Come in Houston…

Written By: - Date published: 5:56 pm, July 11th, 2013 - 15 comments
Categories: health, quality of life, Social issues - Tags: ,

Today, a passenger on the bus I was travelling on, had a fit or seizure of some description. Luckily for them, they slumped sideways into the recovery position and the bus was stationery, having just pulled into a bus stop.

The driver and another passenger ‘oversaw’ the person for the duration of their seizure. So far so good. The person then responded to the driver that they had never had such an episode before. And so, the driver, quite reasonably and presumably acting on the precautionary principle, phoned emergency services.

Obviously, the call centre wasn’t in Dunedin as the driver had to reiterate he was in Albany Street, describe where Albany Street was and point out that ‘Albany’ began with an ‘a’ and not an ‘e’. Had the street been by any other name, then that small breakdown in communication wouldn’t even have been noticed. But questioning the whereabouts of Albany Street? I mean, for the benefit of anyone unfamiliar with Dunedin – anyone – everyone in Dunedin knows where Albany Street is due to the fact it runs down by the side of the University.

Anyway, the call proceeded on the basis of the driver answering direct questions or running rudimentary first aid diagnoses under instruction from the person on the other end of the phone.

Then he was told an ambulance would be on its way. So we waited.

And ten minutes became fifteen minutes. And fifteen minutes became over twenty minutes. And still there was no sign of an ambulance. Again, for those unfamiliar with Dunedin, Albany Street is one block away from the hospital…a two to three minute walk. The driver re-dialled emergency services and again was told to wait and assured that an ambulance would be there.

And more than forty minutes ticked by.

During that period, the person who had ‘fitted’ left the bus and began to walk along the road. I caught them up and suggested they come back to the bus as we were awaiting an ambulance. They hadn’t realised…had forgotten…that was why the bus was just sitting there.

So they, perfectly functional but discombobulated, came back to the bus. I asked where they had intended to go when they had left the bus and was told they were heading towards the hospital, though they had no idea where they were. And as minutes ticked by they became more inclined to be upset – tears of embarrassment, guilt, confusion or whatever bubbling just beneath the surface in spite of reassurances from the other passengers that any delay to our journey was inconsequential.

I don’t know what happened in the end as another bus came to ferry the rest of us passengers home after forty minutes or so.

But what the fuck is it that emergency services say they are sending an ambulance from no more than three or four hundred meters away and more than forty minutes pass and no assistance has arrived?

Is this common place? And if it is, is it acceptable? The driver, myself and the other passengers have been left gobsmacked.

I mean, if emergency services were reasonably confident that no emergency existed, then why did they instruct the driver to wait? Why, if there was deemed to be no emergency, weren’t instructions issued to simply bring the person (either by bus or on foot or ‘later’)  to the hospital for a check-up/over? Anyone out there have any experience/knowledge that could provide answers or a measure of understanding? Or is it all as a consequence of the information contained in this article from the turn of the year?

15 comments on “Come in Houston…”

  1. Tim 1

    http://thestandard.org.nz/no-one-was-there-to-meet-them-no-one-went-to-help-them/

    Comments 1 & 1.1

    Same shit – different stink!
    This risk managers and bean counters have been hard at work

  2. wolf 2

    Would like to hear st johns / dispatchers side of the story before passing judgement

    • Draco T Bastard 2.1

      No, after better than an hour, I’d say that their side no longer counts except as an example of what we need to fix.

  3. weka 3

    At a guess I would say they prioritised the available ambulances based on what was said in the phone call. I’ve been in that situation where the medical person on the other end of the phone asked quite specific questions and based on the answers made a decision about whether to use the ambulance or whether we should drive the injured person in. The main issue is if there is a life threatening emergency and the one available ambulance is tied up with a non-acute case.

    I’ve also been in the situation where I was waiting for an ambulance that never arrived (I eventually rang friends to pick me up and take me to A and E). The thing about that, and your situation today, is that communication could have been way better. Yes we will send an ambulance but it’s likely to be 30-40 mintues time. We’ve assessed the situation as not acute (or whatever), so please wait etc.

    btw, The 111 call centres were centralised in the 90s (eg all the South Island ones went to Chch). Prior to that time a call to 111 would go to a local exchange, staffed by people who knew the area. I don’t know what level of training staff were given but the general feeling was that if you lived in Dunedin and called 111 and said Albany St, then they would know where you meant. At the time of the change people said it would cost lives and there have been a few high profile cases where that looks to be the case.

  4. McFlock 4

    Intense.
    Needless to say, if a replacement bus can arrive before an ambulance, someone fucked up somewhere. Seizures w/o previous history can be associated with very big issues.

    In the mid-noughts I had to call for the emergency services pretty regularly to the same area (including incidents where my response to the “fire/police/ambulance” question was “all of them”), and I never had a wait that long – and usually had good feedback on how far away folk were.

    Basically, it sounds like a resource issue – the depot is only 5 blocks from the hospital, so obviously all the vehicles with crews were out and about. Cruely ironic that the ODT had an article this very day headlined “No lack of city St John volunteers”.

    So barring a fuckup at the comms centre, my guess is that all the trucks were doing patient transport or at other incidents, with none spare to cover central Dunedin. this article reckons their central dunedin response time in 2/3 of incidents is 12 minutes, so your situation is a definite long tail and deserves investigation. A letter or email to St John might give some perspective.

  5. Pasupial 5

    I’m sure that everyone has experienced the feeling that the call centre on the other end of the phone doesn’t give a damn whether you live or die. It is a bit on the nose when the call is for an ambulance though!

  6. Rogue Trooper 6

    kinda like waiting on the runway, alongside a broken, burning 777…
    http://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=10897191

  7. Noko 7

    Totally good post, but not quite factually right. The hospital is 400m from Albany St, but St John ambulance station is on lower York Place, another 800m from the hospital.
    Super chump.

    • McFlock 7.1

      oh, well, at those distances they should have used the helicopter /sarc

    • Colonial Viper 7.2

      And where are the spare buses kept?

      • McFlock 7.2.1

        Depends on the company, but two or three times the distance to the ambulance depot.
        Although it was probably just the next one on the schedule.

  8. My name is Rick Jones, and I am the Southern Communications Centre Manager for St John.
    We’d like to respond to the weblog post made last week about an incident in Dunedin.
    We certainly appreciate that situations like these can be very distressing for the people involved, especially for bystanders.
    In this specific incident, through our call taking process, we were able to ascertain that the patient was not in a life-threatening condition.
    We spoke to the driver three times during this situation and advised them that because of workload (all available emergency Ambulances were at other incidents) we would be with the patient as soon as possible. The driver also updated us regularly on the condition of the patient, which had not changed.
    In the event, the patient’s family arrived and took the patient to hospital.
    With regards to the comments around locating the incident, the Southern Communications Centre is based in Christchurch and handles over 700 calls a day (both emergency and non-emergency) for the entire South Island.
    If people have further concerns or questions they are welcome to contact me directly at rick.jones@stjohn.org.nz.
    Rick Jones, Southern Communications Centre Manager, St John

    • r0b 8.1

      Thanks for taking the time to describe the incident form your point of view.

    • McFlock 8.2

      Thanks for that information, Rick.

      I suppose that the issue for me is the amount of time that it took for the person to actually reach medical help (based purely on a phone diagnosis) when their incident happened in the middle of town (conflict of interest disclaimer – I’m usually in that part of town, and have reached the age where physical decrepitude seems to be fast approaching. You’re getting old when you feel that it might be a wise personal healthcare move to memorise the defibrillator machine locator map 🙂 ).

      Surely there’s a better way of advising callers as to the expected arrival time of an ambulance beyond “as soon as possible” – I get annoyed enough when the taxi company says that and they’re forty minutes or more away, let alone an ambulance. Is there any policy on advising when to do self transport to hospital, given that the distance was so small in this case?

    • Bill 8.3

      Thr three times the driver spoke to you were the two occasions mentioned in the original post and on a third occasion (according to the conversation I had with the driver today) about 15 minutes after the rest of us passengers had been ferried away and after family members had arrived and taken the person to the hospital themselves.

      Can’t see where ‘regular updates on the condition of the patient’ come into it.

      Regardless, it seems that the question of the original post has been answered. A second rate emergency response is the norm for NZ. Good to know.

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