2.5hr wait for an ambulance for critical incident.

banie01 · 22-06-2023 12:38AM #1

My 34yo brother collapsed on Monday night. Luckily he had a friend over at the time and a 999 call was made near immediately at 8:30pm

Now to lay the scene he lives on the N20, in Ballyhea Co. Cork. Certainly a rural location but one with good road access and within 40 minutes of both Cork & Limerick on decent roads. So there was never going to be a 10 minute ambulance response, which is fair enough.

The 999 call triggered the local community 1st responders. They arrived within 10 minutes and went straight to work.

They initially thought that he had had a stroke. He was drifting in and out of consciousness and had lost all power on his right side.

The 1st responders worked to stabilise him and fed his condition back to their control centre.

Who despatched another community responder. Those people did Trojan work in keeping my brother relatively stable, and reassuring the people who were on the scene.

They couldn't do much more for my brother other than keep his airway clear and keep him in recovery position.

Multiple further calls were made to 999 and to SouthDoc to press for the ambulance to be speed up and to have a doctor attend.

The Ambulance arrived a touch after 11:15pm, they were called at 8:30pm!

Over 2.5hrs!

My brother is currently in ICU in CUH, in an induced coma. He has improved slightly today but he has a long and arduous road to recovery.

We are a big family, and he will have all the support we can muster to get him well again.

My 1st concern is his recovery.

My 2nd, when we get him well again? Will be obtaining the complete records of the calls to 999 both from friends on the scene, and whatever Comms log the 1st responders have.

Not as part of a claim or lawsuit, but as part of a review to see how a critically ill patient is identified, triaged and how the response is managed and what priority was assigned to his call.

Rural living comes with risks. There was never going to be an instant ambulance, but? I am certain there are lessons to be learned from how the response to my brother's emergency was managed and prioritised, that will improve the response times for similar cases in the future.

My Brother's collapse was at 8:30pm, the Ambulance arrived at @ 11:15pm and my brother arrived at CUH A+E shortly after midnight.

Time was lost to arrest the brain damage caused by his bleed. If nothing else?

I am going to do my utmost to ensure that priorisation and despatch of emergency ambulance and PHECC is improved in light of our experience.

I would like to say, the care and attention my Brother has and is receiving at every point of this calamity, has been excellent.

The issue I have is with the delay, and the system that allowed it, not the people who have gone above and beyond.

The 1st responders, the staff at CUH's A+E and ICU, along with the accomodation provided by Brú Columbanus have all helped make an awful situation easier to navigate, Bru Columbanus in particular will be getting a donation as soon as I can manage it.

TLDR: Brother is fucked, would likely be considerably less fucked if 999 priority was better managed and ambulance arrived within 1st hour.

22-06-2023 12:48AM

There’s inadequate capacity in the national ambulance service. I had a really bad experience waiting for an hour when my mam had a stroke and this was in the middle of Cork city !! The ambulance had to come from some huge distance way out in the county.

It needs investment and much more capacity. They’re just under way too much pressure.

Sending my absolute best wishes to your brother and your family.

NIMAN · 22-06-2023 12:54AM

https://www.boards.ie/discussion/comment/120747395#Comment_120747395

100%.

The ambulance service do a sterling job, considering they are so woefully under resourced.

They do their best. They will try to get to every incident as fast as they possibly can. Unfortunately there will be occasions when they are just too late, but that is as a result of policy and under investment. Doesn't excuse a near 3hr wait, but i think you'll find there was probably nothing done wrong in the process, just they were dealing with other emergencies.

I really hope your brother makes a full and speedy recovery.

banie01 · 22-06-2023 01:03AM

https://www.boards.ie/discussion/comment/120747395#Comment_120747395

https://www.boards.ie/discussion/comment/120747398#Comment_120747398

Fully agree on the capacity issues. Resourcing is a huge bottleneck that needs to be addressed at a national level.

I appreciate the good wishes too, thanks 👍

Agree also that Ambulances can/could have been on other calls and that capacity is tight. It's just that something isn't sitting right with me about the response and how it was managed. Might be my mind looking for "reasons" for a Scape goat, and I'd certainly understand why some might think that, but it's not that.

Deeec · 22-06-2023 06:23AM

Sorry to hear about your brother op. That wait for an ambulance is unacceptable.

The problem is of course limited resources. I strongly feel there should be a national campaign to advise the public on when an ambulance should be called. I know my in-laws have called for an ambulance when really some of the family could have drove them to hospital. They said their GP advised them to always call an ambulance if unwell which isn't great advice if the problem is minor. I have been annoyed in the past about their judgement on using an emergency service. There also seems to be a belief out there that if you go to hospital by ambulance you get attended to quicker which is not the case at all!

Ambulances should be for emergencies as in the case of your brother. Unfortunately people's definition of emergency differs and yes some people treat it like a taxi service to the hospital which is very wrong.

kippy · 22-06-2023 06:53AM

So sorry to hear about your brother and the stress and anxiety this has put on you and your family.

I don't think I can help only to say that it's yet another service that hasn't expanded to account for our growing population.

I've unfortunately had first had experience of healthcare that literally meant the difference between life and death which came down to availability of resources, which I am sure man can also attest to.

Have you contacted your local representatives in the first instance with your story?

Akrasia · 22-06-2023 07:01AM

We have a 10 billion euro budget surplus with some of the highest taxes and retail prices in the world linked to the highest excise duties in the world.

The government need to take that money and spend it on public services.

What happened to your brother OP is absolutely unacceptable and I hope he can make a full recovery as quickly as possible

prunudo · 22-06-2023 07:02AM

Are first responders volunteers or do they get any sort of payment?

Cookie_Monster · 22-06-2023 07:21AM

https://www.boards.ie/discussion/comment/120747605#Comment_120747605

Depends. Many are volunteers but I'm a paid first responder (in NZ). I work in patient transfer rather than emergency front line and FR is the required qualification for that position, I would imagine it's similar in Ireland/UK, most of the setup is.

I can be dispatched to cardiac/respitory arrest outside of my core role but thats all. I could, if I wanted, also be on a FR community response list for anything that comes up in my locale.

StrawbsM · 22-06-2023 07:23AM

Sorry to hear about your brother, OP. I hope that his recovery goes well. My father had a severe stroke and I remember the helpless, in limbo feeling in those first few days.

I’ve had to attend a&e many times with him since then and a very obvious issue with ambulance crews is the fact that when they arrive at the hospital, there’s nowhere for the patient to go. Before covid the crew would bring the trolley inside the emergency department and stand and wait. Since covid the ambulances with patients in them would be parked outside. The most serious of patients would be rushed straight into resus.

Every ambulance waiting an unnecessarily long time at the hospital is one less ambulance on the road and there’s nothing the crew can do about it.

Take the news report a couple of weeks ago regarding no more funding this year to adapt peoples houses - the majority of those people (610? In Monaghan) cannot be released from hospital until the work at their home is done. So they’re possibly in an acute hospital bed. The patient in the emergency department cannot leave their cubicle because there’s no space upstairs. The patient on the ambulance trolley can’t leave the ambulance because the patient in the cubicle hasn’t been moved. The ambulance crew cannot attend an emergency call because they’re still at the hospital because…..you get the drift.

airy fairy · 22-06-2023 07:32AM

Unfortunately, it's not the first time I've heard of inadequate ambulance service. It is now linked to a centralised call unit I believe. I know of an instance recently where ambulance was requested for south side Cork city and the ambulance available came from Waterford.

I am very sorry about your brother, his recovery will most certainly be determined by the lack of speed of emergency services.

We shouldn't be depending on first responders to hold the ambulance service together. They are only meant to be a compliment to aiding the ambulance crew.

Our hospitals are a mess.

I wish you every success in gaining records and getting answers for the delay your brother experienced. We are far too quiet in this country and are accepting of the top heavy admin that steer our pathetic health service that we pay for.

22-06-2023 08:26AM

My brother had a bad fall and lost consciousness in his workplace a few months ago, (he has a history of syncope and has had a brain bleed previously as a result of a fall). His employer called an ambulance and the dispatcher said it would be at least three hours until one could get to him. This was in Dublin on a work day morning.

The service is completely overstretched.

I'm so sorry for the stress you're under and I hope your brother makes a full and speedy recovery.

BattleCorp · 22-06-2023 09:20AM

https://www.boards.ie/discussion/comment/120747637#Comment_120747637

In my town there are first responders who are volunteers. The local retained fire fighters (part-time and paid - poorly) are sometimes called to attend to people while they wait for an ambulance.

I remember reading this story a good while ago. Not life or death but very painful. The school were told not to move him and wait for an ambulance. The ambulance came, over 6 hours later.

https://kclr96fm.com/injured-secondary-school-student-in-tullow-co-carlow-waited-over-six-hours-for-an-ambulance-to-arrive-yesterday/

BrianD3 · 22-06-2023 10:04AM

Ambulances taking hours to arrive (this is far from an isolated incident and it happens in urban areas too) and relying on volunteer first responders to provide essential public/emergency services is typical of this State's failure to plan, organise, fund or manage...anything.

We are flying by the seat of our pants in every area. Relying on a hotch potch of public bodies, NGOs and the for profit private sector. Vested interests, ass coverers, little fiefdoms and snouts in the trough.

The out of hours GP service is, like everything else, a sh*tshow. Ambulances get called out on the basis of phone "consultations" and ass covering. When ambulances arrive, crews run a few basic tests and find that their time has been wasted. Meanwhile, people like the OP's brother are waiting 2.5 hours and end up in a dire situation

Everyday, people's lives are seriously affected if not ruined/ended when they try to access health services.

Also, state agencies responsible for providing services regularly demonstrate their gross incompetence. 7 and 8 figure payouts to people who have had their lives ruined through negligence in public hospitals. Also, regular scandals, as we saw in yesterday's news, the HSE struggles with basics like preventing sexual assault and rape of residents by its own staff in its own facilities. if they can't manage that, is it any surprise that something much more difficult like operating a reactive, emergency, off site service for the entire country is such an issue.

WheelieKing · 22-06-2023 10:17AM

Strong economy but a weak society. The scary thing is we've never had this much money and yet the idiots in power have proven again and again they are incapable of fixing the many varied issues that confront us be it health, housing, rent, crime, immigration etc...

Makes you wonder how bad it will be when inevitably things go belly up.

BattleCorp · 22-06-2023 10:34AM

https://www.boards.ie/discussion/comment/120748265#Comment_120748265

The idiots in power are our fault. The Irish people keep electing them because that's what their father/grandfather did. A politician retires, up comes their son/daughter for nomination. More like a monarchy than democracy. There's no consequences for them so they can do what they like, or as little as they like.

Unrealistic · 22-06-2023 10:51AM

https://www.boards.ie/discussion/comment/120747637#Comment_120747637

The Community First Responders referenced by the OP are completely voluntary. Separately there are fulltime National Ambulance Service paramedics, who can sometime arrive in advance of an ambulance, either by car or motorbike. I guess the later is the equivalent of your role in NZ?

Community First Responder groups in Ireland can either be restricted to cardiac arrest callouts, or go through additional training to be classified as 'Enhanced', which it sounds like the Ballyhea group have done if they were called to a suspected stroke.

Hope your brother progresses as well as he can, OP. Waiting 2:45 in the case of a suspected stroke is desperate.

foxsake · 22-06-2023 11:15AM

I hope your brother recovers and you are all ok .

While there are clearly issues with the emergency service the general public are also at fault here, very much so

they clog the 999 lines with frivolous issues

like people who get referrals from a GP ring for an ambulance for a "lift to hospital"
minor aliments like swallowing an aspirin
people who just are fcuk ups (i.e. regulars)
drunks
etc etc...

Until such people are jailed (yes jailed) the ambulance service won't be worth a toss.

Of course, ambulances get diverted for "emergencies" that in the end are the entitled class exaggerating the issue cos they matter more than the regular guy

sure our health system is in **** - but there is a huge entitled class that clog the sh1t out of it also

banie01 · 22-06-2023 11:16AM

Thanks for the good wishes and the messages of support folks, they really appreciated.

Agree with a lot of the comments re: the lack of any growth in the Ambulance (and other emergency)service over the course of our recent population spike.

One of the benefits of a budget surplus is that hopefully steps will be taken to address the glaring gaps in hospital and pre hospital emergency care.

One would also imagine that a huge benefit of a 5yr census cycle? Would be better response from government to short term pressures, and better population based resourcing. That this still seems to be so far beyond our government, is infuriating. We seem to have a grà for doing more with less, rather than doing more, with enough resources to be sure it's done well.

The failures of Government resourcing all too often only become apparent to many of us when it's one of our family members in need. That frustration is all too easily and all too often faced by those poor bástards working on the frontline. When collective ire should be directed at the Government who are happy to coast along until a disaster strikes.

22-06-2023 11:27AM

I would agree with the point on over centralisation. There needs to be an ambulance dispatch centre that can speak to you in each region.

You'd expect a complete dispatch centre in Dublin, Cork, Limerick, Galway, Waterford, Sligo / Letterkenny and probably one of Athlone/Tullamore or Portlaoise covering the midlands.

You need local knowledge in a lot of cases. It obviously can't be entirely county by county, but it could be a lot more local.

I'd agree we should have more serious penalties for abusing 999 / 112, particularly prank calling it. It's a total waste of resources.

You will always get scenarios where people can't triage an issue themselves though and there needs to be actual medical staff on the end of those lines to assess needs before sending a crew out.

I know of plenty of situations where someone's had some agonising pain and someone's called 999 and an ambulance was dispatched, only to turn out that it was something non-life threatening, but at the time they had no way of assessing that themselves.

For example, a friend of mine was doubled over in agony and throwing up and someone called 999 in Dublin for her. When she got to hospital she was lectured about wasting resources, but she had gall stones and didn't know and was in absolute agony. So, I'm not really sure how someone like that can assess whether it's a serious issue or a non serious issue themselves. She wasn't able to walk to or get a taxi to hospital and while it turned out it was just a case of waiting for an episode to pass and ultimately getting her gall bladder removed later that year, I'm not really sure how else she could have handled it.

You are also always going to get scenarios with hypochondriacs and people with mental health issues, which may lead them to call 999 for various reasons. That's where networks of first responder paramedics, especially in urban areas, could help a lot by going to somewhere ahead of an ambulance, perhaps by motorbike where it's unclear what's going on.

They seem to be creating 'widow maker' jobs though where the resources are too thin, so the jobs become too stressful and people then emigrate or don't apply for them at all. So, we're not building resources. It's the same in nursing and front line medical care. The HSE seems to run things in a lot of front line services in a permanent state of crisis, which is no way to work and makes working environments very unpleasant.

ThreeGreens · 22-06-2023 11:37AM

I hope your brother makes a full and speedy recovery.

It's not just rural Ireland. I know of someone recently in Dublin who had a stroke and it took 3 hours for the ambulance to arrive.

It's really an unacceptable situation, but one that I think is more common than most people realise.

Cluedo Monopoly · 22-06-2023 12:01PM

Sorry to hear about your brother OP. I have been saying it for years - our inadequate health service is killing citizens on a weekly basis. Between ambulance delays, A&E delays, extreme waiting lists, lack of mental health services, inadequate front line staffing levels, misdiagnosis, trolley crisis etc etc, people are suffering and some are dying prematurely. Our power swap governments have been too cowardly to tackle the problem head on. When was the last Health minister that actually achieved anything substantial? The Children's hospital disaster is impacting other capital projects which will have knock on impacts.

22-06-2023 01:29PM

What really gets to me about this is that literally everyone is always doing their best, often in trying circumstances and chaotic systems, so it just drifts along as a big amorphous mess.

There are definitely policy issues, but I also see where ministers try to drive change, the system seems to just steamroller them into submission.

It absolutely needs reform. There's no question about that. It's not working in key areas that are really causing serious difficulties for people and that's notably A&E.

We simply cannot keep drifting like this. Whatever the issues are they need to be resolved. If it means policy makers going in and really ruffling feathers and annoying people, so be it. It has to be done.

Geuze · 22-06-2023 01:34PM

Expenditure on healthcare has increased strongly recently.

Huge resoucres are poured into h/c, with massive annual increases.

Spending has increased by 33% in five years.

The problem is not a lack of spending.

We paid GP double what the UK paid to administer the COVID vaccine.

Geuze · 22-06-2023 01:35PM

https://www.boards.ie/discussion/comment/120749244#Comment_120749244

Few politicans will take on the entrenched power of the medical doctors, or the trade unions.

BattleCorp · 22-06-2023 02:14PM

https://www.boards.ie/discussion/comment/120749281#Comment_120749281

Those figures will go up a good bit this year too due to the increase in the cost of fuel and electricity. I was at a presentation a few weeks ago where the Sustainability Officer showed us how the running costs (electricity) of some of our buildings has gone up well over 100% between this year and last.

Feisar · 22-06-2023 02:30PM

A friend is in the service, it's scary how light on the ground they are.

_Kaiser_ · 22-06-2023 04:04PM

I'm guessing in this case, it wasn't safe to move him yourselves? Otherwise if it were me, I'd be in the car and breaking multiple speed limits to get my loved one to the emergency room of whatever hospital was closest - with calls en-route to the local Gardai and A&E to give them the heads up.

Regardless, I hope your brother makes a full recovery OP.

banie01 · 22-06-2023 04:22PM

https://www.boards.ie/discussion/comment/120750026#Comment_120750026

It wasn't, but if the despatch centre had made clear how long he may have been waiting? A judgement call could have been made on that front. The risk of moving versus the risk of waiting.

He was drifting in and out of consciousness and on top of that other than the folk that originally responded no-one there could drive. His van was there and he could have been loaded into that. Truth be told if I'd known what the situation was at the time? I could have been there inside 40 minutes to move him. It wasn't until shortly before the ambulance arrived that I knew what had happened.

The combination of advice to keep him in recovery position, the understanding that an ambulance was enroute and that the situation was in hand. All conspired really to add to the delay and prevent anyone on the scene deciding to move him rather than continue waiting.

BattleCorp · 22-06-2023 05:45PM

https://www.boards.ie/discussion/comment/120750125#Comment_120750125

Moving someone in that situation yourself is a damned if you do/damned if you don't situation. Impossible to know what's the right thing to do.

Goldengirl · 22-06-2023 10:11PM

https://www.boards.ie/discussion/comment/120750125#Comment_120750125

Am very sorry to read this op. It is just not on that we are in these situations in a country that is meant to be flush with money .

The ambulance service have been calling for more funding for the service which is at a critically low level throughout the country .

However from what you are saying someone maybe did not progress that call with the urgency it required . I hope not, but there will be records .

I hope your brother in law is ok now and improving . That is a frightening experience for all of you.

I hope you get answers .

2.5hr wait for an ambulance for critical incident.

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