My desert-island, all-time, top ten most memorably rubbish, pointless and waste-of-time 999 calls, in no particular order.

1. “There’s a bee in my front room!” (Had it stung anyone? No. Was anyone there allergic to bees? No. It was a straightforward case of Bee In Front Room…)
2. “I’ve stubbed my toe!”
3. “I had a dream my friend has been shot. I tried to ring him but no-one answered. Can you go round and make sure he is okay?” (It was 2am, I’m not surprised no-one answered…)
4. “My cat has scratched me!”
5. “I’ve just got a new SIM card, and I don’t know the number. Could you tell me, please?”
6. “My boyfriend has a boil on his bottom and can’t sit down!” (What made this one worse was the fact that the caller kept ringing back every ten minutes bemoaning the fact we hadn’t sent an ambulance yet.)
7. “There’s a rat in my kitchen!”
8. “My child has stuck a pea up his nose!”
9. “I think I’m going to get an abscess in my mouth!” (He hadn’t actually got it yet… I guess he was thinking that prevention was better than cure!)
10. “I had an accident last week and was taken to hospital by ambulance. I’ve just been discharged, and there is blood all over the carpet. Could you come round and clean it up?”

That said, these are not the calls that really get my heckles up. When I joined the Nee Naw service, I knew that some people make wildly inappropriate 999 calls. They are relatively few and far between, and rarely cause much inconvenience — they are highly unlikely to get an ambulance sent to them, and often provide a source of amusement to a dispatcher who was about to doze off during the early morning lull. (It is, of course, less amusing at busy times when there are callers waiting to get through, and I am certainly not recommending anyone makes this kind of call for our amusement).

But the calls that really get my goat are not these, but the far more common variety of timewaster who think it is appropriate to call ambulances out for stomach aches, migraines, toothaches, flu and other minor ailments that are really the remit of GPs or pharmacists, or maybe even of the variety that can only be cured by retiring to bed, calling in sick and waiting for it to go away. I remember clearly as a child being taught to dial 999 and being told it was only for life and death emergencies. I wouldn’t have dreamed of calling an ambulance for flu or toothache, and I am reliably informed that 20 years ago no-one else did either. Yet nowadays, “ambulance” has become synonymous with “mobile medical treatment unit” or even “free taxi to the hospital”.

These calls aren’t rare, either. I would estimate that 75% of calls on nightshifts and 25% on dayshifts are of this nature. The ambulance service does not have unlimited resources, and attending these calls inevitably means longer ambulance waits. While we usually manage to get to the immediately life threatening calls (heart attacks, etc) within 8 minutes, response times for lesser emergencies are not as good. It’s not uncommon for old people to lie on the floor with broken bones for half an hour because we’ve no ambulance to send to them. And where are the ambulances? No, contrary to popular belief, they are not all parked up behind St Thomas’ A+E eating sandwiches… they’re all out dealing with kids with stomach aches and students with the flu.

Why does the ambulance service send out ambulances to these calls? Well, two reasons. The first is that some callers — especially those who do it habitually — know the “right” answers to the triage questions. They know that if you mention certain symptoms, an ambulance will come blazing on blues and twos, whereas if you tell the truth, you’ll get a call back from Telephone Advice. The second is something I’ve mentioned before — the ambulance service are running scared from being sued. While Telephone Advice can and do weed out some of the inappropriate calls by pointing out a GP or a taxi to A+E would be more appropriate, some people insist that they only want an ambulance. You can imagine the newspaper headlines that would result if that “stomachache” turned out to be appendicitis, and resulted in a burst appendix whilst the relatives were trying to persuade us to send an ambulance, and you can bet your life that the papers wouldn’t point out that the patient refused to consult a GP (who would have authorised an ambulance straightaway), or speculate about what would happen if we sent ambulances to every child with stomach ache.

I am scared of this too — I considered writing a piece on “When not to call 999″ which people would hopefully stumble across when googling for “should I call 999 for…” type queries, but was scared that I might put off someone experiencing a genuine emergency. Instead, I’m going to list the four symptoms for which you should always call 999 for an ambulance:
Chest pain (better to be safe than sorry with this one)
Severe difficulty in breathing (eg. unable to talk in full sentences, gasping for breath. It does not mean having a bit of a cough or gasping in pain!)
Reduction in consciousness (“A bit drunk” does not count; if the person can tell you what day it is and recognise their own family they are what us dispatchers would call “alert”)
Serious bleeding (ie. spurting or pouring, cannot be controlled with a cloth or dressing)

If none of these apply, think about whether you really need an ambulance. Needing an ambulance is not the same as needing medical treatment. Can the patient get to the hospital without an ambulance? (Not being able to afford a cab is not a good reason for an ambulance!) Do they need to go right now? (If not, a GP can organise a non-emergency ambulance for them). Remember that arriving by ambulance does not mean you will be seen any quicker. Ambulances do take the sickest patients straight in, but ordinary patients still have to wait in A+E (and if a critically ill patient arrives by car, they still get seen straight away too). If a patient has flu or a stomach bug, waiting in A+E for four hours will make them really uncomfortable — they’d probably be better off at home in bed, waiting for an emergency GP or drinking a cup of Lemsip! If in still in doubt, call your GP (the emergency GP number will be on their answer phone) or NHS Direct (0845 4647).

On the other hand, trust your instinct. If you think someone’s condition is life threatening, don’t hold back from calling 999 because you are worried you might be wasting someone’s time. The ambulance service can deal with the odd genuine false alarm, and no-one will be cross with you. Just don’t use the ambulance service as a taxi service or an alternative to your GP. Remember that while that ambulance is ferrying you and your toothache to the hospital, it’s not available to send out to someone who’s having a heart attack or lying on the floor with a broken hip. That person could be your gran…

Published Nov 10, 2005 - 43 Comments and counting

43 Comments on “When NOT to call an Ambulance”
  1. Becca Says:

    I’ve got severe asthma, and I do actually spend a lot of time worrying about whether or not I’m at the point where I need to call 999. I was also taught only to call in life or death situations, so I try really hard to avoid calling before it reaches that point. That being said, my experience in the past has been that if it does get so bad that I go in an ambulance (and sometimes it’s been my GP calling one) I get seen immediately, whereas if I take a taxi in it does take more time to try to make it clear that I’m having a problem that needs to get seen immediately, and sometimes I end up waiting several hours. Which in principle I’m not against, I don’t mind waiting my turn, but sometimes that need for oxygen makes it difficult.

  2. Mark Myers Says:

    I would expect anyone having an asthma attack that they can’t control to call 999. I’m surprised to hear that you’ve found you get treated quicker when you arrive by ambulance — perhaps the times you’ve gone by ambulance you’ve been in a worse condition? That certainly goes against everything we’ve been taught, but I’ve not been the patient enough times myself to know from experience!

  3. SWbod Says:

    re; the four symptoms….. can i point out a few things??
    Chest pain. sudden severe pain at rest or during activity, recent history of drug taking (like cocaine), family history of cardiac related problems or diabetic history…… Not indigestion!
    Difficulty in breathing/shortness of breath. obviously a history of breathing problems eg asthma, COPD, also any sudden shortness of breath with no related symptoms, any recent chest injuries, bites stings and allergies…. Not a cold or tonsilitis!!
    Reduced level of conciousness. meaning anyone unrousable from a bit of painful stimuli, diabetic problems, possible head injuries or brain attacks (like a stroke)…. Not your pissed up friend after 3litres of vodka!!
    Serious bleeding. as obvious as it sounds….. Not a small nick to the finger, if its not hanging off im not interested!!!
    Also, regarding the asthma attack, no disrespect intended but some peoples view of an actual attack vary greatly……. im almost positive that if you arrived at A+E by taxi and booked in you would have been triaged by a nurse within 5mins of arrival, if you had any difficulty in speaking in full sentances or your o2 levels were below 95% then you would have been taken into ‘majors’ and no doubt nebulised…… this of course is only in my humble experience…….

  4. SWbod Says:

    …..oh and i forgot, maternitys.
    Not a medical emergency requiring a blue light response if your membranes have only just ruptured and you are not experiencing any form of contractions, or if the contractions are every 15mins, or if you felt a twinge 3hours ago…. if your partner can ‘follow in the car’ then what stops you from travelling in it??
    Sorry, rant over.

  5. Mark Myers Says:

    SWbod: absolutely!! Thank you for that input. You are totally right and I think I will make an edit to the post to explain that (although I will let the chest pain one stand, as I’m told people often think their heart attack is “just a bit of indigestion”!)

    Don’t get me on to Maternataxis… in fact I have a whole post about them waiting to come out, but I’ll wait as two posts of this nature in one day will have the general public thinking I hate them all ;-)

  6. SWbod Says:

    Bit of a faux pas on my account there, regarding the indigestion ;-) you’re quite right about the possibility of it being a cardiac event but i cant begin to tell you how many large burps later that a patient has suddenly felt better!!
    Also for a real bit of trainspotter info, diabetics can present a heart attack with upper abdo pain instead of the classic chest pain as can people of asian and middle eastern origin, and ‘silent’ MIs occur more freqeuntly in people with a diabetic history…….
    now i really need to go to bed, earlies await me :-(

  7. Passer by Says:

    Hi
    I just wanted to say thanks for the effort that you put into this blog: it’s completely fascinating, and I look forward to every update. Please keep up the good work!
    PB

  8. Sophie Says:

    Fab blog btw, been reading since I spotted a link in “Random acts of Reality”.

    You are spot on with this entry – in fact I want to print it off and post it as a flyer through the doors of the houses in our community.

    Let me explain myself – I’m a CFR with Staffs Ambulance Service (so trained in more than just defib.) and I’m totally appalled at the number of unnecessary calls that we respond to (not appaled that we get sent, just appaled that people ring for something that can be treated at home/A&E/chemist). Eg. A while ago we were sent to a “Life Threatening” – “Chest pain”, go on blues, patient wouldn’t let us in! They had rang Doc’s for advice, mentioned the BUZZ word (Chest Pain) and Doc proceeded to send out the cavalry without even telling the bloody patient! We don’t mind attending anything, we are volunteers and don’t cost the service anything, but when the ‘big white taxi” turns up and as you say, could be on a “real” call, the whole thing seems bananas!

    In fact our CE was on the local news tonight as calls have doubled this week and we were stretched way beyond belief.

    As an integral part of CFR training we have to do a couple of observer shifts in our Nee Naw control room – its a real eye opener, the number of patients having trouble breathing (whilst holding a perfectly coherent conversation) was astounding – but again you are right – with the ambulance chasing “Instant Claims” hype you have to err on the side of caution. Rambled too long – just popped in to say GREAT BLOG!!

  9. Kat Says:

    Hey there, loving the blog! I’ve only had to summon an ambulance once (and I was just listening as the phone call was made) and this blog has made me feel much better about the way I generally handle things. It’s also helped me by explaining that you guys send an ambulance if needed even while you’re asking what seem to be dumbass questions at the time lol At least now I know that whilst my mate is unconcious and dead looking from a snowboard crash your guys are on their way :o )
    I’m also a HUGE fan of NHS direct, they really are good people to call if you’re unsure of how serious something is and have seemed to give me good advice in the past regarding a burnt hand, broken ribs and vomiting flu type stuff :o ) Here;’s hoping more people use them or their GPs and stop bothering you guys

  10. Mark Says:

    Just as a point of interest when my son last had tonsilitis he had sats of 81%, measured at home whilst he was asleep. Thus we called an ambo. By the time the FRU arrived (about 6 minutes quite good but they did have to phone for directions – I can see the station it came from from our front door!) Evil Child ™ had been woken (as requested by the dispatcher) and his sats had risen to the dizzy heights of 93%. This led to a very grumpy FRU bloke – on handover he said “the parents are just scared”. I think you would be hard pressed to find a parent who is less scared and more matter of fact about calling 999. The paramedic and EMT who arrived a couple of minutes later were less grumpy I think they realised that most children are not fed through their stomachs, most households do not own their own pulse oximeter and parents aren’t conversant about O2 levels, sats etc.

    The boy was taken to hospital and was allowed out after a week, a spell on ITU and emergency surgery. In retrospect perhaps we were only being paranoid…..

    We won’t use NHS Direct as they take far too long to respond to queries and are unable to cope with anything that is out of the norm and it only delays the inevitable. The out of hours GP service is worse. Now we just have our own oxygen supply, a large stash of prescriptions and antibiotics and if all else fails direct access to the ward and a lovely letter from his consultant which basically says “This boys parents know more about his condition than you do so if they say he needs to be here he does.” This is of most use for SHO’s.

    All that being said I appreciate that we are an odd case – my wife and I are both phramacology grads so we know alot of medical stuff, our son (1 of 3) has a profound disability and we have a history of hospital admissions so we don’t flap if he needs to go in again. My biggest problem is the assumption that some professionals make that they automatically know more about my son in 30 seconds than I do.

    Cheers for the blog

    Mark

  11. Mark Says:

    Forgot to say that I had a great conversation about Random Acts and the ‘Big White Taxi Service’ with the paramedic whilst the EMT sorted stuff out. He was very surprised at my use of the term ‘NHS Redirect’ although he did find it very appropriate.

    Cheers

    Mark

  12. SWbod Says:

    Mark (above), i hope you dont think i was generalising too much in my previous post about tonsilitis. Having worked with profoundly disabled kids for many years before now, i totally understand how a simple infection could knock your son for six, it just aggreives me how many fit, healthy and able to get off their bums people there are out there who think tonsilitis is akin to losing a limb…… Apologies if i offended you in anyway.
    And you’re quite right about NHS redirect ;-)

  13. Mark Says:

    SWbod

    No worries mate I wasn’t offended in any way.As I say I really appreciate the work you guys do I just wanted to show a slightly different side of the coin. I must admit I’m my own worst enemy in these situations as I tend towards a dark sense of humour at the best of times. Also I should apologise to all the dispatchers out there as I am one of those horrible people that just want to give the information and go and not answer a lot of questions.

    The last time I spoke to the out of hours GP he assumed I was a medic because apparently most parents don’t give pulse, respiritory rates, sats etc. I didn’t ask why a medic would be phoning a GP for advice as that seemed a bit cruel ;-)

    Cheers

    Mark

  14. H.G. McCarthy Says:

    6. (What made this one worse was the fact that the caller kept ringing back every ten minutes bemoaning the fact we hadn’t sent an ambulance yet.)

    8.

    This article is worth picking up by all the national daily’s and weeklies! I nearly agree with every word. Now, I mean this in the best possible way but, “My child has stuck a pea up his nose!” always has the potential to quickly become severe difficulty with breathing. With a child any movable, nasal obstruction could do exactly that. “My boyfriend has a boil on his bottom and can’t sit down!” Believe it or not, although this has not the same level of urgency as the pea, there is still a substantial potential that this could turn into a life threatening situation. One thing the boy-friend mustn’t do is sit down! What is commonly referred to as a boil on the bum, by members of the general public in too many cases turns out to be an abscess or an imbedded pylonidal cyst. An abscess is an enclosed collection of puss and a reaction to bacterial or microbial infection. A pylonidal cyst or abscess is a reactive process where the bodies defence mechanism turns on its self. It can be provoked by a hair end puncturing the skin or a blocked follicle, where the hair starts to grow inward. A nest of entwined hair is often found at the core of these cyst/abscesses. These are usually associated with hirsute patients, but can affect any-one with pubic, perineum or perianal hair. Both these conditions are very painful and can swell-up to quite large masses. Sitting on or lying, in such a position that further pressure is applied to the effected area, can and does cause additional swelling which can lean to further infusion of infected material into the surrounding tissue. If an infection process, this can then become systemic and a precursor to septicaemia. I have knowingly dealt with a few of these cases as doctors emergencies, they often require careful patient handling and particularly so with the elderly or the infirm. Bed sores are their cousins!
    A surgeon told me, when I experienced this condition (“ambulance-mans bottom”, the charge nurse called it) that it was caused by hair, sweat, heat and friction (all these things are factors associated with driving or attending on an emergency ambulance) and that the only sure way of dealing with them was to cut them out! This was just before I was put out for the count, prior to an emergency operation to deal with the issue. Other people on my station had similar, although not as serious problems as me, but one medic at a nearby station nearly developed septicaemia prior to his emergency operation. This condition falls under what are termed embarrassing conditions, such as haemorrhoids and often are recorded as “back ache” on return to work! At least that was what was suggested to me by a fellow suffering shift manager after she presented me with a sickness/accident report form to fill in. I wouldn’t be surprised if more than a few EMD’s hadn’t experienced this condition what with the long periods of sitting at a control room desk! There is a solution though! People who spend long periods sitting in what in the affected, is a hostile environment should invest in a four to six inch thick sponge cushion that has a two inch wide slot down the middle. This removes pressure from areas which are particularly sensitive to these conditions and one can insert a cooling device in the slot. This condition can take quite a long time to clear up but if one is particularly keen to get back to work this device will work on an ambulance, but it does eventually play havoc with the lower back. I know I managed to do this for over nine months! Unfortunately the condition can become recurrent and lead to permanent disability! Over fifty thousand soldiers were discharged from active duty in the US army, during the Second World War and it continues to plague military personnel in every corner of the globe and all put down to driving over rough terrain whilst sitting on well worn seating. The relatively new hobby of 4X4 cross county driving has led to a large increase in civilian incident reports. I suggested to the Services Occupational health team, that my own case was due to the above precipitating factors and the introduction of traffic calming measures, such as sleeping policemen, which created urban rough terrain! This would account for the increase of this condition in metropolitan emergency ambulance services, QED. Why do you think Mr Bradley no longer rides out in ambulances? Like me he is very tall(99th % male) and has a hairy arse!
    Once again very good article!
    Eat well and prosper.

  15. domino Says:

    “7. “There’s a rat in my kitchen!””

    gah! *gets ub40 stuck in head*

    I may have commented before, but I have a shocking memory – so “excellent blog!” :)

  16. meeper Says:

    and on the other side of the coin, when I had a haemorrhagic stroke in May my husband decided to phone nhs direct rather than an ambulance because he didn’t want to waste your time! so there I was, couldn’t walk, couldn’t move my right side and couldn’t speak at 1 in the morning, scared out of my wits but he decided that there was nothing much wrong and phoned them instead! (he later claimed he “knew it was a stroke all along” – I doubt it!)

  17. Gwyn Evans Says:

    It’s sometimes hard to know – back at the end of last year, I had a bit of a chest pain that came on gradually late in the evening, so after a bit, called NHS Direct for advice. Obviously a hit with the trigger words, as a quick transfer to the nurses desk then to the 999 switchboard, leading to an unexpected journey that evening!
    One of the initial treatments was Gaviscom (sp?) in case it was indigestion, but it ended up with a trip to Oxford for angiogram/plasty the next day (3 stents in 2 arteries) and a rather hightened sensitivty to twinges in the upper body!

  18. Mark Myers Says:

    Mark — that’s exactly what I was worried about when writing this post. 9 times out of 10 (at least) calling an ambulance for tonsillitis would be completely inappropriate but with sats like that it’s clear your little boy was obviously a medical emergency. So rather than miss the one in ten who does need an ambulance, we go out to the nine in ten who don’t. If only all parents had oximeters knocking around!

    Interesting to see people’s different experiences of NHS Direct. I’ve never used them myself but I’ve taken plenty of calls from them. Next time I get ill I will have to give them a go ;-) My main problem with them is that they sometimes seem to force people into doing whatever their protocol dictates — making us send ambulances to people who don’t want to go to hospital and who will refuse to travel. And I’ve known them to say “The patient can’t afford to get to hospital, and he didn’t think it was right to call for an ambulance for his cut finger/whatever, so I said I’d get one for him”. I’ve had a conversation with an NHSD nurse on here, though, and she assures me that they are not supposed to do that and that I have let a few bad apples colour my experience. And, as she pointed out, there are hundreds of people who we never hear about who are satisfied with the advice they receive from NHSD but who might have called an ambulance if they didn’t have them to turn to.

  19. Marie Says:

    I had to phone NHS Direct the other day for my 6 year old daughter. She had an accident last Friday lunchtime, knocking a tooth backwards. On Saturday she had the tooth extracted. On Sunday she hadn’t eaten or drank anything since Friday before the accident.

    Sunday evening she was looking straight through us, with huge pupils, not speaking, not reacting to anything, not even wanting a cuddle. Her breathing etc was fine though.

    Rang NHSD and after going through the questions with me, they said that they wanted to send an ambulance out to us.

    I said no, that I have transport and can get to hospital fine, I was more ringing for reassurance than anything (didn’t think her condition was life threatening, more that she was in shock). I didn’t want to a) waste the paramedics time when there are more important things out there and b) frighten the hell out of my daughter!!!!

    Went off to hospital in the car, and luckily went straight through. They thought she might have broken her jaw, but she hadn’t.

    She is now making a good recover at home, and is now eating and drinking.

    Great blog by the way!

  20. Arwen Bijker Says:

    Just pointing out that if you find your friend has just drank 3 litres of vodka, calling an ambulance most certainly IS the right course of action.

  21. Anonymous Says:

    Oh God! I’m still reading and I’m still defending. As an NHSD nurse and also as an A&E/critical care nurse of some 15 years (so yes i do have some experience) can i point out that NHSD is a phone line for health advice. It is not for diagnosis and we work to much the same trigger words as ambulance control. And we have our frequent callers who know exactly how to respond.

    For a patient ‘out of the norm’ who has open access to a ward NHSD is not the most appropriate first point of contact. The ward is. If you are aware of the medical history and have been hospitalised to that extent, then if you think hospital care is needed it probably is. You do not need that to be confirmed by NHSD.

    As for long waiting time. There’s a system called triage in the medical world. If you phone up dead or dying you will speak to a nurse immediately. If you aren’t you’ll get categorised as can wait. And you will be told every time, e.g. callback time is 3 hours, however if you get worse do not sit there waiting – call us straight back. Funnily enough people complain about the callback time later because they got worse while waiting but it’s very few who do call us back as instructed.

    As for being unable to give advice on medical problems out of the norm. We’re not here for that. We assess your current symptoms and take medical history into account. And most symptoms boil down to pain/numbness, fever, vomiting, diarrhoea, dizziness/headaches. We advise you what you can do at home or direct you to the most appropriate health care provider. Ambulance or not. Or we give general advice on a medical condition. If it’s an active acute symptom relating to a medical condition it needs face to face care.

    Sorry, I’ve got a sense of humour failure tonight after being shouted and sworn at. I refused to advise a gentleman he needed a GP. I’ve given him home care advice and worsening instructions. Because he does not need to see anyone, therefore I will not advise him he needs to.

    By the way – any idea how many calls we are expecting on Xmas day? the average area, e.g. East Midlands, Essex, are expecting 4000 plus calls each in 24 hours. Wonder where the long waiting times are coming from?

  22. Anonymous Says:

    PS If any asthmatic walks in with a wheeze, reduced sats, peak flows or inability to do one, raised pulse and failure to respond to home treatment I would always nebulise them. They may have to wait for medical treatment if they respond well, but they wouldn’t have to wait for lifesaving treatment.

  23. Mark Myers Says:

    If your friend had drunk 3 litres of vodka, they would almost certainly be unconscious, so you’d be calling the ambulance for that reason.

    I should point out that both the boil-on-bum man and child with pea up nose were conscious, alert, breathing, normally and otherwise fine. It’s interesting to know how these situations could have escalated into emergencies, but they were still no emergencies are they were.

  24. Mark Myers Says:

    Oh, and Mark, please please please just answer the questions! For me! I promise they won’t delay the ambulance (they may even make it come faster) and if there’s an extra information you need to give us, do so after the last question. It makes life so much easier!

  25. Mark Says:

    Ok I will answer the questions. Promise. However I think you should be safe down there unless you ever feel the need to answer the phone for South Yorkshire Ambo Trust :-) The thing I find funniest is that we always get a phonecall about 1 minute after I put the phone down. This is to ask for directions. As I said earlier you can virtually see the station from our house but we are on a new estate (been there nearly 4 years though) and our post code is not yet found on all the mapping software. The Police and Fire Brigade don’t seem to have this problem though.(*)

    Great blog by the way

    Cheers

    Mark

    (*) It does appear that I phone 999 (or 112 :-) ) a lot doesn’t it?

  26. Jean Says:

    Just got back from hols and haven’t checked e-mails yet, but can’t resist going straight to your blog! You obviously hit a real nerve with this one.
    Love it – plus it is helpful and informative and makes me smile.

  27. Linda Says:

    Would you call 999 for a broken arm? My cousin once broke his by falling off a climbing frame (this was a good 10 years ago, he was 6 at the time) and we called for an ambulance, and got one. I think we called 999 because his screams were horrifying, his mother had gone into total panic at the sight of him and we weren’t really sure that he didn’t have more serious injuries, but on reflection, should we have moved him and tried to drive him to casualty?

    Incidentally, I love your blog, and I think this was one of the funniest entries ever.

  28. Mark Myers Says:

    Reply to Linda: I wouldn’t *necessarily* call 999 for a broken arm, but in some cases it would be appropriate — as you point out, your cousin may well have had other injuries from falling off the climbing frame so you did the right thing in not moving him. On the other hand, if I fell over and broke my arm, and I knew that it was only my arm injured, I’d call a taxi.

  29. Nicola Says:

    To SWbod – Unfortunately as an asmatic I have experiece whre having a bad asthma attack – and taken to hospital by a friend, I was almost not triaged.

    I sat in front of the receptionist, who was taking such exciting details such as my address, and kept telling me to speak up and telling me that she needed this information before anything could be done. I was whispering and speaking in bursts of two or three words – when I finished giving my details she told me to wait over there. I was unable to get out of the chair at this point, so she summoned a porter. I was left in a chair until someone called me in to triage – unfortunatley when I was called, I was barely breating and cetainly unable to draw attention to the fact that it was my name being called by any other method than falling off my chair.

    Since then I have always called 999, as the operator can tell that I am having an astham attack – and relay all me name and address details to the New Naw control, who then reassures me that “help is on its way”. A nive amblance then makes it to my door at about the smae time I do, and I get my first nebuliser sat in my hallway – it is usually easier to bring that up to my flat than get me down! I am then either OK, or if I need a second I get it on my way to hospital.

    I also feel horribly guilty as I know that I could easily get a firned to take me to hospital if I need it – but I am now willing toput myself through waiting in reception again!

  30. Nicola Says:

    And my typing is bad!

  31. Katherine Says:

    Mark

    Love the blog, absolutely compulsive (and educational!) reading.

    However, I have to take you to task over one thing. I am a migraine sufferer and have been for years. It really irks me when people dismiss migraines as a fad or some kind of Edwardian-handkerchief-clutching-hand-to-forehead thing. Yes I know that some people get a slight twinge and go for the migraine option but anyone who has a genuine one will know how bad they can be.

    A good friend of mine died when she was dismissed as “just another wannabe migraine sufferer” when in fact she had meningitis which can present the same way. This happened in an A&E in NZ.

    My boyfriend did call an ambulance for me a while back for a migraine as I was hallucinating, inable to speak, having perceived problems breathing, had been vomiting straight for 14 days and was unconcious and unresponsive for long periods. I don’t remember the 14 days at all. That surely is a good enough reason to call for an ambulance.

    So please, remember that it is a genuine condition, however badly maligned.
    Cheers!

  32. Mark Myers Says:

    Ah, but you were having trouble breathing and lost consciousness. THAT is a reason to call an ambulance, but having a migraine on its own isn’t. If everyone who had a migraine called an ambulance, we’d have no ambulances left.

    People like you and the above mentioned example of the little boy with tonsillitis are examples of why we’re really wary of saying “You can’t call an ambulance for THAT” — every case is different.

    I know someone who was blued in (rushed as a top priority case) to hospital with a cut finger, too. Just goes to show!

  33. Mark Myers Says:

    PS. Sorry to hear about what happened to your friend. I hear meningitis is notorously hard to diagnose, so I always err on the side of caution if any of the symptoms suggest it…

  34. Soap Says:

    You’re right about the fine line between advising people what not to call 999 for, whilst not discouraging people when they *should* be using the emergency service.

    About 15 years ago, my grandfather had a massive MI at about 3am. My grandmother didn’t call for an ambulance until closer to 6am as ‘she didn’t want to bother anyone and thought it was just indigestion.’

    He died, unsurprisingly.

    As you say, one or two genuine false alarms is far preferable to preventable deaths.

    Fab blog.

  35. MJ Says:

    I’d also recommend calling 999 for an overdose or suspected overdose (i.e. if patient is found comatose/semi-conscious and surrounded by pills). This is NHS guidelines as far as I’m aware??

  36. jac Says:

    Remember going to one call that we thought was ‘only’ a migraine to later discover that it was a subarachnoid. Oops!

    Katherine – I understand what you are saying and will be more sympathetic to migraines in the future. Good point, well made.

  37. ElBurto Says:

    To the anonymous NA- thanks. I’m sick of defending NHSD to people who don’t care how the service works, think their OCP/heatrash query is of national importance, and dismiss it as one of Tony’s “Pet Projects” when things don’t go their way.

    ElBurto – a disillusioned HA

  38. tom Says:

    Ok… the definition of an ambulance is ‘A vehicle to transport the sick and injured to further care’.

    a week ago, my brother fell and injured his knee. Because he was in pain and i susppected he needed an x-ray, i dialed 999 for an ambulance because the rrv at my local icc was busy.

    I do not drive and no-one on my street was able to help me becuase they were all at work or out.

    How was i meant to get him to hospital, 20 miles away if i shoulnt call 999 except for those 4 situations you indicated above.

  39. Mark Myers Says:

    That isn’t what I said, is it? I said that if none of those situations apply, you should think very carefully about whether you really need an ambulance or not. A leg injury is sometimes cause for an ambulance, sometimes not, depending on the severity of the injury and the patient’s general health and mobility.

    (Incidentally, if the reason you called 999 was just because you didn’t know anyone who could drive, I suspect you didn’t really need an ambulance. What’s wrong with a taxi? Please don’t say you couldn’t afford one. The NHS can’t afford to send ambulances to people who don’t really need them.)

    Also, while an ambulance can be defined as “a vehicle to transport the sick and injured to further care” please remember not all ambulances are 999 ambulances. 999 ambulances are primarily designed for life threatening emergencies.

  40. Wendy Says:

    12 years ago my mother fell on her way home from a friends house and very badly broke her ankle (snapped both tib & fib at the joint). this happened at approx 2:30 in the morning on a very cold and wet October night. Thanks to a couple of young men who were willing to help her at that time in the morning, she managed to get to the bottom of the stairs leading up to my flat. The ankle was quite obviously badly broken as her foot was, to put it bluntly, swinging about on the end of her leg. it didnt even occur to me that she may need an ambulance. with the help of the two passersby I managed to get my mum into my car and drive the 20+ miles to the nearest A&E. the poor nurse who met me at the other end had to then deal with an almost hysterical 22 yo (me) and my mother who was drifting in and out of conciousness.

    Even 12 years later and now working for the ambulance service on emergency vehicles, I still wonder if I should have called 999. I do think that there are “borderline” calls that could be dealt with either way and as such those callers should be given the benefit of doubt.

    What get my goat is the 18yo standing outside her GP’s with a torn toenail who dials 999 because the nurse at said GP’s is not available to dress said torn toenail. (We dressed it and told her to make her own way to MIU)

  41. Mark Myers Says:

    Crikey, your poor mother. “Dangly foot” injuries really give me the heebie jeebies. I definitely wouldn’t have any problem with sending to a call like that!

  42. Trooper Says:

    Two things that I worry about as I have both!
    1. asthma – people I know usually just say "oh, get over it! It's happened before". Yes, but I can't talk, stand or breathe! To respond to Anon who said they would nebulise those who came in with a wheeze, often the main symptom is wheezing and that can often be controlled by the relievers. (But you probably know better :S)
    2. anaphlyaxis – I don't think anyone would deny that this can be lifethreatening, but the number of people who treat it as a joke and can't recognise it worry me.

  43. becky Says:

    what about when you cant breathe is tht not or call 999

    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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