Original posted 19/12/08. Edited 20/12/08 In this time of too many calls and not enough ambulances I thought I'd try and give you an idea of the main things we look at. This isn't the shortcut to a quick ambulance. These are the 4 areas that could cost you your life and hence have the most effect on our triage system.
Chest Pain You have probably all so seen the big billboard campaign of the man with the belt around his chest!! This was designed to help reduce cardiac related deaths by telling people to get early intervention. Yes it may be indigestion. Yes it may be a pulled muscle. Yes you may be having a heart attack. Call us. Some of the symptoms of a heart attack are: Aching Pain Chest Pain that has now gone Constricting Band Crushing Discomfort Pain in jaw, neck or upper back Clammy Nausea and/or vomiting Impending sense of doom
Difficulty Breathing Asthma Attacks, Exacerbation of COPD, Emphysema - all the classic breathing calls. "It hurts to breathe" does not count as difficulty breathing. A cold which means you are breathing through your mouth is not difficulty breathing. REAL difficulty breathing is very different and you only have to listen to it once to realise. Difficulty speaking between breaths or being unable to complete a full sentence are good indicators. Blue lips or a blueish tinge are other signs that not enough oxygen is getting round the body.
Severe Bleeding When we ask about severe bleeding in trauma we are looking for blood squirting or pumping out - a severed artery in other words. Severe bleeding is a tough one though - certain parts of the body pour blood but it's not necessarily life threatening. Heads for example bleed brilliantly and look a lot worse than they actually are. Tough to say what to call us on but first thing you should do is get a clean dry towel or cloth, apply firm direct pressure and don't lift it up to look. If you do have an injury that makes you bleed give this a shot first before jumping on the phone to us! Rule of thumb - All bleeding always stops!! .... eventually!
Conscious Real bone of contention this one! Unconscious is one thing - call us! Altered levels of consciousness is a completely different story. The reasons for altered conscious could fill this blog tenfold. Alcohol and narcotics make up a huge amount of these calls. Being simply drunk and calling us is just annoying - being drunk and unconscious is dangerous. And don't get me started on why (or how) people can drink enough to get in that state. People, seriously - enjoy a drink and make your way home to sleep it off in your nice warm bed regretting, but laughing about last nights antics. Don't enjoy a drink, vomit on the street, call an ambulance, abuse the crew, vomit on both the ambulance and the crew, take up a bed in an A&E department and wake up feeling a complete twat and having to sheepishly apologise to the nurses before leaving to finally get home.
Strokes, UTI's, Low blood Sugar and the like can all cause huge changes in a patients alertness and in some way need treating - whether by home care or hospital. Mental Health patients can have altered levels for many different reasons. A bad cold can make you lethargic as can a head trauma.
So when do you call the ambulance? Again it's hard to judge so you just have to apply some common sense. Has anything happened physically to the patient that could have caused it? Has the patient been unwell? Does the patient display any other symptoms? Has the patient taken anything that could have caused it? How different are they behaving from their normal self?
Those are our main 4 areas - the ones we call our priority symptoms. I can't sit here and say if you have this, this and this then call an ambulance. It doesn't work like that. If you are concerned about the patient then look at the other pathways the NHS offers before jumping straight onto 999.
Your GP - when your surgery is closed, ring them anyway and you will hear an answer machine message that will give you the Out of Hours GP number. When you ring them, they will take all your details (much like NHSD ) and then a Dr will either call you back or come round and visit. NHS Direct - you will be able to get help from one of their advisors or a nurse to help find the best solution to your illness or injury including self help care. NHSD will also be able to assit you in finding out where your local services (such as those listed below) actually are as well as their opening times. If in doubt, give them a call. The website especially is incredibly comprehensive and easy to use.
Walk In Centre - like a GP/advice/drop in centre for health care. You don't have to be registered with a Dr and you can get help and treatment there Minor Injuries - like a mini A&E for the less serious injuries. Most deal with cuts and grazes, sprains and strains, broken bones (fractures), bites and stings (including human bites), infected wounds, minor head injuries, and eye problems, such as minor eye infections, scratches or something that is stuck in your eye. However they are UNABLE to deal with chest pain, respiratory problems, abdominal pain, gynaecological problems, pregnancy problems, drug overdose, alcohol related problems and mental health problems. They are also unable to deal with children under 3. Local Pharmacist - those lovely people that make up your prescriptions for you are very knowledgeable too and they can help with relief from cold and flu symptoms, diarrhoea and headaches to name a few. Go and have a quick chat with them. You don't generally have to wait more than a few minutes to see them and a lot of them even have their own little consulting rooms for privacy. Again, like NHSD, they can assist you in where local services are and what is the best pathway for your problem (Thanks Steve!!! Forgot them in original post!!) Make your own way - Do you really need an ambulance to take you? Can you get a bus, taxi or a friend to drive you. Hell can you actually just walk over there? We get far too many calls from people within spitting distance of an A&E department. What is the actually reason you are calling an ambulance - a genuine emergency medical problem or a genuine lack of money and/or effort to make your own way?
To find your local GP, Emergency & Urgent Care Units, Hospitals, Dentists, Pharmacy or Optician then you can click here
* I have edited this post once to include more "alternative pathways". If you think of any more let me know and I can keep adding them!