"In many cases they will probably get to your place, and then the hospital in the time it takes you to get to hospital."
Ambulances are no longer a taxi with blue lights. The vast majority of patients will be assessed and stabilised before departing for hospital. None of us, including many medical pros, have the skills or equipment to do this. The paramedics have real-time advice and support in addition to their own training. Trust me, they know what to do. Scooping up your loved one and putting them in the car is really not an option in a post-traumatic medical emergency.
Fine if SWMBO is in early stage labour, or junior has popped their wrist falling off a bike, but otherwise, leave it to the professionals.
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certainly agree with this. The treatment starts when the medic arrives, not when you get to hospital.
Those guys and girls really know their stuff, sometimes its best to stand back and let the pros get on with the job. I was very impressed with the service that I/my mother recieved.
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Also worth bearing in mind that the first vehicle to attend may be a car/motorbike with one/two paramedics. The stretcher and traditional ambulance is not needed until some time after the paramedic is on scene, so that may follow in slow time. A well-driven bike with blues and twos will be fast - far faster than us, and far safer, as it's the job they are trained for.
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We had an accident at work a few weeks ago, when someone cut himself badly. We took him in the van up the road to casualty, where they said he needed specialist attention not available there. They had no ambulance available, so our driver was virtually ordered by the doctor to drive from Aberystwyth to Swansea hospital as fast as he could.
All this talk of 999, rapid response, motorbike paramedics, air ambulances, was complete nonsense in this case. It was DIY or bleed to death.
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I agree with Blue that if the emergency seemed dire enough you simply wouldn't bother with speed limits and so on, but leave all that to be sorted out later. But DVD is right too: you want to get there without complicating the situation by having a crash. If you have never practised driving too fast for no good reason except that you wanted to, an emergency situation is not the one in which you should try it for the first time. You may be devoid of natural talent.
I used to live in hope of a copper leaping into my 2CV at the traffic lights shouting: 'Follow that car!' and pointing to the 3.8 Jag containing four big blokes in balaclavas wheelspinning off down the middle of the road. It hasn't happened yet though.
Obviously, if dialling 999 was the most efficient way of dealing with the emergency you would do that. But it isn't always.
Edited by Lud on 29/05/2008 at 15:02
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needed specialist attention not available there. They had no ambulance available so our driver was virtually ordered by the doctor to drive from Aberystwyth to Swansea hospital as fast as he could.
So he wasn't then.
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I had a similar experience to the OP with driving to the maternity ward with my wife.
I did drive through red lights and passed a gatso at allot more than 30. I considered it an emergency as when I pulled up at casualty the head was popping out (oh no - too muh detail !!!!!- sorry)
Anyway after chatting to the midwives afterwards they told me that they would write a letter if I was prosecuted in any way - and when they have done this in the past it has helped get the driver off.
I suppose that if you have an accident that may be a different story though - as the emergency services with blues and 2's can be prosecuted for dangerous driving and by law are not entitled to speed even with the lights flashing - is my understanding.
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needed specialist attention not available there. They had no ambulance available so our driver was virtually ordered by the doctor to drive from Aberystwyth to Swansea hospital as fast as he could.
So he wasn't then.
But at least he could say he was only virtually speeding - I don't know how many points virtually speeding would get you ??
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I'm sorry, Pendlebury, but giving birth is a perfectly natural happening. Amazingly the human race has survived for thousands of years before it had cars with which to break speed limits. If the head is popping out at such short notice you're pretty much there. You'd have been better off letting her have it at home - much less messy in the car, too. As for your poor lady wife giving birth when you're taking it too quickly through traffic lights, that's no way to treat her.
If a description of a baby's head is too much "detail" what sort of world do we live in?
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>> needed specialist attention not available there. They had no ambulance available so our driver was >> virtually ordered by the doctor to drive from Aberystwyth to Swansea hospital as fast as >> he could. So he wasn't then.
Precisely.
OED definition,
virtual - " That is such for practical purposes though not in name or according to strict definition. Hence virtually"
Obviously he was not actually ordered to, because a doctor has no power to order someone else's employee to do anything. But it was made abundantly clear that
a) the hospital could do nothing
b) it was our responsibility to take him to another hospital
With blood pouring on the floor and all over the van, what else could the driver do?
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"It was DIY or bleed to death."
But the trip to Morriston Hospital from Aberystwyth must be nearly 70 miles and at usual speeds and no holdups close to 1hr 15min... no way would someone in a life threatening condition be driven that distance. Sounds like he needed specialist care after the bleeding was stopped.
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Our driver was in no position to argue with a doctor's verdict that the chap had to be taken to another hospital asap. What would you have done - walked out and left him there?
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I still cannot believe the A&E department at any hospital would send someone away who is bleeding so badly. Or is this what has happened with the NHS in Wales?
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when our baby was born we were called and told to go in immediately - this was 12 hours after the waters broke and we had been sent home(due to a complication wifey needed high doses of antibiotics before the birth). Typically the traffic was awful and it took me an hour to get home, and another hour and a half to get to the hospital. It was another 24 hours or so til junior appeared. I had been rather looking forward to a mad dash to the hospital but we didnt need it.
The day after the birth i got from home to the hospital in about 10 minutes i was sthat excited to go and see them both. Early sunday mornings are pretty clear on the roads apparently - and i was driving enthusiastically with a big grin on my face.
Its a more sedate drive now.
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>>>> Its a more sedate drive now.
Yes, once you've had the first dozen or so, the novelty wears off.
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"Our driver was in no position to argue with a doctor's verdict that the chap had to be taken to another hospital asap. What would you have done - walked out and left him there?"
It's hard to imagine an A+E doctor discharging a patient whose treatment plan was not complete and insisting that his mate drove him 75 miles across country to another A+E where another doctor, perhaps without warning, would be expected to pick up where the first had left off.
The chances of the patient having complications en-route, or the driver/vehicle becoming unfit (why do ambulances have two crew...) and all the other possibilities just make this story inexplicable.
I'm surprised that you/the patient didn't get it splashed all over the local/national news. It's a story that most provincial journos would give their eye teeth for. I'd expect the Chief Exec of the hospital trust concerned to swing for it, and the doctor to get at least a severe reprimand.
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Not all a&e departments are equipped or manned to do everything, as I discovered myself a couple of years ago. One would expect of course that they would all be able to prevent a patient with a cut from bleeding to death, and assessing whether although still losing blood the patient would survive a fairly rapid 75 mile journey. But isn't it possible that with a deep bad cut needing proper surgery - repairing tendons and veins, arteries or major nerves for example - the hospital might send the patient to a place with the right facilities? Just a thought. I'm not a medic.
The essential thing is the outcome. Would you really run screaming to the local reptiles without waiting for that onb?
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Lud - I might well have tipped off the press if this had happened to me as described above, as it's outrageous!
Sure the hospital may not have had the facilities to treat the guy to completion, but the poster suggests he was barely stabilised. I'm amazed. He'd have been stabilised, admitted, and a road/heli transfer would have been arranged to take him to a booked bed for the treatment to be completed.
NHS can call on the RAF/Royal Navy for assistance if a patient needs transferring at night/in poor conditions. By the sound of things this started in day time.
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OK, point taken onb, and I must say I am no fan of the post-Thatcher organisation, management-heavy and technician-light, of the NHS (or anything else for that matter). Management by definition is stupid, ignorant and self-important, fit only for secretarial work (OK, secretarial work writ large) but unfortunately very jumped-up in the world we inhabit and in a position to lord it over its betters.
Perhaps the case didn't seem as dramatic and urgent to the a&e department as it did to the patient's workmates. Perhaps the ambulances were all on call and the case didn't warrant a helicopter. It's all just practical stuff most likely: how do we get this non-dying bloke to the hospital with the orthopaedic surgeon quickest and easiest? His mates are here and want to help. Great!
It may be disgraceful, but it may not. You'd have to have been there.
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I'd expect the Chief Exec of the hospital trust concerned to swing for it and the doctor to get at least a severe reprimand.
With one important proviso:-
That the facts were as stated by the OP.
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That is a dreadful story. In the early 1980's I was a casualty officer in Bronglais Hospital in Aberystwyth and the hospital offered a full orthopaedic service that would have dealt with this sort of situation without a transfer to Swansea.
On one very rare occasion, at which point I was working in paediatrics at Bronglais, we took a sick baby to Cardiff, I think, by helicopter. In general, however, Bronglais was equipped to deal with almost anything.
I feel that the event you describe should be reported to the hospital managers as a complaint as Bronglais covers a huge area and should still be offering a comprehensive service to the people of mid-Wales.
Swansea is just too far for untrained folk in a van to have to take responsibility for their own transfer.
If you complain, I would be interested in the feedback that you receive as I always felt a sense of pride in the service provided at Bronglais A+E (by the way, I was relatively inexperienced but the wonderful nursing staff guided me through the job).
If you have any feedback, email doctorchris@lycos.co.uk
Chris
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Hasn't the NHS been cut financially and messed up by increasingly numerous and incompetent managers since the early 1980s dc? My impression is that it has.
Edited by Lud on 30/05/2008 at 00:16
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NHS policy is to centralise specialist services, the logic being that those providing the services are more experienced therefore better and safer. It does also save money.
However, this only works in densely populated urban areas and can never work in mid-Wales where the distances to specialist centres are huge and the ambulance service is overstretched.
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Lud has described the situation pretty accurately.
I don't know what the reason was for the lack of ambulances, perhaps engaged at a major accident elsewhere. We don't have to jump to the conclusion that the local NHS was so run down that the ambulances were all broken down, or sitting in the carpark full of grannies on stretchers waiting for proper beds indoors.
Presumably all the harassed doctor saw was that here was a case that did indeed need specialist attention at another hospital, and the patient had someone with him to keep the bandage tight, a driver, and a vehicle that was immediately available. In those circumstances you don't wait to write to the hospital trust chairman, or your MP, you just do what the medical man on the spot says.
I don't think it was necessary actually to speed unduely, therefore this is not really an example of the kind the OP was raising, but it does show that there can indeed be circumstances where an ordinary member of the public suddenly finds himself in the role of ambulance driver.
BTW - the man indeed needed tendons repairing but is recovering satisfactorily. The bleeding was, we discovered later, due to his being on blood-thinning medication. The real hero was not the driver, but his mate who kept the patient calm while keeping the bandages tight. It was quite an event - we don't normally have to hose down the inside of the cab after use.
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doctorchris points out in his last post above how a one-size-fits-all a&e national policy works OK in London, Manchester or the West Midlands - traffic jams apart - but doesn't suit more scattered and thinly-populated areas. I would point out that this is precisely an example of managerial (which in this context alas often means political too) stupidity.
That said, I feel I may have given the impression that I am an NHS-basher who thinks the NHS is useless these days. I don't think that of course, just that it could obviously be better and more efficient with less management interference and gigantist governmental uberplanning, and more local autonomy and variety led by healthcare professionals.
I have good reason to value the NHS. It has moved extremely fast and effectively when necessary to provide me personally with life-saving services not available to most of the world's population. I worry about politicians and moronic jobsworths of all sorts messing it up.
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I don't want to labour a point, Cliff but in the early 1980's Bronglais had 2 experienced orthopaedic consultants with good junior doctor back up who could repair tendons, even on a patient taking Warfarin to thin the blood, which would be partly for the anaesthetist to deal with anyhow.
What has happened over the past 25 years to reduce Bronglais to a mere staging post where such work has to be transferred to Swansea?
What next, downgrade the Swansea hospitals so that such work requires a transfer to Bristol?
You guys living in rural areas should be fighting hard to preserve your local specialist services or lives will be lost.
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