question for HSE ambulance crews?

ivabiggon

just a question for my Colleagues in the HSE, as a firefighter/paramedic in Dublin and am aware of the catchment areas of the dublin hospitals, but if a client rings for an ambulances outside the Dublin area for a maternity case are the crews allowed transfere direct to a dublin hospital straight from the scene providing the mother to be is already attending that maternity hospital.
for example if the mother is living in tullamore and attending the rotunda or coombe.
thanks

Tango Alpha 51

Can only speak for my area mate & the answer would be no. In our area we transfer to the Limerick Regional Maternity. I know this really doesn't answer your question

Delancey

My understanding is that in the example quoted above the ambulance would bring the mother to a Maternity Unit in the Midlands region and not to Dublin.
Anyone care to confirm ?

ivabiggon

ok thanks, but maybe a more realistic scenario, say naas, and attending the coom bee...., i know i've taken patients from julianstown in the past, many years ago in north county dublin to the rotunda, even tho we were closer to their attending hospital (lourdes) only because we in the DFB didn't service the lourdes catchment area, unlike now! would that be possible via the HSE.

I have on many occasions been sent to meet civilians driving their pregnant partners up the naas road from the country & heading for a dublin hospital, in fact some of them have done their research and arrived on the doorstep of tallaght fire station, bags in one hand and hospital card in the other requesting to be taken to their attending hospital, forthwith..
this obviously does happen in the HSE/country scenario.
thanks again

Bang Bang

Re; the Naas area, yes crews would transport to a Dublin maternity unit if that's where the mother was attending.
I worked that area some time ago and this was a regular occurence. In other parts of Kildare, for example the Laoise side of Kildare Town some mothers may attend Port Laoise maternity unit so you would take them there.

coolmoose

I would imagine that this transport to a mat hospital that might be further than nearest facility is based on clinical status of the patient.

I'm in the same station as buzzman, and would assume if we picked up a patient who was pregnant and attending say a Dublin mat hospital, and she was presenting to us with an obstetrical situation that we would just transport her to the Limerick Mat and once stable etc. she would be transferred on to Dublin?

ivabiggon

ok thats great thanks for the info.

Actual Paramedic

We transport the patient to the facility they are booked into. In the event that it is further away we will go if the patient is stable. We do cross county and HSE boundaries in this event also.

If a patient is near delivering the crew may stop at the closest facility and that may well be a maternity hospital or even a general hospital ED.

This situation is unique to obs cases and every other patients destination is determined by catchment areas

angelfire9

I have to say as a pregnant woman I think that's kinda crazy!

So if I'm in Galway shopping and went into labour the ambulance would bring me all the way to Limerick Mat. rather than Univ. College Hosp Galway???

I'd much rather be brought into Galway and put on every drug available rather than an hour + trip to Limerick

Does the mother have any choice?

Especially as I actually have my prenatal chart in my possession at the moment this being the new way of doing things in Limerick Mat.

Bang Bang

angelfire9 wrote: »

I have to say as a pregnant woman I think that's kinda crazy!

So if I'm in Galway shopping and went into labour the ambulance would bring me all the way to Limerick Mat. rather than Univ. College Hosp Galway???

I'd much rather be brought into Galway and put on every drug available rather than an hour + trip to Limerick

Does the mother have any choice?

Especially as I actually have my prenatal chart in my possession at the moment this being the new way of doing things in Limerick Mat.

angelfire9 I think you're missing the point totally.
There are a number if issues addressed in the replies to the OP so far.
Bordering counties, for example Kildare/Dublin, it is common for the crews to transport to the Dublin maternity unit that the mother is booked into.

Further distances can prove different, for example I responded to a call for a pregnant lady in Dublin, she was attending Ballinasloe in Galway, she was in the very early stages of labour, there is no way we could transport across the country, but we did take her to a Dublin maternity unit for observation.

The clinical status of the patient has been covered in a couple of replies so if need be we can divert to acute Emergency Department for further intervention and/or assistance, the mother and baby, if delivered, would then be transfered on when they are stable enough.

Your concern and requirement to be "Put on every drug available", we do carry pain relief in ambulances so I'm sure whatever crew would be attending would do their utmost at ensuring your comfort.

Your question "Does the Mother have any choice?"
Of course the mother has a choice, but each scenario may present different issues, ie; my example of the mother attending Ballinsloe yet she was in Dublin. The Mother in this case couldn't request transport to Galway, it wouldn't be feasable from any angle.
I had a similar call in Dublin recently where the mother was from the North and was attending a Belfast hospital, we transported to a Dublin maternity unit, and yes we administered medication and the lady was pain free and comfortable for the journey.

I hope this helps to answer your concerns.

coolmoose

angelfire9 wrote: »

I have to say as a pregnant woman I think that's kinda crazy!

So if I'm in Galway shopping and went into labour the ambulance would bring me all the way to Limerick Mat. rather than Univ. College Hosp Galway???

I'd much rather be brought into Galway and put on every drug available rather than an hour + trip to Limerick

Does the mother have any choice?

Especially as I actually have my prenatal chart in my possession at the moment this being the new way of doing things in Limerick Mat.

you've completely mis-interpreted this angelfire. You would not be transported from Galway to Limerick if you were in labour and delivery was imminent. If you are stable (i.e. no delivery imminent or other obstetrical issue) then you may be transported to the facility you are booked in to if you are clinically stable and it is possible (i.e. service demands etc.), otherwise it would be nearest facility (be it Mat or General ED) or delivery of the baby on-scene with transport afterwards if time does not allow.

This issue only really arises where there is more than one maternity facility nearby, which may not be the woman's own facility. Of course the expectant mother has a choice, but this is dependant on clinical status and the situation that is presented to the crew.

angelfire9

Actual Paramedic wrote: »

We transport the patient to the facility they are booked into. In the event that it is further away we will go if the patient is stable. We do cross county and HSE boundaries in this event also.

This was the sentence that caught my attention!

In my scenario I'd rather be brought to Galway
I've no idea what kind of pain relief available in an ambulance I kinda assumed epidurals wouldn't be included and i've NO intention of having a 2nd natural labour because my first was a disaster!

coolmoose

I agree with you, but the key point there is if the patient is stable. If you are in labour you will be brought to the nearest facility to deliver. Being transported from Galway to Limerick whilst in labour is not something that is going to happen.

You would be offered Entonox (gas) for pain relief in an ambulance until you arrive at a facility that can provide you with more appropriate pain relief. Epidurals are not a type of pain relief offered pre-hospital.

angelfire9

coolmoose wrote: »

I agree with you, but the key point there is if the patient is stable. If you are in labour you will be brought to the nearest facility to deliver. Being transported from Galway to Limerick whilst in labour is not something that is going to happen.

You would be offered Entonox (gas) for pain relief in an ambulance until you arrive at a facility that can provide you with more appropriate pain relief. Epidurals are not a type of pain relief offered pre-hospital.

Entonox = puke

I would want every drug known to man :cool:

Feel better now, cheers!

coolmoose

Well that's where bringing you somewhere that can give you more pain relief comes in! Best bet is don't go shopping in Galway, stick to O'Connell Street and we'll have you at the Mat in 2 mins!

angelfire9

coolmoose wrote: »

Well that's where bringing you somewhere that can give you more pain relief comes in! Best bet is don't go shopping in Galway, stick to O'Connell Street and we'll have you at the Mat in 2 mins!

I live in Ennis
Reckon I'd get to the Mat quicker from home than ye would get me from O'Connell St during peak hours

coolmoose

angelfire9 wrote: »

I live in Ennis
Reckon I'd get to the Mat quicker from home than ye would get me from O'Connell St during peak hours

touché...

Actual Paramedic

angelfire9 wrote: »

Entonox = puke

I would want every drug known to man :cool:

Feel better now, cheers!

Why every drug known to man? Thats not the best for baby.

If you feel your ever in imminent danger of delivering then be close to the maternity hospital or be present in the hospital.

angelfire9

Actual Paramedic wrote: »

Why every drug known to man? Thats not the best for baby.

If you feel your ever in imminent danger of delivering then be close to the maternity hospital or be present in the hospital.

Simple
When our daughter was born 9 years ago she weighed 7'11 and was delivered au naturel complete with 3rd degree tear and I couldn't walk or sit down properly for 3 months after it was a HORRIBLE experience and i have no desire to repeat it!

As for imminent delivery babies tend to come when they want and with it being the 2nd i've no idea how long the labour may last so its not practical for me to be close to the Mat for the entire month of December (due 19th)

Shield

angelfire9 wrote: »

When our daughter was born 9 years ago she weighed 7'11 and was delivered au naturel complete with 3rd degree tear

Fawwwwk! :eek:
Sorry - Had to be said. That must have hurt more than a tad...

angelfire9

psni wrote: »

Fawwwwk! :eek:
Sorry - Had to be said. That must have hurt more than a tad...

LOL
Why do you think it has taken me 9 years to go for a second babs?

Hence the:

angelfire9 wrote: »

I would want every drug known to man :cool:

And i have to say that this:

Actual Paramedic wrote: »

Why every drug known to man? Thats not the best for baby..

Has to be written by a man!!:p

Delancey

I weighed 10.5 pounds - I sometimes wonder does that have anything to do with my mother having no more after me ?

Actual Paramedic

angelfire9 wrote: »

LOL
Why do you think it has taken me 9 years to go for a second babs?

Hence the:



And i have to say that this:

Has to be written by a man!!:p

Thats up to you thats its taken 9 years, as for the size and the pain, maybe your consultant needs to talk with you about a Caesar and been taken in early. Drugs are good when needed, not demanded

angelfire9

Actual Paramedic wrote: »

Thats up to you thats its taken 9 years, as for the size and the pain, maybe your consultant needs to talk with you about a Caesar and been taken in early. Drugs are good when needed, not demanded

I cannot understand how anyone would advocate a SURGICAL procedure over provision of pain killers for childbirth??

It took 9 years of persuasion from hubby to have No. 2 and frankly i am terrified of a repeat performance re labour this time which is precisely why i will be having every drug available
All surgery carries risks that I would prefer not to undergo unless there is a valid medical reason for it and to be frank a few hours of agony is not a valid medical reason!!
Besides... I don't intend to be in agony this time

C-Sections take weeks to recover from and carry a higher risk of mortality for the mother than the natural "route"
And inductions carry risks as well

coolmoose

@angelfire - Well from what I've read you've requested an epidural which is an extremely common pain relief method during labour. I don't know why you're being attacked over that and having C-Sections recommended to you?!?

@ Actual Paramedic I think the "every drug known to man" line was a hyperbole.

angelfire9

coolmoose wrote: »

@angelfire - Well from what I've read you've requested an epidural which is an extremely common pain relief method during labour. I don't know why you're being attacked over that and having C-Sections recommended to you?!?

@ Actual Paramedic I think the "every drug known to man" line was a hyperbole.

coolmoose are you a paramedic?
If so I have another question for ya

In light of the fact that my due date is in December and remembering the lovely weather we had last year in December... how did the Ambulances cope with the roads last year??

Paulzx

angelfire9 wrote: »

In light of the fact that my due date is in December and remembering the lovely weather we had last year in December... how did the Ambulances cope with the roads last year??

They drove at 2 miles an hour like the rest of the traffic.

On the worst nights of ice and snow there was a 3 hour wait for ambulances in Dublin that were requested as 999 calls. People were rung back to see if they could make their own way to hospital.

If we get weather like last year get ready for a home birth:eek:

angelfire9

Paulzx wrote: »

They drove at 2 miles an hour like the rest of the traffic.

On the worst nights of ice and snow there was a 3 hour wait for ambulances in Dublin that were requested as 999 calls. People were rung back to see if they could make their own way to hospital.

If we get weather like last year get ready for a home birth:eek:

:eek:
Feck feck feck

I was hoping the extra weight or something might have made them a better option than a car in the snow/ice

I'll be praying for good old Irish rain instead then!

Actual Paramedic

Paulzx wrote: »

They drove at 2 miles an hour like the rest of the traffic.

On the worst nights of ice and snow there was a 3 hour wait for ambulances in Dublin that were requested as 999 calls. People were rung back to see if they could make their own way to hospital.

If we get weather like last year get ready for a home birth:eek:

No extra ambulances were put on, crews were told to make their way safely to all calls. Vehicles were not provided with winter tyres or snow chains, just run of the mill tyres.

Calls were still taken but waiting times for the response was given and people were asked if the journey was necessary. 4 wheel drive vehicles were king and got more places.

angelfire9

Actual Paramedic wrote: »

No extra ambulances were put on, crews were told to make their way safely to all calls. Vehicles were not provided with winter tyres or snow chains, just run of the mill tyres.

Calls were still taken but waiting times for the response was given and people were asked if the journey was necessary. 4 wheel drive vehicles were king and got more places.

That's crazy
Surely there were accidents as a result (involving ES vehicles) and people left waiting for hours??

coolmoose

Angelfire, the lads have answered the question, it was basically just respond as per normal, but a lot slower. Couldn't make it to some calls because of road conditions, and had to meet people , walk some of the way etc.

And yes there were accidents involving ES vehicles, and people were left waiting, but there was no other way (bar putting on extra vehicles). Of course if there was any foresight in this country the ambulance service would have 4x4s in each station at our disposal for the coming winter but that is not the case.

Here's hoping this winter isn't as severe (or that I'm off when it is!). O'Connell St is looking like a better option now isn't it?

angelfire9

coolmoose wrote: »

Angelfire, the lads have answered the question, it was basically just respond as per normal, but a lot slower. Couldn't make it to some calls because of road conditions, and had to meet people , walk some of the way etc.

And yes there were accidents involving ES vehicles, and people were left waiting, but there was no other way (bar putting on extra vehicles). Of course if there was any foresight in this country the ambulance service would have 4x4s in each station at our disposal for the coming winter but that is not the case.

Here's hoping this winter isn't as severe (or that I'm off when it is!). O'Connell St is looking like a better option now isn't it?

If road conditions are that bad that the ambulance can't get to me do you REALLY think i'd go shopping??
The self preservation gene is far stronger than the shopping one

Actual Paramedic

Some ambulances were involved in crashes, some that caused the vehicle to be taken off the road due to crash damage, others that could continue once released. Having an accident is the same as other road users, the crew and vehicle are meant to stay at scene and exchange details and wait for the Gardai.

January

Just back to the original question. I lived in Dublin 11 and wanted to book into the Coombe (South Dublin, nearest mat hospital would have been the Rotunda). When I rang to book in the lady on the phone told me that if I needed emergency assistance in labour that the ambulance would only take me to the nearest maternity hospital not to the hospital I was booked into.

ivabiggon

not true, she doesn't know what she's talking about, if you need an emergency ambulance for maternity assistance they will take you to any maternity hospital in Dublin and that includes mount Carmel.
This also applies for pediatric emergencies there is no catchment area for kids or maternity...in Dublin

Actual Paramedic

True Ivanbiggan but if imminent labour and a closer Maternity hospital that would be used.

Most maternity hospitals only want to see who is booked into them.

Have brought patients to Mount Carmel and the Bons before. Paed hospitals generally are catchment area designated with us.

cybrandian

Hi All,

Apologies for going off-topic, but a friend of mine is hoping to train to be a Paramedic, but hasn't a clue on where to start.
I would like to help him, but he seems to think that he needs some form of pull withing the HSE to have any chance of getting in.
Can anyone advise where he can send his application?
Does he need to complete a course in advance, and if so, which course is the most recognised, and where can this be completed?
He is willing to re-locate to anywhere in Ireland, but just needs to be pointed in the right direction. Apparently there are a lot of courses available withing Ireland, but they are not recognised by the HSE?

Any help but would much appreciated.

Thanks.

coolmoose

cybrandian wrote: »

Hi All,

Apologies for going off-topic, but a friend of mine is hoping to train to be a Paramedic, but hasn't a clue on where to start.
I would like to help him, but he seems to think that he needs some form of pull withing the HSE to have any chance of getting in.
Can anyone advise where he can send his application?
Does he need to complete a course in advance, and if so, which course is the most recognised, and where can this be completed?
He is willing to re-locate to anywhere in Ireland, but just needs to be pointed in the right direction. Apparently there are a lot of courses available withing Ireland, but they are not recognised by the HSE?

Any help but would much appreciated.

Thanks.

Answered in the recruitment forum, try searching, this question has been asked and answered so many times! And that's going waaaaay off topic!

angelfire9

coolmoose wrote: »

Answered in the recruitment forum, try searching, this question has been asked and answered so many times! And that's going waaaaay off topic!

Yes, the question for today is.....

Does Angelfire want Coolmoose to be the responding paramedic when she goes into labour in the frost and snow of mid December

Actual Paramedic

Simple question and a simple answer. YES, why wouldn't you want him?

Coolmoose is a professional and will be capable and courteous in his work, so why not have him?

ivabiggon

Actual Paramedic wrote: »

True Ivanbiggan but if imminent labour and a closer Maternity hospital that would be used.

Most maternity hospitals only want to see who is booked into them.

Have brought patients to Mount Carmel and the Bons before. Paed hospitals generally are catchment area designated with us.

well in my career, i've delivered in the region of 15-20 babies and any time i have experienced imminent labour, we always try for the patients requested hospital, or deliver there and then. mind you all but one was successful, and in that instance the closest maternity unit was the womans attending hospital.
oh and i have often gone to private hospitals only to be turned around at the nurse station and told you better get this woman to a maternity hospital.

coolmoose

angelfire9 wrote: »

Yes, the question for today is.....

Does Angelfire want Coolmoose to be the responding paramedic when she goes into labour in the frost and snow of mid December

Just make sure you ask for me when your ring 999 so...

I'll ask every pregnant woman I meet in December if they're angelfire now...