CALLING OUT UNNECESSARY CALLOUTS

Frivolous Calls to National Ambulance Service Disrupting Emergency Response Times

A high number of extremely frivolous callouts in September of last year le National Ambulance Service paramedics angered at the triaging system that assesses emergency care needs.

One individual called for an ambulance when they were su ering from a “bad hangover”, putting that paramedic crew out of action and unable to attend to other medical emergencies for three hours.

is was just one of several unnecessary callouts made over a single weekend when ambulance crews are extremely busy, but under NAS rules, all callouts must be attended to, no matter how ippant they turn out to be.

e series of frivolous callouts resulted in many paramedics questioning the current triaging system and arguing that it is not the most e ective way to manage the eet of life-saving vehicles.

While there is a system in place to further triage patients, multiple sources within the NAS say it is not used o en enough, or when it is used, is not e ective enough to gauge whether the patient is de nitely in need of medical attention, or making an unnecessary call.

One paramedic source said the hungover patient mentioned above was not su ering any chest pains or any other symptoms that would have required an ambulance.

Unnecessary

Several other seemingly unnecessary callouts in one region further angered NAS paramedics, including a case where an elderly man was sitting on a bench “minding his own business” according to an NAS source, who explained: “A lad looking out his window thought this old man looked unwell, but instead of going over to the man and asking him if he was ok, he just dialled 999 and an ambulance was dispatched, only to be told upon arrival by the old man that he was ne and just sitting down to enjoy the weather.” e NAS member went on to outline how disruptive such calls can be on an already strained frontline workforce.

In another incident, paramedics were told over the phone that a patient had su ered “huge blood loss”, only to nd that the person in question had nicked themselves while shaving their legs.

“We are criss-crossing the country, passing other ambulances on the road. Limerick ones going to Cork to cover calls, and Cork ones going to Limerick for calls. It is just infuriating,” he said.

Screening

e HSE has repeatedly urged the public not to call for an ambulance unless in the case of an emergency, but many paramedics have consequently asked that a further pre-screening of patients, on top of the current triage questions posed to callers, ought to be carried out as par for the course, or at least more frequently, before they are dispatched to calls. is can include questions regarding whether patients are breathing or having chest pains, or have su ered a head injury.

NAS sta have said they are aware that many people who do ring 999 or 112 are genuinely stressed, but that this doesn’t necessarily constitute a medical emergency.

Politicians have also spoken on this issue in the past few months, with Labour TD Duncan Smith telling one media outlet that we are reaching “a perfect storm” in relation to the ambulance service in this country.

“Unfortunately, we’re dealing with a suboptimal system in terms of our emergency ambulance care and cover, and we have a stretched service across the HSE and Dublin Fire Brigade,” he said. “We have had countless examples of delayed responses because ambulances have been sent miles away from centres to pick up and deal with calls well outside their geographic location.”

Commenting on the dissatisfaction among NAS paramedics regarding the number of unnecessary callouts, the HSE said that if services are tied up at a frivolous call, it can mean they may have been unable to get to another destination in the case of a real emergency, and that to ensure those patients with life-threatening or potentially life-threatening illness or injury receive the fastest response, all 999/112 calls are clinically triaged.

Responses

Speaking about the triaging system and the delays in dispatching ambulances to certain incidents, a HSE spokesperson said: “National aggregate response times targets for these calls are set out in the HSE’s

National Service Plan each year, and are described as ECHO (life-threatening cardiac or respiratory arrest) or DELTA (life-threatening illness or injury, other than cardiac arrest). ese callouts account for approximately 48% of all 999/112 calls.

“All other 999/112 calls are not encompassed by any response time target, are responded to in priority order based on clinical triage, and when a response resource becomes available, hence during very busy periods, these calls can wait longer for a response.

“In the case of lower acuity 999/112 calls, these can be further triaged through our Clinical Hub by trained doctors and nurses to establish if sending an emergency ambulance is appropriate compared to other options such as selfcare, visiting a pharmacy, a GP or GP Out-of-Hours Service.”