There’s a letter in this month’s London Ambulance Service News that has got a lot of control staff up in arms. It’s from a very angry paramedic who has been to one too many “category A” calls on blue lights and sirens only to find a baby who was described as “choking” sitting up and playing with toys on arrival. The child’s parents told the paramedic that they categorically did not state that the child was choking, so the paramedic seems to have concluded that everyone in control is useless and deliberately “sexes up” low priority calls for the sheer hell of it.
I wonder if he’s ever done an observation shift in Control? Mr Angry Paramedic, if you’re reading this, I’d like to invite you to come and listen to some calls, and you’ll see what we’re up against:
a) Callers Lie. You don’t have to be brain of Britain to work out that the worse you make something sound, the quicker you get an ambulance. We have a good idea when they are lying, but what can we do? We’d be hauled into QA faster than you can say “disciplinary” if we accused them of it. Of course when the ambulance turns up, they will say “I never said he was choking!” They are big fat liars.
b) Callers panic. Callers have not been sitting reading medical dictionaries in preparation for dialling 999. “Choking” to us means “has an object lodged in his throat”. “Choking” to a caller can mean “making a choking noise when breathing even though breathing normally”. If the caller says “choking” in the first five seconds, and it takes five minutes to establish what is really happening, then sometimes the ambulance will already be there by the time the ticket is updated.
c) We hate AMPDS as much as you do. See below.
The Angry Paramedic also complains in his letter about AMPDS and the fact that it churns out category A “Severe difficulty in breathing” for a call that is known in the business as “A load of old rubbish”. This is a complaint that I sympathise with entirely and have made myself in the past. Management are always talking about reaching category A calls on target but for some reason have failed to implement the one change which would slash the number of false category A calls and enable them to get to all the proper ones on time and meet their precious target. That change would be to replace the AMPDS question “Is he breathing normally?” with “Is he having difficulty breathing?”
Anyway, calling all London Ambulance Service crews! There’s a form called an LA410 you can fill out every time you get a call that you think was inappropriately categorised. You can download it here (the link will only work if you’re on a London Ambulance Service computer). Print off a bundle, and fill one out EVERY time you go to a “Severe Respiratory Distress” call that turns out to anything but. Several times a shift, if need be. Pop them in the internal post to the QA office, and they’ll soon be drowning in so much paper that they will *have* to do something about it.
Call takers hate, hate, hate making category As out of rubbish calls as much as Angry Paramedics do. Whilst crews are worried about running people down whilst attending these calls on blue lights, call takers tend to focus more on patients who lose out on an ambulance as a result. We’ve all had an experience when we’ve been staying on line with someone who has been pleading for an ambulance for a seriously ill relative, when we know we’ve just sent the last available ambulance to someone round the corner with flu. Stop this nonsense! Fill out your LA410s today!!