Some good news for all LAS staff: assaults and traumatic injuries with “abnormal breathing” are no longer coded as an automatic category A. Neither are maternataxis with supposed “imminent delivery”. This is a huge and welcome step in the right direction. Well done, powers that be, for sorting this out.

May I hope that there is a similar change to the “sick person” protocol soon? (”Sick person” is what people with flu, etc get triaged as. Any “abnormal breathing” results in a spurious category A call).

Remember folks, keep those LA410s coming!

Published Apr 07, 2006 -

20 Comments on “Are You Breathing Normally?”
  1. iAmbu Says:

    Wahoo!!!!!!!!

  2. Dave M Says:

    spreading the word about LA410, seems to be working. Good news, to you and the road crews

  3. Claire Says:

    Hmmm…. I am just a tiny bit concerned about the maternataxi thing… what happens if you have got a woman who really IS about to have a baby? 2 of my clients have had babies with LAS in the last 3 months (non-English speaking woman with 4th baby didn’t call me in time and baby born in ambulance; first time mum went from early labour to second stage in 2 hours and baby born at home with crews in attendance). I know that women themselves are notoriously bad at telling if they are about to have a baby but it’s pretty difficult to telephone triage women in strong labour… will we still get neenaws if we need them?

    Claire, midwife

  4. Mark Myers Says:

    They will still get ambulances, but they will be category B instead of category A. BBAs will still be category As, as will anyone with bleeding or complications. Blame the hundreds of women who told us their contractions were two minutes apart when they were really half an hour apart for this — they all got category A responses for what turned out to be a leisurely ride to the hospital with no baby in sight.

  5. SWbod Says:

    Ooh my fave subject to whinge about…. Claire, of course you will still get nee naws but can you guarantee ME one thing? That the next midwife i go to who is ‘in labour’ herself (and gets a blue light taxi by uttering a single magic word) will she be remonstrated for actually saying whilst giggling that ‘all my pts call ambos so i thought i would’, whilst friend of midwife “in labour” states ‘i cant drive’…….. EXCUSE ME but you both have a perfectly good set of fingers and thumbs, and have demonstrated adequately that you can use a phone, TO CALL A TAXI!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! FFS.

  6. Steve Says:

    But will this make much difference to us crews? Cat ‘A’ or Cat ‘B’, our response is identical - ie, blues and twos - or at least it should be. (Surely no-one actually drives faster because a call is an ‘A’, do they? Maybe if they’re totally fresh out of training, but not in the real world.) And at least when it’s categorised as an ‘A’, there’s a chance of a car getting there first and doing a bit of work for you. I don’t see that this helps at all. Not the crews, anyway. Just the numbers, which is all that seems to matter these days.

  7. Mark Myers Says:

    Well, look at it this way. All the ambulances at your station are out. Someone rings up, their nan has had a stroke. Amber 1. Ten seconds later, someone rings up for a maternataxi and gets a Cat A. When you green up, we send you on the maternataxi while the old lady waits and her relatives get upset (and call back five times and shout). Maybe you’ll hear us GBing the stroke call on the radio whilst you make small talk with the mother-to-be about baby names. Most of the time you won’t know what we’re holding when we send you out on a rubbish call, but when I’m on dispatch I often feeling tempted to ignore those categories and send to the people who deserve it most first. This is one step towards dispatching those ambulances in the right order.

  8. Renal Says:

    Anyone know why ‘abnormal breathing’ with the flu is still CatA? Surely ‘abnormal breathing’ in trauma is more likely (I know it’s hardly guaranteed) to indicate a problem?

  9. Mark Myers Says:

    Because AMPDS is a load of rubbish?

  10. Claire Says:

    Totally get your points. Just that I’ve only been qualified 6 months and been on community 3 months and in that time have genuinely needed ambulances 5-minutes-ago for 3 of my women (one major unprovoked fetal bradycardia, one non-english speaker havign 4th baby who didn’t ring me till she was pushing, and baby was born in the ambulance and one precipitate labour that led to a BBA; I got there 10 mins after LAS caught the baby and if I’d have had a siren and flashy light and been able to go in bus lanes I’d have caught the baby and not just the placenta).

    And believe me, our women are under strict instructions to call us when they are in labour and we will assess them at home. They know when an ambulance is necessary; and if any of them call an ambulance and not us, when one is not needed, we take a very dim view of it.

  11. Big Al Says:

    Westcountry Amb now just started our AMPDS training, switching from CBD on June 1st apparently. In many ways the new system seems to have advantages over CBD, but these articles worry me.
    Oh well, just have to suck it and see. Surely it can’t be all bad???

  12. Claire Says:

    Hoorah, our team had another BBA last night, she had the baby in A&E. And it’s times like those that I thank the Lord for speedy LAS personnel…

  13. eeyore Says:

    why is it that there is so many cac staff who stay in unavailable and do not answer calls when they should do calls are mounting up and patients lives are at risk……..managers SOO’s & Superintendents ignore it.

  14. eeyore Says:

    So many cac staff sit in unavailable or have friends and family ringing them instead of taking 999 calls or selling avon and other contraband in cac, calls mount up whilst staff justb sit there doing their make up reading newspapers, it is outrageous that staff get away with it. putting callers on hold and leaving them on hold whilst waiting to be given advice by the call takers….anyone else know of these things that have happened and still happen in London Ambulance Service CAC 9EOC)

  15. Mark Myers Says:

    I’ve seen people doing that, yes, but I wouldn’t say it was common. I certainly never do it! If someone is sitting in Unavailable at a busy time, it only takes the CTC (supervisor) a few seconds to come around and prod them. I know this because if I’m in Unavailable for a reason (just had a stressful call, rebooting my computer or whatever) he/she will be wanting to know why straight away.

    Do you work in CAC, Eeyore?

  16. eeyore Says:

    Yes, it is so annoying i don’t know what team your are on, but i know the majority of teams the ctc gets fed up with it and doesn’t do anything because their hands are also tied….there is a group of 6-8 members of staff who do it constantly and get away with it, SOO’s, Super’s etc all get told and ignore it.
    Alsob there are individuals who are abusive towards callers and ring them back through the shift and again get away with it….it’s disgusting that these staff are still in the job, and the service lets them stay…saff have not answered the phones and calls mounted up and 7 plus suspended calls have come in poor patients….
    people having personal calls on their mobiles or using the gpt phones or use on dr’s lines…..

  17. eeyore Says:

    Mark Myers….Are you aware of the call taker that has only just got the sack last week for calling back a caller over 60 times and being abusive towards them after the caller had rang for amb as relative had passed away….it took the service nearly a year to finally sack them.
    Quite a few staff don’t bother answering the calls and sit their in unavailable or work, loads of entries in ctc book about it, and are abusive towards callers and get away with it.
    Another one sat there on a suspended putting the caller on hold and pretending to be the supervisor when caller wanted to complain, outrageous.

  18. Mark Myers Says:

    Eeyore - Yes, I know about the first call taker but I don’t think I ought to be discussing individuals on my blog… all I will say is that I was flabbergasted at her behaviour and flabbergasted that she wasn’t sacked on the spot. I can also guess who the group you’re referring to are — but there’s only 6-8 of them out of a total of 250ish EMDs and I think they are firmly in the minority.

    I’m on B Watch. Which watch are you on? I don’t know if I’m being naive but I’ve never noticed anyone sitting in Unavailable while there have been calls waiting and I don’t think I’d get away with it either (not that I’m going to try it!) Never heard about the incident with the suspended either. Why on earth would someone want to put a caller on hold with a suspended? I don’t get it.

  19. 168 Says:

    it did not take nearly a year to sack *********, she took both calls from the patients father in October (unlucky caller), she then rang back 22 times on xtn 2030 and then once more from xtn 2006 @~0600, she was suspended in November and then went sick during the investigation and finally left or was dismissed (I’m not sure which) in march. the delay for getting her dismissed is due to the long procedure for disciplinary (right or wrong is your opinion) but her going sick added to the length of it as she did not attend some hearings due to her sickness.

    As for the ‘doctors’ lines staff you refer to yes they do get away with murder, i will not defend them. And yes ******* imitating the supervisor was very stupid but it was not done on a suspended call, it was done to a doctor complaining about an as2 being held

  20. Mark Myers Says:

    Please don’t refer to the people involved by name! I’m going to edit your comment, if you want to discuss the matter further perhaps you could take it to email? Thanks!

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