Bee-Baw Bee-Baw Bee-Baw

You’re driving along in your car, minding your own business, when BAM! Your rear vision mirror is filled with red and blue flashing lights. An ambulance screams by, sirens wailing into the night.

Ever wondered how ambulances work out whether or not they should use lights and sirens when traveling to a patient? Sometimes you see them with lights on, other times you don’t.

In theory, a balance is measured between the risk posed to paramedics/ the public by high-risk increased speed driving, vs the risk of additional time delay to the patient. In reality, someone also factors in the risk of an ambulance service being taken to court for not traveling with lights and sirens.

What this results in for the western world is a commonly used algorithm, where a call operator asks a series of preset questions to determine where in the algorithm you fit.

Language changes varying by jurisdiction, but generally looks something like this:

Priority 0: is a patient believed to be in respiratory or cardiac arrest.
Priority 1 :A patient with time criticality, such as a chest pain patient.

All the above get lights and sirens. The ones underneath don’t aren’t dispatched with any bells or whistles.

Priority 2 are patients who requires some sort of timely treatment, but nothing immediate, this may include something like a broken bone.

Last and least: priority 3. These are patient’s who have something like the flu and require no emergency treatment or assessment.

The problem with this is, the algorithm has a lot of trouble telling the difference between the ‘haemorrhage’ coming from a stubbed toe, and the ‘haemorrhage’ coming from an amputated foot.

Further more, with GPS tracking on most vehicles now, the closest truck is often the one dispatched, meaning a crew returning from the regional hospital can get caught up going to jobs well outside their coverage zone.

The result of this is an often skeptical attitude towards pager messages. See, most of the time our ‘unconcious’ patients, are alert and having a jolly chat when we arrive. Likewise, ‘breathing problems’ can be someone with a blocked nose and the sniffles.

For us, it’s a little like crying wolf. But we have to respond the best way we can each time. Sometimes people play the system using the buzz phrases of chest pain, weakness, not alert or difficulty breathing to get an ambulance faster.

Other times, the system gets it wrong (more on that next post), and you casually walk into a house which you’ve mosied along to and discover a critically ill patient who needs treatment yesterday.

But that’s part of the fun, you never know what you’re going to get.

Regardless of how sick they are, once our patients are loaded we always drive slowly back to the hospital. The lights come on only to clear traffic: its damned difficult to do CPR in the back of an ambulance going around a round about. It’s even harder to set up an IV line and give drugs.

How do things work in your world?

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