Voluntary ambulances forbidden from transporting anymore?

Just heard from a CD colleague that all ambulances transporting will now need to have 2 Paramedics on board to be "sec" compliant. That can't be true can it?

adam88

isure is, it came from the top, effective immediately, no transfers unless min paras and cen compliant ambulance

gem112

This is an extract from a Civil Defense document released yesterday:

Quote:
During a conference call with Dr. Cathal O’Donnell, Medical Director, National Ambulance Service this morning, voluntary organisations were informed that an instruction is due to issue this week to Ambulance Control, that voluntary ambulances will no longer be tasked to transport patients to hospital. Instead should a call be received from a voluntary organisation in relation to the transport of a patient, or requesting Advanced Life Support (ALS) – a HSE Ambulance should be dispatched to take a handover and transport the patient.

The following reasons were stated in relation to this decision:
• This is the published PHECC Standard.
• The HSE Ambulance Service, as the Statutory Ambulance Service has a statutory obligation to patient care, if the HSE request a voluntary ambulance to transport a patient, the HSE is then legally liable to that patient.
• There have been incidents where a voluntary ambulance transported a patient to an incorrect hospital – considering the HSE by-pass policy. This caused problems for the patient and the hospitals concerned. Civil Defence were not involved

For specific events, if a voluntary organisation can confirm in writing to the HSE Ambulance Service that they meet the PHECC standard to transport a patient, then the voluntary ambulance can and will be tasked if required.

Hooch

This is cover your ass stuff. The key to this is " control will not TASK"

This takes the blame away from the HSE if something happens. Vols can still transport themselves informing control of such. Remember CPGs say to transport when you can for more than half the EMT CPGs.

adam88

Hooch wrote: »

This is cover your ass stuff. The key to this is " control will not TASK"

This takes the blame away from the HSE if something happens. Vols can still transport themselves informing control of such. Remember CPGs say to transport when you can for more than half the EMT CPGs.

Some serious clarifications needed on this

miju

not really much to be clarified on to be honest it's been a PHECC standard for a loooonng time ( see here )Though haven't heard anything about it myself in relation to Vols

After reading that sheet, I have to wonder if volunteers were thought of at all. It makes no mention of whether the lower classes hand over to the minimum standard, and leaves space open for some smart alec to run sirens blazing to a hospital, telling no one until they arrive at A&E with their patient.

If volunteers can't transport, that's a lot of equipment, time, training & money gone down the swanny so. Might as well sell off the ambulances & all get 4x4s with responder kits.

sgthighway

gem112 wrote: »

For specific events, if a voluntary organisation can confirm in writing to the HSE Ambulance Service that they meet the PHECC standard to transport a patient, then the voluntary ambulance can and will be tasked if required.

This will be the way to go for most of it but I can see the word specific taken out. It will be a case of agreeing a protocol with them. Not too bad if you only have one ED to go to.

I wouldn't speculate too much until I see it in writing.

adam88

And now to throw it all up in the air. This whole change has been suspended until negotiations take place

Medic475

Was talking to Ambulance Control in Ballyshannon all weekend and nothing was said!

adam88

Medic475 wrote: »

Was talking to Ambulance Control in Ballyshannon all weekend and nothing was said!

As above the implementation has been put on hold

19hz

adam88 wrote: »

As above the implementation has been put on hold

Yup its been put on freeze but as already said above it refers more to voluntaries being TASKED by HSE Control rooms....not the normal trn from an event. I'd imagine this applies to voluntaries in the rural areas that help HSE respond. Think OMAC had an amb in some part of Waterford responding to the occasional call.

Topper7

19hz wrote: »

Think OMAC had an amb in some part of Waterford responding to the occasional call.

CFR responder car in Tramore. Top quality video! http://www.youtube.com/watch?v=NiBRW-5o5QA

I thought PHECC where compiling a list of responders, starting with EMTs & then filtering down, that could respond to a incident quickly in their locality? Similiar to the UK responders for the NHS? Hence why PHECC are currently gathering information on where defibs are located around the country (make, model, who has access, etc). Pretty sure I read in the paper round Christmas that they were starting trials soon??? Maybe I missed something

miju

Yes they are to respond not transport and it's plans are fairly well under waythats why you see that responder vehicle is a car and not a 4x4 with stretcher or ambulance

Topper7

miju wrote: »

Yes they are to respond not transport

Ah I see, thanks! Out of curiousty do you know what stage are those plans at? Have trial runs been carried out, problems etc?

emtdoozer

just curious as to what is a cen compliant ambulance?

miju

emtdoozer wrote: »

just curious as to what is a cen compliant ambulance?

Google is your friend ;);););)

http://en.wikipedia.org/wiki/CEN_1789

Medic475

So that's it, as and from 9 this morning all voluntary Ambulances are grounded! There's a list of very minor injuries for which you can transport, other than that you have to ring Ambulance Control, let them know if you have a casualty, whats wrong with them and then they make the decision whether you transport or not.
Will be a shame if a Cardiac Arrest occurs at an event and there a few EMT's/Responders and Drivers on an Ambulance and then to be told to wait for a HSE Ambulance!!

emtdoozer

I really hope nothing major happens anyone this weekend at the many events around the country. The HSE just don't have the fleet or staff to cope with what the Aux services handle across the country. The only people who can be hurt by this are the many patients the aux services treat very week and most in a very efficient and professional manor.

Tango Alpha 51

Medic475 wrote: »

So that's it, as and from 9 this morning all voluntary Ambulances are grounded! There's a list of very minor injuries for which you can transport, other than that you have to ring Ambulance Control, let them know if you have a casualty, whats wrong with them and then they make the decision whether you transport or not.
Will be a shame if a Cardiac Arrest occurs at an event and there a few EMT's/Responders and Drivers on an Ambulance and then to be told to wait for a HSE Ambulance!!

Medic,

We're did you get this from as none of control room staff are aware of it. As I know there is vol ambulances out on dutiies in this area today & none of their senior officers are aware of same?.

sgthighway

Medic475 wrote: »

So that's it, as and from 9 this morning all voluntary Ambulances are grounded! There's a list of very minor injuries for which you can transport, other than that you have to ring Ambulance Control, let them know if you have a casualty, whats wrong with them and then they make the decision whether you transport or not.
Will be a shame if a Cardiac Arrest occurs at an event and there a few EMT's/Responders and Drivers on an Ambulance and then to be told to wait for a HSE Ambulance!!

Where did you here this?
Re: Cardiac Arrest - AFAIK it is protocal for ALS to be contacted. ALS or Ambulance Control will make the decision for you to wait for ALS or Load and Go. I'm open to correction.

Still reckon this won't work.

TylerIE

adam88 wrote: »

Where did you hear this from. Hse and phecc agreed to postpone this direction until the heads of the vols had been properlm consulted. I seen the email wit my own two eyes

And postponement was withdrawn earlier this week.

Some of the vols have issued their own directives since.

vidar

Medic475 wrote: »

So that's it, as and from 9 this morning all voluntary Ambulances are grounded! There's a list of very minor injuries for which you can transport, other than that you have to ring Ambulance Control, let them know if you have a casualty, whats wrong with them and then they make the decision whether you transport or not.
Will be a shame if a Cardiac Arrest occurs at an event and there a few EMT's/Responders and Drivers on an Ambulance and then to be told to wait for a HSE Ambulance!!

Only one of the four vols/aux ambulance service have grounded their fleet. This was decision was taken internally. The other vols are AFAIK still operating as normal.

ectoraige

vidar wrote: »

Only one of the four vols/aux ambulance service have grounded their fleet. This was decision was taken internally. The other vols are AFAIK still operating as normal.

Which one? CD?

How often do vols transport to hospital? Would some do it more than others?

I wonder how long before the calls to Joe Duffy.. "My little Johnny was roarin' so he was, and they wouldn't take him to the hopstipal, it's a disgrace Joe..."

vidar

The amount of transports required are random, you could go a good few duties without having one and then get 4/5 on the one duty. Basically transported as needed

Medic475

Well lads, just back from duty this minute. Yeah the CD Officer had it, she got the email yesterday that from 9 this morning there was to be no transports, as the day went on there were phone calls to and fro and the latest is CD and another Voluntary are going to carry on as normal untill Monday morning and then there's to be another meeting about it. Word on the street is that it will fall apart within a week or two!

Medic475

sgthighway wrote: »

Where did you here this?
Re: Cardiac Arrest - AFAIK it is protocal for ALS to be contacted. ALS or Ambulance Control will make the decision for you to wait for ALS or Load and Go. I'm open to correction.

Still reckon this won't work.

Yeah sure enough, there would be enough Volunteers for one to ring Control (while others are loading/providing treatment/driving) and let them know and then rendesvous with an AP or HSE Ambulance.

Medic475

ectoraige wrote: »

Which one? CD?

How often do vols transport to hospital? Would some do it more than others?

I wonder how long before the calls to Joe Duffy.. "My little Johnny was roarin' so he was, and they wouldn't take him to the hopstipal, it's a disgrace Joe..."

We do quite a bit. Just this evening we had a shoulder dislocation at a tag rugby match!

ectoraige

Medic475 wrote: »

We do quite a bit. Just this evening we had a shoulder dislocation at a tag rugby match!

Hah, so did we! Unless tag rugby gets lots of shoulder dislocations, guess that's means I know who you are, D, right?

I'm just wondering what percentage of transports are from vols, compared to the HSE. I imagine it's pretty low and that the HSE don't see the workload being a problem. Is it just Omega codes that the vols are allowed transport, assuming they have the two EMTs?

coolmoose

A lot of mis-information as per usual, PHECC have clarified this am

http://www.phecit.ie/Documents/Home%20Page/Event%20Ambulance%20Cover%20-%20Clarification%20Statement%2022.06.12.pdf

donalgeraghty

Ya i heard cd have to ring ambulance control to see if they can transport. Is any of the other vol/aux doing this ?

Whats the idea of stopping voluntaries transporting injured people to hospital ?

flazio

It may just be a case of making sure they go to the correct hospital for the injury presented. A volunteer unit might not know that straight out.

sgthighway

I can confirm as an active member of the Order of Malta I have not heard anything about this.

Mycroft H

sgthighway wrote: »

I can confirm as an active member of the Order of Malta I have not heard anything about this.

The only thing I've heard of this external of Boards.ie was an AP in our unit mentioning it to a few of us. We'll continue to transfer as normal as per CPG's.

As for the confusion as regarding A+Es, anyone who is transferring someone that there may be a chance that they may be sent to a differing hospital (ie a stroke etc..) should be ringing the A+E to see if its ok.

Mycroft H

A friend of mine linked me the memo that basically started this whole thing, it's up on NASRA's website if anyone wants a look.

http://www.nasra.ie/images/220612.pdf

Bigbear899

We would call ambulance control if we ever have to transfer and tell them who we are what the casualty is etc. Control will usually ask if we think we have the skills neccessary in order to transport and meet a hse ambo on the way. Other times there are no HSE vehicles available and so we would transport all the way. By Control asking this they are putting the call back on us.

Another example is I and another EMT recently transported a pt w/#tib/fib. pt was allergic to all pain relief we could administer and entonx was making the pt sick and so was was turned down after 5 mins. Pt had a pain score of 10 and so we called control requesting a paramedic or AP for pain relief but there were none available. and so we had to transport to Hospital with the pt in serious pain.

as we entered the city we got caugt in heavy traffic and slowed to a bare crawl, again controll was called requesting Paramedic or AP again there were none available. We eventually requested to upgrade to blues and twos in order to get through the traffic with the pt on a score of 10. Control came back saying that the Vol Org we are with is an organisation in its own right and that they can not give or withold permision to upgrade the call and to make the decision ourselves.
Ambulance Control will not take responsability for a vol org if they need to begin a transport.

iceage

If you were in an Ambulance I don't think anyone would have shot you for using your lights in that circumstance.

Bigbear899

Thats my point. But we are ment to look for permission from control to upgrade the call but they are not willing to give or not give permission.

iceage

You misunderstand.. I'd have stuck on the lights with or without Controls go ahead. If you have requested assistance and none is available and you have no choice but to transport a patient with a suspected lower leg fracture with a pain score of 10, not able to take entonox and you're sat in traffic.. I'd defy anyone to say you were in the wrong for using your lights and sirens on a marked Ambulance.

timmywex

Even if control denied permission in that instance id be on blue's. They are not my control and at all times the clinical lead has to evaluate the situation and decide appropriate care, not someone sitting on the other end of a phone attempting to understand the situation.

seven_eleven

Yeah, if control said no AP was available the first time you needed to work with what you had. You dont need controls permission to use your blues, you can use them whenever you deem appropriate, as long as you can back up that decision in the very unlikely event you need to.

Mycroft H

Just an FYI for OMAC people, there is a new transport policy in place in OMAC which gives guidance to this very situation. Something all practitioners should be aware of in the org. Give me a pm and I'll forward you a copy of it if needed...

19hz

BX 19 wrote: »

Just an FYI for OMAC people, there is a new transport policy in place in OMAC which gives guidance to this very situation. Something all practitioners should be aware of in the org. Give me a pm and I'll forward you a copy of it if needed...

Very progressive, great to see something being put into place.



On the earlier post, the decision to use lights and sirens should always be made by the attendant, hes the only thats dealing with the patient, not a dude sitting at a phone miles and miles away. Of course, the driver can always refuse this. (I've seen that happen and in some cases with good reasons)

Thats the way I was always thought and was generally accepted when we had patients.

Mycroft H

19hz wrote: »

Very progressive, great to see something being put into place.

Absolutely. It was a long time coming. Transporting, was for a long time a grey area with people transporting in the care of responders etc. Not a viable option. Now limited to attending practitioners only otherwise its a no-no. Driving standards is the next thing to be examined....

Pad33

iceage wrote: »

You misunderstand.. I'd have stuck on the lights with or without Controls go ahead. If you have requested assistance and none is available and you have no choice but to transport a patient with a suspected lower leg fracture with a pain score of 10, not able to take entonox and you're sat in traffic.. I'd defy anyone to say you were in the wrong for using your lights and sirens on a marked Ambulance.

The practice of vols using lights and sirens should be discouraged as most do not have proper training or experience to deal with the the hazards of driving under these conditions with the exception of vols who work within the emergency services

iceage

Pad33 wrote: »

The practice of vols using lights and sirens should be discouraged as most do not have proper training or experience to deal with the the hazards of driving under these conditions with the exception of vols who work within the emergency services

Hmm, and there's the crux. As of yet there is no blue-light driving course being implemented throughout the Voluntaries, I say as yet, I've heard that things are to change.

As to my point above, stuck in traffic the use of lights to alert other drivers to the need for you to get by to a Hospital should not be ruled out under certain circumstances, I am not suggesting using defensive driving techniques of course unless you are experienced or have been trained to do so.

Pad33 here made one post, and one post only since his existence on boards.

Forgive me if I consider less of his input than other, more active users, who post in the main ES forum as well.

As for blues, if you need them, know (have been trained) when to use them, and how to use them, use them. Forget some internet warriors looking over your shoulder.

seven_eleven

The way I see it is, all drivers need to be taken out for several spins in the vehicle first to get used to its size and weight, they should also be told to driver a lot more carefully.
You cant take a roundabout or speedbump like you normally would with a pt and medic in the back, so they need to know what its like to be in the back too.

Blues and sirens should only be used when needed. But still, you should only drive like you normally would, the only difference being cars will give way to you. Drivers shouldnt be afraid to use them if they have justification.

Some people have this notion that blues and sirens will magically make your vehicle turn into a race car. When in reality, its a lot different for a 3 ton ambulance.

Hopefully a drivers course will become available to the vols soon, and as far as I'm aware, there is at least one in development for the near future.
But in general, I think most vols are good with this, I've never seen or heard them being abused.

Pad33

[Deleted User] wrote: »

Pad33 here made one post, and one post only since his existence on boards.

Forgive me if I consider less of his input than other, more active users, who post in the main ES forum as well.

As for blues, if you need them, know (have been trained) when to use them, and how to use them, use them. Forget some internet warriors looking over your shoulder.

Well seaslacker I do a lot of work in the voluntary sector and ive seen first hand the effect of going on blues and twos has on certain members ( red mist ) while im in the back treating a patient.

Dont get me wrong im not painting everyone with the same brush, but I definitely think that a lot more training needs to be given before someone drives on blues.

miju

Pad33 wrote: »

Dont get me wrong im not painting everyone with the same brush, but I definitely think that a lot more training needs to be given before someone drives on blues.

100% agree, I've seen many an occasion were a voluntary was handed the keys unfamiliar with the vehicle and told if you need blues just use them

iceage

In this day and age, I find it very difficult to believe that any CDO or OIC of any of the Voluntaries would sanction the handing over of keys to an unfamiliar vehicle to anybody Miju especially an Ambulance and anybody accepting said keys really needs their head examined.

Thankfully things have changed over the last few years and the training, experience and professionalism of said organisations has greatly improved considering the increased amount of work they are undertaking these days, never mind the implementation of stricter controls over the designated drivers of said vehicles.