October 3, 2008

What Happens When You Dial 999 for an Ambulance

CALLING for an ambulance can be one of the most anxious moments in your life, but it is thankfully something most of us will only do once or twice in our lifetime.

People ring when they are worried, stressed or anxious, which is why it is best to be prepared with the answers you need to help the ambulance 999 call taker.

When you are transferred to the ambulance control and contact centre by the BT operator, the first question you will be asked is your location.

If you are calling from a BT landline at home, this information will automatically appear on a screen in front of the operator, who will nevertheless still check the details.

Control and contact centre manager at North East Ambulance Service, Graham Robinson, said: "There are occasions when someone will call us about a relative whom they are worried about at a different address and so it's important that we get the right address as quickly as possible."

At this point, a dispatch officer in the control and contact centre will begin to assign an ambulance to the patient.

"Sometimes people aren't aware that an ambulance is already on its way while the call taker is still asking questions," said Graham. "But the faster we can get an ambulance to someone with a life-threatening condition, the better chance we have to help them.

"We move ambulance vehicles around different locations that are identified as offering the best and fastest geographical coverage for our resources. We call these standby points and when other crews are working, we'll move our spare resources to these standby points to maintain maximum cover.

"Motorists who have seen ambulances and rapid response vehicles parked in the laybys or flyovers of busy roads will recognise these points."

Increasingly, the English ambulance services are adding rapid response paramedics to their fleet of ambulances in both urban and rural areas. Director of strategy and clinical standards Colin Cessford said: "By splitting the clinical role of the ambulance service with the transport element, we can help more patients in a faster timeframe.

"For example, in the case of a heart attack, the quicker we can apply a defibrillator to the patient, the better chance they have of survival. There is still a need to take the patient to hospital, but the greater priority is to get a qualified clinician to them first to start their recovery."

A life-threatening problem - such as chest pains; severe loss of blood; loss of consciousness or not breathing - will trigger an ambulance dispatch within 30 seconds of being answered in the 999 contact centre.

However, about one caller in 10 does not receive an ambulance as the patient assessment system, known as NHS Pathways, uses evidence- based outcomes to determine the best care for every patient.

That can mean a caller being referred to a doctor or nurse or even being told to make their own way to hospital.

This system - and the increased skill of paramedics in treating patients - also means that fewer patients are being taken to hospital than ever before. Fewer than three-quarters of patients who are seen by an ambulance crew in the North East are taken to hospital. This amounts to 2,500 fewer patients every month being taken into an A&E unit after calling 999 for an ambulance.

Colin said: "Over the course of a year, this adds up to 30,000 fewer cases being taken by us into hospital than before."

The staff in the control and contact centres answering 999 calls go through a six-week training course before they start work as emergency medical systems officers (EMSO). EMSO Alan Dall said: "Most people are quite relieved just to hear our voices and know that we can help. But not everyone needs an ambulance and our training on the clinical patient assessment system that we use does offer alternatives.

"That can often be a big relief for callers, to know that their situation is not as bad as they had feared and that help is going to come from elsewhere, such a local doctor or nurse rather than a trip to the A&E department of the nearest hospital."

Occasionally, the stress of a call can be too much for some people, who panic about their loved one. Alan said: "Sometimes people are outdoors when they call us and simply don't know where they are. They start panicking.

"We try to help, but we can only get the information we need by calming down the caller and getting them to help us locate their position."

Road signs, positions between towns or villages, a nearby pub or shop or other distinguishing landmark can all help to direct the ambulance to the caller. Advances in technology also mean that the ambulance control and contact centre can pinpoint a mobile phone call using triangulation of phone masts - although in the countryside, because the masts are farther apart, this is not always accurate.

Alan said: "Some callers think that we need to know what has happened, but first and foremost we need a location. After that, we have a series of steps that we go through to ensure the best response to the patient."

His final piece of advice is to stay as close to the patient as possible when speaking to ambulance control.

"People aren't aware that an ambulance is already on its way while the call taker is asking questions

(c) 2008 The Journal - Newcastle-upon-Tyne. Provided by ProQuest LLC. All rights Reserved.