Do you need an ambulance?

Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
Apologies for the rag that this is linked to, but it's where the story was drawn to my attention.

Story
“Surely losing a limb is an obvious emergency?”

As members of the public, rather than biased like me, do you think that this man should have been sent an ambulance?
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Comments

  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    Certainly not if the ambulances were at full stretch (which they usually are) ... why couldn't his uncle take him? :confused:
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    Is a finger a limb?

    I suppose it depends on the circumstances. If they had ambulances sitting spare, possibly yes (though against them being able to do some medical care on the way and being able to drive faster and safer needs to be balanced against them having to get out there).

    If there's more urgent things (heart attacks, people being knocked down and fear of spinal injuries etc) then probably not.

    I'm guessing its the latter case...
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    Is a finger a limb?

    Exactly, it's why I quoted that comment. Talk about over playing something...
    I suppose it depends on the circumstances. If they had ambulances sitting spare, possibly yes (though against them being able to do some medical care on the way and being able to drive faster and safer needs to be balanced against them having to get out there)

    If there's more urgent things (heart attacks, people being knocked down and fear of spinal injuries etc) then probably not.

    I'm guessing its the latter case...

    Whilst they may have one sitting free at that specific moment, the next call might be an emergency. This would be a "Category C" call, basically they have to be really quiet before they will go out to one of those. The others you mention are Category A, they must have vehicle on site within eight minutes and once you pick someone up you cannot drop them off while you rush to a more urgent call.

    In this case I think that the bloke is taking the piss and it's a non story IMHO The interesting part is that an ambulance was provided once he had got to the first A&E Dept. problem there is that the hospital is now responsible for him and would have to do this even though it still wasn't really warranted...
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    it would depend on whether he could get to the hospital without one I think.
    if not, then send an ambulance. Losing an inch of your finger is quite a lot.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    it would depend on whether he could get to the hospital without one I think.

    Yes, if you are on your own when something like this happens then an ambulance would be correct - just not immediately.
    Losing an inch of your finger is quite a lot.

    Not in a clinical sense.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    To add, Random Acts of Reality is an excellent blog by a London Ambulance driver, worth reading IMHO.

    Oh and he has a book out too (which I mentioned in the Book Club thread in Entertainment) - a fascinating insight into what the Ambulance staff face on a daily basis.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    Given the area, the ambulance operator was quite right to tell him to make his own way there. Northumberland is a massive county and ambulance stations are not spready widely; Bedlington is also about a 5-minute drive from the nearest A&E unit at the Wansbeck Hospital in Ashington.

    What an utterly stupid story. As much as anything it would be quicker to make your own way there.
  • Teh_GerbilTeh_Gerbil Stalin's Organist Posts: 13,327
    It would probably have been quicker to make his own way there, yes - but they should have sent one out.

    I dislocated my knee about... ooh... an hour from the hospital and got sent an ambulance.

    The only reason I needed to GO to Hospital was to wait about 6 fucking hours for X Rays to make sure my knee was OK. Joy.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    A knee is different to a finger though- with a knee you're unable to walk, and so can't make your own way there.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    No he shouldnt have got an ambulance. When i chopped off the end of my finger i ended up going by Taxi.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    I'm going to buck the system and say yes I think he should have been sent an ambulance, loss of that much of a finger would count as a disability. Maybe not one of those big ambulances but one of the car ones would do the trick nicely.

    After all shock is a killer and they would be painted in an even worse light he'd been affected worse by shock. It would have also increased the probability of him going to the best hospital in the first instance and thus saving his finger.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    "Horrified nurses bandaged the hand and transferred him to Newcastle’s Royal Victoria Infirmary..."

    How does the Sun know they nurses were 'horrified'? I'm guessing they dealt with things nastier on that one shift.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    It isn't a case of the "best" hospital, he would have been taken to A&E (five minutes away) and then transferred to the specialist unit in Newcastle (35 miles away) afterwards.

    And as I say, Bedlington is about five minutes drive from Wansbeck General Hospital in Ashington. An injured hand, if its free from machinery, does not justify sending an ambulance, and especially not where a small number of ambulances have to serve a county in excess of 400 square miles in size.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    If he was losing a lot of blood from it he might have passed out though. If he had to get on public transport or whatever then I'd say call an ambulance but maybe the car would have been ok.

    My step-brother had a very similar problem when he put his hand into a turbo at work and it chopped a large part of his finger off. I don't know how he got to hospital though.

    But also my friend went to UCH in an ambulance and my other friend couldn't travel in the ambulance with her so they walked there and arrived before the ambulance even though they'd both left the building at the same time :shocking:
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    Kermit wrote:
    It isn't a case of the "best" hospital, he would have been taken to A&E (five minutes away) and then transferred to the specialist unit in Newcastle (35 miles away) afterwards.

    And as I say, Bedlington is about five minutes drive from Wansbeck General Hospital in Ashington. An injured hand, if its free from machinery, does not justify sending an ambulance, and especially not where a small number of ambulances have to serve a county in excess of 400 square miles in size.
    I'd say it's a bit further away that that but it's still not that far :p
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    I'm going to buck the system and say yes I think he should have been sent an ambulance, loss of that much of a finger would count as a disability. Maybe not one of those big ambulances but one of the car ones would do the trick nicely.

    So it's a disability. People in wheelchair can make their own way to hospital, as can the blind, deaf and elderly. This man's life was not in danger and he was with someone who had a car.

    As for the car, they are fast response and actually there for much more seroius things than fingers. These are the people who will get to you fastest (they are straetically placed around an area - which is why you will see them parked on the side of the road "doing nothing") and so they are used for heart attacks and the like.
    Randomgirl wrote:
    If he was losing a lot of blood

    The important word there is "if" and that tends not to happen with a loss of a finger.
    But also my friend went to UCH in an ambulance and my other friend couldn't travel in the ambulance with her so they walked there and arrived before the ambulance even though they'd both left the building at the same time :shocking:

    Are you saying that having called an ambulance, they didn't actually use it?
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    I think she meant that the person who needed the ambulance used it, but an accompanying friend who couldn't ride in it with her walked to the hospital.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    Renzo wrote:
    No he shouldnt have got an ambulance. When i chopped off the end of my finger i ended up going by Taxi.

    but i was then told i should have got you an ambulance...
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    In my eyes there are two points here, did he need/deserve an ambulance, and are there enough ambulances to serve the people that need them.

    An effective system would have got him an appropriate ambulance, possibly prevented a future disability (which was the point I was trying to make about disability) by treating the injury sooner and taking him to the best hospital for his condition.

    Maybe the current system can't manage this, it seems to have the cars on rapid response hanging round the roads, when they can't actually move a critical patient, and the vans that could actually get them to a hospital safely tucked away in an ambulance station. And evidently the ambulance service isn't capable of meeting the needs of the community it serves.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    In my eyes there are two points here, did he need/deserve an ambulance, and are there enough ambulances to serve the people that need them.

    :thumb:
    An effective system would have got him an appropriate ambulance, possibly prevented a future disability (which was the point I was trying to make about disability) by treating the injury sooner and taking him to the best hospital for his condition.

    The appropriate form of transport was already there. His mates car.

    The NHS is a treatment service, not a taxi service.
    it seems to have the cars on rapid response hanging round the roads, when they can't actually move a critical patient

    Becuase they take the person who can give the treatment to the patient fast - it's how they get to 98% of Cat A calls in eight minutes (god knows where that target came from) whereas the vans don't all carry such specialists.
    And evidently the ambulance service isn't capable of meeting the needs of the community it serves.

    Important word there is "needs", when what you seem to be suggesting is "wants"...
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru



    The appropriate form of transport was already there. His mates car.

    The NHS is a treatment service, not a taxi service.

    Some could see it as treatment as identifying the injury and an appropriate place to treat it sooner and possibly preventing the loss of the part of the finger. Yeah fair play he had transport, but no competant person with him.
    Becuase they take the person who can give the treatment to the patient fast - it's how they get to 98% of Cat A calls in eight minutes (god knows where that target came from) whereas the vans don't all carry such specialists.

    Last time I heard, they carried the guy with the defib, which isn't a particularly specialist skill (or doesn't need to be). Maybe a reallocation of what is where with whom would be sensible (although I accept will never happen).

    Important word there is "needs", when what you seem to be suggesting is "wants"...

    Depends what you see as needs:

    I see it as "needs" being a service that does the best by it's community and minimises permanent injury and death. I want one that will give me tea and biscuits, but that's a different matter.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    Some could see it as treatment as identifying the injury and an appropriate place to treat it sooner and possibly preventing the loss of the part of the finger. Yeah fair play he had transport, but no competant person with him.

    So should the NHS provide an ambulance every time someone hurts/needs medical attention themself?

    If not, where do you draw the line?
    Last time I heard, they carried the guy with the defib, which isn't a particularly specialist skill (or doesn't need to be). Maybe a reallocation of what is where with whom would be sensible (although I accept will never happen).

    The cars do more than that, are better trained etc.
    Depends what you see as needs:

    I see it as "needs" being a service that does the best by it's community and minimises permanent injury and death.

    In what way did they fail in this story?
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    So should the NHS provide an ambulance every time someone hurts/needs medical attention themself?

    If not, where do you draw the line?

    Where time will make a significant difference, where there is a high risk of infection (which there would have been in this case and probably contributed to the failure in reattaching the finger), and where there is a reasonable risk of someone going into shock.
    The cars do more than that, are better trained etc.

    Oh yeah? They can't do that much, as they tend to get stuck waiting for a van to turn up after they've done the defib. Yeah, they rock for statistics.....
    In what way did they fail in this story?

    He went somewhere that couldn't really help him, and by the time in got to the more suitable place he lost the part of the finger. I don't really see that as a storming success.

    I realise I'm looking for an ideal, but looking towards it is a far better way than accepting mediocrity.
  • Teh_GerbilTeh_Gerbil Stalin's Organist Posts: 13,327
    Kermit wrote:
    A knee is different to a finger though- with a knee you're unable to walk, and so can't make your own way there.

    But WHY even waste time taking me to the hospital? I could have gone in for X Rays anytime that week - even to my local department (until it shuts, soon too!).

    They could have gone to the next call out. Instead, I enjoyed sitting in A&E for 6 hours, not allowed to eat or drink.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    Where time will make a significant difference, where there is a high risk of infection (which there would have been in this case and probably contributed to the failure in reattaching the finger), and where there is a reasonable risk of someone going into shock.

    1. We don't know why the finger couldn't be reattached, there is nothing in the story to explain that part. Something I find a little sus because the story is only told from the blokes pov. Could be (just as likely) that it was too damaged.

    2. The protocols that the Ambulance Control people use take all that into consideration and they would not have said to him, it's just the top off your finger don't worry. They would have asked a lot more before they came to the conclusion that no ambulance was needed at that time. Remember the risk of a lawsuit is in their minds ;)
    Oh yeah? They can't do that much, as they tend to get stuck waiting for a van to turn up after they've done the defib. Yeah, they rock for statistics.....

    They do more than defib - they just can't transport. Tell me which would yo urather have - a five minute wait for the person who could save your life, or an eight minute wait for the person who could possibly save your life and then take you in. Remember that brain death for those three minutes is crucial to your chances of survival.

    Then take a look at the cost. We can employ 30 people, have ten vehicles on the road at any time in a car (which is cheaper to buy and run) and who could treat you, or we can employ 60 people, have ten vehicles on the road at a time who could treat you?
    He went somewhere that couldn't really help him, and by the time in got to the more suitable place he lost the part of the finger. I don't really see that as a storming success.

    Again, we don't know why he lost the finger but I'm sure his lawyer will tell you that it was because of the ambluance service - although I note that such a stance wasn't mentioned in the article. Funnily enough sometimes you can get there in three minutes and not be able to do anything.

    Yes he went somewhere that couldn't help him that instant, there is nothing to suggest that he would have been taken anywhere else by the ambulance either.
    I realise I'm looking for an ideal, but looking towards it is a far better way than accepting mediocrity.

    Mediocity is 90(ish)% of emergencies are attended within eight minutes - I forget the actual figure. Compare that with a few years ago and you would have to admit a huge improvement. I am not saying that things are perfect but perhaps if the public took some responsibilty themselves when calling for an ambulance this would improve further. This isn't just a one way relationship.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    Teh_Gerbil wrote:
    But WHY even waste time taking me to the hospital? I could have gone in for X Rays anytime that week - even to my local department (until it shuts, soon too!).

    So the question is would ask is, if you could have done that at any time, why go to A&E in the ambulance at all? As you say, "They could have gone to the next call out."
  • Teh_GerbilTeh_Gerbil Stalin's Organist Posts: 13,327
    So the question is would ask is, if you could have done that at any time, why go to A&E in the ambulance at all? As you say, "They could have gone to the next call out."

    Yeah.

    It seems Ambulance aren't good at prioritising. I heard of someone who's son a had to wait 6 hours with a broken arm. :( Poor fucking kid.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    i think they definately should of sent an ambulance for him as he was in a lot of pain.
  • Former MemberFormer Member Posts: 1,769,851 The Mix Honorary Guru
    but u can hardly drive with blood pouring out the end of ur finger and say the loss of blood made the man faint and he had crashed his car. he would of been charged with man slaughter if anyone got killed as a result. i guess his uncle could of taken him but he needed medical care quickly in my opinion
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