the lungs. Whilst this may sound scary, it is not immediately life threatening. However, your relative acted, in my opinion, correctly by coming to the ED when he thought his life was at risk – not before because he thought it might be. It's a sad fact, but this is the way the system was designed – to be there when things have already gone wrong – not to prevent them.

    I think a problem the comments have highlighted for me is the poor management of primary care in the UK. I can see a nationalised scheme of out of hours doctors connected to the ambulance service being the only way to alleviate a lot of confusion surrounding the services. It is, however, important to remember that the GP services in the country are currently under great strain – being told not to let anyone with flu-like symptoms within 10 miles of their surgeries – so are having their ability to compromise between care of the individual and care of the community tested to the limits.

    Thanks for reading, just my opinion as usual so feel free to highlight anything you want to discuss :)

  84. ED-Doc Says:

    Hi Again,

    I think the (justified, in my opinion) anger of some of the posters here needs to be used for good rather than ranting at medical staff (such as myself and Suzi) who always have the best interests of our patients at heart, whatever you might believe.

    Hammo, I'm also so glad that your baby is OK. I'm just wondering (and certainly not criticising so don't get me wrong) what was your child's temperature before his episode in the night? Were his symptoms being treated? (ie. with ibuprofen/paracetamol for temperature and close monitoring of temperature to prevent hyper/hypothermia)

    Andy, I think your relative's GP reacted entirely appropriately. The symptoms you describe of fluid retention and shortness of breath are (in short) caused by an increased blood pressure affecting the way the kidneys work, thus causing fluid retention. The difficulty in breathing was likely caused by fluid being retained on the lungs. Whilst this may sound scary, it is not immediately life threatening. However, your relative acted, in my opinion, correctly by coming to the ED when he thought his life was at risk – not before because he thought it might be. It's a sad fact, but this is the way the system was designed – to be there when things have already gone wrong – not to prevent them.

    I think a problem the comments have highlighted for me is the poor management of primary care in the UK. I can see a nationalised scheme of out of hours doctors connected to the ambulance service being the only way to alleviate a lot of confusion surrounding the services. It is, however, important to remember that the GP services in the country are currently under great strain – being told not to let anyone with flu-like symptoms within 10 miles of their surgeries – so are having their ability to compromise between care of the individual and care of the community tested to the limits.

    Thanks for reading, just my opinion as usual so feel free to highlight anything you want to discuss :)

  85. ED-Doc Says:

    Oops – sorry – turns out I was flicking through the comments too quickly! "Andy" in the above post should read "Cameron." Apologies for any confusion!

    As a final note, Hammo, a line from one of your comments absolutely satisfies me that you were justified in calling an ambulance: "if an ambulance had not turned up the othernight i dont know what we would have done, and dread to think what would have happened to my beloved baby. Im just so glad they sent one."

    The words "I don't know what we would have done" – that's why we go to work, and I think I can speak for just about everyone in emergency care when I say that :) Hope your baby's still doing fine :)

  86. Cameron Says:

    Hi ED-DOc – thanks for your comments. What I will say in realtion to them is that as someone non-medical it's hard to know when you have reached the stage where you HAVE to be in hospital. If you've seen your GP who tells you that you're OK, at what point do you decide that you're not?? When you collapse? What do you do if you live alone? Lots of people don't like to trouble the doctor and surprisingly many do do exactly what they're told.

    One of my sons has had a couple of nasty Croup attacks – I took him to a UK GP when he was gurgling away and making a horrible rasping noise whilst breathing and she decided not to treat him with anything – and I can tell you that it's not easy trying to work out if your child is going blue or dribbing in the middle of the night and you live a 30 min drive away from the nearest A&E dept. It's not even remotely amusing!

  87. Fed Up Says:

    I work within another ambulance service and myself and my colleagues are almost at the end of our tethers now dealing with swine flu calls.

    Dont dial 999 if you think you have it WAIT for nhs direct to call you back even if it does take a few hours, unless your having severe breathing difficulties.

    Tamilfu isnt a miracle cure, you will still have symptoms after you finishing taking the course, dont dial 999 again

    I have heard of Dr's dialling 999 for an ambulance because they have it and still feel unwell after taking tamiflu, they should no better.

    I am angry with the government and the media as well because not once have I seen either of them say dont dial 999.

    Sorry rant over

    P.s. Thanks suzi for blogging about things like this

  88. helen Says:

    Amanda, you didn't have flu. You had bacterial pneumonia. Flu is caused by the influenza virus, and as the name implies, is viral not bacterial. Both absolutely horrid, and very often fatal; neither what joe public insists on referring to as 'a touch of the flu' and half the reason the response to this current epidemic is so skewed.

  89. helen Says:

    eek, sorry, i've just noticed one of the above commenters is using the name JoePublic – my use of the term joe public was just in its usual meaning, 'punters on the street' and not a specific reference to this commenter.

  90. helen Says:

    Viral meningitis would be the main common one I can think of

  91. helen Says:

    the 'self diagnosis' questionnaires are great! we were trying to use one once to work out if my boyfriend had symptoms of appendicitis (turned out just to be particularly awful gas!) and had a little fun (in between our panic!) spotting the 'is dying of a heart attack' questions and the 'has only got a hangover questions'….or for women 'is blatantly preggers but doesn't know it yet'…

  92. helen Says:

    the 'self diagnosis' questionnaires are great! we were trying to use one once to work out if my boyfriend had symptoms of appendicitis (turned out just to be particularly awful gas!) and had a little fun (in between our panic!) spotting the 'is dying of a heart attack' questions and the 'has only got a hangover questions'….or for women 'is blatantly preggers but doesn't know it yet'…

  93. hele Says:

    i tend to find that those of us that work in the health service are the most cynical. We spend all our working days dealing with whatever is thrown at us and inevitably, when we get off shift, are a bit world wearied. My mum says psychiatrists are the world's least sympathetic people, for perhaps the same reasons.

    I think if these posters had read anything more than just one of your posts it would be abundantly clear to them just how much you do care.

  94. Tinker2 Says:

    Hi ED Doc,__As a frontline ambo bod, a lot of our problems are with the people who are not registered with a GP, can't register, won't register attitude from some for whatever reason, they call 999. Ok for the visitors with travel insurance, but others are abusing the NHS and my washing bill has escalated!! But every time I go with a smile, help and advice, and scream quietly after we have sorted them out. As for OOH GP's, we know who is on duty….the good GP's don't call us unless there is a REAL medical emergency. :)

  95. molliemallone Says:

    You've just answered your own question then really haven't you Hammo (BTW, really glad that Benjamin is ok) but as you say, lucky an ambulance turned up when it did. Imagine if all the available ambulances had been tied up with Mickey Mouse jobs whether related to the swine flu outbreak or not?

  96. ED-Doc Says:

    Hey Cameron – no worries. It's a hard judgement to make when to decide you have to go to hospital and one I see people make wrongly every day – but if it's with the right intentions I don't care.

    Again, you've highlighted a good point here: those so ill they are at risk of collapse, especially those who live alone. That is a group of people I would have absolutely no qualms about having in the ED (though the bed manager might see it differently!) as if the worst happened and they did collapse, who knows how long it could be before help gets to them. So I would say, personally, I would be calling an ambulance when I thought my life was immediately in danger (e.g. chest pains, severe difficulty in breathing) or when there was no other option (e.g. I'd badly broken my leg – can't see a taxi journey being much fun at all!)

    Also, whilst I can't advise on whether the GP's decision was correct, I do know that whilst the cough and stridor (rasping noise) can be alarming, the condition usually takes care of itself. The only treatment option possible is to give a patient corticosteroids but their use is still somewhat controversial as there is no evidence they work in the outpatient setting though their benefit is firmly established in hospitalised patients.

    So just to reiterate what I was saying, it must be hard to judge when to take a sick child to hospital and when to call an ambulance (fortunately I've never had to do so). I don't mind if you come to ED when you don't need to, I'd rather you did that than have a child become seriously ill because you were afraid you'd trouble the hospital staff – it's what we're here for (though people can take this to extremes, at the end of the day, it is!). Please, all me (and I think Suzy) are saying is please consider your other options before simply dialling 999/going to A&E just because it's the easiest thing to do. And you seem like the kind of guy who does that so I wish you all the best :) Please comment back if you want to discuss anything further.

  97. LittleMissAlien Says:

    Viral meningitis is rarely fatal. Bacterial meningitis is the time-sensitive one. You can't even be given antibiotics for viral meningitis as there's no bacteria to kill. I've had viral meningitis twice – first time (aged 5) my parents called the out of hours GP and then took me to hospital in the car, the second time (aged 18) I thought I had a migraine for a week before I let my Mum get the GP and was diagnosed again, this time staying at home, no hospitalisation needed, especially as I could infect others. Both times I was very ill for 2-4 weeks, then took several months to recover, but there was nothing else that could be done other than rest.

    On a personal level I would not consider an ambulance for any suspected meningitis, simply because although the ambulance would get through traffic faster, you have to wait for it in the first place. If it were my partner or son I'd rather bundle them in the car and get going instead – where I live I'd get to A&E by car in the same amount of time it would take an ambulance to get to my home. But I have had experience of it, which I guess could account for my views.

  98. LittleMissAlien Says:

    To be honest that sounds similar to the advice I received – my son had his second birthday 3 weeks ago and had swine flu at the same time. His temperature was 39.2 when I rang NHSD and was told there was a 4 hour wait for non urgent calls. As he was only 2 and had a high temp we had a call back within an hour. However, we were told not to go to A&E unless his temp went up to 39.5 and to just try to give him calpol in the meantime. We followed this advice and by the morning his temperature had gone, and a week later was back to his usual self. You wouldn't even know he'd been ill now. Funny thing is my partner and I haven't caught it off him, and I'm also NHS staff, working in schools with lots of swine flu.

    It IS scary, as a mother I can totally sympathise with you, but going into hospital with your baby would only serve to infect others, there's nothing there you can't do at home – rest, drink plenty etc. (I have plenty of hospital experience and would prefer to rest at home any day – hospitals aren't great for getting rest!). Tamiflu isn't a cure either, it only reduces symptoms by about a day and carries many other health risks. I wouldn't have given it to my son (calpol did the trick just fine), and my partner and I have both opted to not have it if we get ill. Lemsip will suffice in this house if we begin oinking.

  99. Aussie ED Doc Says:

    That's complete and utter crap. It's a media beat up.

  100. Aussiedoc Says:

    Out of 10 patients I saw on my last shift – 8 were mildly ill with flu and worried about swine flue and dying.

    Two were genuinely unwell.

    I blame the media.

  101. Cameron Says:

    Hi ED Doc – thanks for your comments. I've just found out that my relative with heart failure is now on 160mg (!!!) of Furesomide to control his odema. I'm not medical but having looked up the normal dose on the BNF online that's a BIG dose. When you're dealing with someone who has almost died and spent some time in ITU I think it's only sensible to be careful, particularly when they're only just over a week post-surgery… I think the fact that he then spent a further 3 days in hospital justifies his admission. I can't see a taxi wanting to take a very sick bloke who can't breath properly into hospital at 2am!

    Personally, I think it is better to treat issues appropriately at an early stage – costs less money and is safer for the patient – than to only admit those on their last legs who require greater input and more aggressive treatment. It you view hospital care as a last resort you'll end up with lots of very sick people with additional health issues as a result of not having given the appropriate care at an early stage.

  102. ED-Doc Says:

    Hi Again,

    I absolutely agree with you that issues need to be treated appropriately early on and I think this is a huge failing in either the way our primary care system works in this country or perhaps a cultural misjudgement. If you don't mind me using the example of your relative once more, you were right to go to the GP when you did. They may or may not have been right to send him home but we'll give them the benefit of the doubt. I think we need an additional stage between GP and Emergency Department, which is what the out of hours doctors are supposed to cover but frankly, even I find the system mind boggling at times!

    I suppose what I'm saying is that whilst your relative did need further treatment, it may have been the case that he didn't, in which case it would probably have been better for him personally to have a practitioner (be they a doctor, nurse or paramedic) visit him in his own home than for him to have the inconvenience of a trip to A&E, risking picking up goodness knows what illnesses. Therefore, I think the current system we have needs a bit of an overhaul really, with paramedics being encouraged to assess and refer to out of hours doctors etc.

    That actually brings me to a question I have for Suzy or any other ambulance staff here as they're so run off their feet it seems nearly impossible to catch five minutes with one these days! Do you think that if the ambulance service were allowed to refer/refuse transport to patients it would make a significant difference to the strain on the service?

    Thanks :)

  103. KHH Says:

    But an ambulance will quite possibly be able to give penicillin there and then, and will get ?meningitis seen on arrival at A&E, without you having to wait to queue up at reception, book in, wait to see the triage nurse etc.

  104. Cameron Says:

    Hello – thanks for your comments – the relaive is loath to use the OOH service because it was so cr*p the last time they used it. Basically the GP left the pt at home when he should have been taken to hospital promto. He wasn't told to ring the OOH back or 999 if his condition changed which it did and his heart failure resulted in an acute episode of decompensation and then the 3 days in ITU and another 3 weeks on a cardiac ward. His condition was 50/50 at one point. Lots of failures along the way, as is often the case, I gather.

    I don't honestly think that the GP is equipped to manage pts with lots of different complex health needs – that's why Drs specialise. The OOH service can't access the pt notes so doesn't get the complete picture. All in all not a very safe or satisfactory system!

  105. Margo Says:

    I hope your baby is better now. For others in a simialr situation it may also be worth remembering that, as I understand it, there is no research as to the effect of Tamiflu on babies or young children

  106. D.d Says:

    Funny thing is, whenever I have had a child ill with something I am worried about – infection during chemo treatment, etc etc – while waiting to see if they worsen or improve, I have NEVER found time to go and read a blog – let alone comment. Perhaps rather than being sarky to Suzi, you should be spending time with your babies?

  107. D.d Says:

    To add to your comments about Calpol doing the trick, it sometimes does not do it on its own. On Doctors advice, have in the past when the temperature of my small son was over 39 – and his is normally 35.5 – given Calpol (paracetamol) 4 hourly with ibuprofen 2 hours after each dose of Calpol. This combination has worked.

  108. Aoife Says:

    i love that quiz because I have underlying health problems that means my day-to-day condition requests I call an ambulance at pretty much every stage (chest pain, intense headaches, sensitive to light, non-blanching rash, sore neck et cetera).

  109. Tinyp Says:

    I fall into the very high risk category. I am also a teacher and two children I taught were dx with swine flu the next day. In what I hope was a responsible manner, I rang my specialist who asked me to speak to my GP and to start Tamiflu as a precaution.

    Am a tad annoyed at people who have got, well, annoyed. It's really quite clear that the point of this blog is that people who call about swine flu when whatever they have is NOT LIFE THREATENING are the people who are winding Suzi up.

    If it's not life threatening you don't need an ambulance. If you phone one and your condition is not life-threatening, you are lessening the chances of survival of someone whose condition is at that very moment, critical. Simple as that.

  110. HFnursey Says:

    Does your relative have access to a heart failure nurse. As he is housebound with co-morbities he should qualify if there is one in your area. Ask the GP or hospital they should be able to tell you. They are not an emergency service but are there to prevent hospital admissions

  111. Blue Light Says:

    Absolutely! It's FLU – FLU – FLU!!!!! Yes, unfortunately some people succumb to it (the elderly and the very young) but its FLU!!!
    PLEASE call your GP and NOT 999! I've had 10 'jobs' today – every one of them have "symptoms of swine flu" by symptoms I mean coughing or sneezing in the last few days or a sore throat. How many of us have coughed or sneezed in the last few days…. NHS "Re"-Direct must take some responsibility here

  112. bluelight Says:

    No of course not! If you research a little more, you will find that most areas have called in assistance from local groups (i.e. 4×4 response, st john, red cross) to assist with delivery of medication to people such as yourself. You just need to do what the rest of us "should" do…. call a GP or OOH and when (and IF) diagnosed with FLU, let them know that you have no friends or relatives to collect medication and they will organise it.
    It isn't a case of mass graves…… IT'S FLU!!!!!

  113. loopyloola Says:

    Sorry to disappoint but an ambulance is not a fast-track service in a&e. Everyone gets seen in order of their condition regardless of how they get there. You will still need to wait in reception, book in & wait to be seen by a triage nurse. And ambulance staff do not give pennicillin. They are an EMERGENCY service & therefore have no need for an antibiotic

  114. angie Says:

    http://www.h1n1vax.com.au/s1/cs/auvx/124987035233

    the Aussys have had there vaxine for a while now! but where is the Uk`s ? odd

  115. hanononymous Says:

    Nah, in Scotland the advice is "have a glass of water and sit on the toilet".

  116. Yahoouj Says:

    Really good work about this website was done. Keep trying more – thanks!

    Nee Naw
    Nee Naw was a blog about life in the London Ambulance Service control room. It was written by Suzi Brent from 2005 to 2010. The blog is no longer being updated, but the archives will remain here.
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