When to Call an Ambulance and Remember the Word AMBULANCE

Challenges for the Ambulance Services

The ambulance service has struggled due to large increases in demand, a lack of funding and widespread workforce shortages. Whilst demand of ambulance services is major challenge across ambulance services around the world, several factors can affect the performance of an ambulance service. These factors contributing to the increased demand include:

• The size of the different geographies
• Population count
• Population profile – in particular aging population
• The rural or urban nature of the geography i.e. spread of densely populated cities versus sparsely populated areas
• Increase of disease burden and trauma cases
• The different health and care systems e.g. the number and type of specialist services, the performance and flow in local acute hospitals
• The quality of community services, care homes, and primary care
• Coordination with other emergency services including the fire service and police service.

When to Call an Ambulance is Mystery for Community?

The stress placed upon the emergency care system is firmly rising and the reason behind it isn’t yet fully understood. Certain patient populations tend to make regular, unnecessary ambulance calls. This causes the overburdening of emergency staff who are regularly overworked. Inappropriate calls also misuse the restricted ambulance and emergency services’ resources [1, 2].

According to a study conducted by Patton & Thakore, an estimate of 30% to 32% of ambulance calls were “inappropriate”, this caused the overburdening of hospital emergency department. The abuse of ambulance services, however, is much prevalent compared to the inappropriate use [3]. The overburdening of the emergency department and increase of patients’ admission by an ambulance time consuming and wastes medical supplies that would be better of used by patients who might have much more serious complaints [4].

To reduce this heavy burden on emergency staff, it is important for healthcare professionals to identify the reason why patients’ misuse ambulance and emergency services and recognize their needs. It is also essential to implement pathways in the United Arab Emirates that will assist paramedics in identifying whether or not patients need transportation to an emergency department. National Ambulance officials stated as, 40% the ambulance calls of the total 44,459 calls received on the emergency number during the first quarter were fake reports. (UAE: Woman calls 998, says she no longer needs ambulance after hearing officer’s voice, 2022) [5]. Similar scenarios worldwide noted for increase of nonemergency cases. This article will also compare the various methods that countries such as the U.K. and the Australia have incorporated in reducing this heavy burden on ambulance services for non-emergency cases.

Managing Low Priority Patients

The NHS in U.K. has focused on responding to the needs of all patients appropriately, to achieve this, the Trust must continue with its current controls over efficiency metrics of increasing Hear and Treat incidents (5.6%), whilst reducing See and Convey incidents and the number of responses sent per incident.

Emergency services in the U.K. have implemented clinical pathfinders in order to decrease unnecessary ambulance transportations. There are different pathfinders for trauma and medical patients. The pathfinders have been proven to have a 94.83% accuracy rate and both senior doctors and paramedics have agreed on their effectiveness [6].

Ambulance Victoria (AV), Australia Experience

AV manage demand through AV’s Referral Service, which employs paramedics and nurses to deal with Triple Zero (000) calls classified as low acuity, where the patient’s condition indicates that an ambulance is not necessary, and an alternative service can be safely provided.

The aim is to ensure the patient receives the best alternative service to meet their needs, which may mean a referral to more appropriate care – such as seeing a doctor or self-treating the condition. In the event of an emergency, an ambulance is sent to a call.

The Referral Service alone was responsible for reducing demand for emergency ambulances by 9.5 percent in the metropolitan region in 2012–2013, thereby increasing the availability of ambulances to respond to emergency calls.

According to St John’s, you should call the ambulance only when you need serious medical aid in life-threatening situations. Conditions that require urgent care include heart attacks, spinal injuries and severe bleeding. But if the patient has less severe injuries, where their health is less likely to worsen such as: burns, sprains etc., they can be sent to the hospital without calling the ambulance [7].

Remember Saving a Life Starts with the Call for Help

When an emergency happens, the first thing you hear is a cry to “Call an Ambulance quick”. People call an ambulance because they expect the ambulance to save the life. However, the ambulance can only save a life and transfer the patient to definitive care if the right things have been done to the patient before the ambulance arrives. What happens BEFORE the ambulance arrives will be one of the biggest factors that determine if a person lives or dies. It all begins with the call; the first few minutes of an emergency are the most important. “If a person has a cardiac arrest, a blocked airway, or a major bleed, they may die in minutes, even seconds.” “So what the bystander or next of kin does is most critical for saving the life of the patient. The ambulance may get there quickly, but by then it may be too late if no one assisted with first aid in critical situation”. The two most critical things that need to occur are the commencement of life saving first-aid and, secondly, the call to an ambulance for help.

To assist with this, Ambulance Services might consider simple following procedure. Procedure for Calling for an Ambulance The three priorities in an emergency are:

• Commence lifesaving skills
• Call for an ambulance
• Give good information so the ambulance can arrive quickly Step 1: Respond to the Patient. Three things that a person may die from within minutes are a major bleed, a blocked airway and a cardiac arrest. Simple first-aid can save a life in these cases. But it must be commenced immediately. Even if the ambulance arrives in minutes, the person may be dead from one of these causes if first-aid is not commenced BEFORE the ambulance arrives.

Step Two: AT THE SAME TIME Ring 998 or 911 for an ambulance. If there is a second person available, have them call for an ambulance. The information the caller gives will determine how quickly the ambulance will arrive. Poor information may cause the ambulance to be delayed. When you call 998, an Ambulance Call Taker will take your call. Immediately state your language. You will be connected to a caller who understands you.

The caller to 998 should provide the following information to 999: The exact location of the patient, the number of patients, details of the patient’s and other necessary details as required.

You can use AMBULANCE acronym as sample to expect the information needed by ambulance call taker and dispatcher (Table 1).

Stay on the line until the Call-Taker advises you to disconnect. As the call taker will give you instructions what to do and how to assist the patient. Ensure telephone is kept open and available. You may be called back for further information or directions.

Step Three: Meet the Ambulance Send someone to meet and direct the ambulance. This is most critical. Alert security (if available) that the ambulance is coming so that they know exactly where the emergency is. The person needs to meet the ambulance where it pulls up, so that they can be directed A Quick Self-Exam: Test Your Readiness Yes No Do you have a current first-aid certificate? Do you know how to do CPR? Do you know the proper technique for clearing a blocked airway? Do you know what position to put a patient if they are unconscious? Do you know the proper technique to stop a bleeding artery? Do you know a person in your office that has a first-aid certificate? Is there a person living in your house who knows first-aid? Do you know the number to call an ambulance? Do you know your mobile number so that you can give to the call taker? Do you know the name of your street? Do you know the name of your building? Do you know the name of the building next door? How many villas/buildings are there to the nearest corner? Can you name one thing that makes your office/building/villa different to others, that may help an ambulance find it? Can you name three significant landmarks that are close by where you a sitting right now that could be used to guide the ambulance? Do you know the telephone number of security where you are right now, to tell them you have called an ambulance? Has your office got a plan of what to do if an ambulance is called? If you do, does everyone in the building know that plan? Do your children know what number to call for an ambulance? Does everyone living in your house/apartment know how to call an ambulance? If there is more than one entrance to your building, do you know which one is best for the ambulance? Write down NOW the directions you would give an ambulance to reach your current location. Are you confident that these directions would enable the ambulance to find you directly and without delay?** Did You Score 100% If You Did Not Answer Yes To Every Question, You Have Some Work To Do!