2.5hr wait for an ambulance for critical incident.

banie01

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.

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

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

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

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

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

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

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

Cookie_Monster

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

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

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.

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

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

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

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

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

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

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

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.

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

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

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.

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

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

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

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

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

_Kaiser_

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

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

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

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 .

NIMAN

You should call Live Line and get this information out there. The country needs to know how bad the situation is.

Op that is horrendous and I wish your brother a speedy recovery.

I was on a run between Sandymount and Poolbeg 2 weeks ago mid week and a girl had a fit and came off her bike and split her head and was uncouncious for a period (Irishtown nature reserve)

Emergency services was rang and a few of us took up different points to direct the ambulance and usher paremedics in at Clanna Gael, Sandymount Village, Road to the lighthouse

1.5 hours later and there was nothing absolutely nothing!!! Ended up having to get her carried into a car and brought to A&E. It just couldn't wait as there was vomiting etc.

My point is, if that's happening in the capital, what chance do the rest of the country have.

We are literally 3rd world aspects of service delivery which includes the ambulance service and healthcare delivery. I won't hear anything else. Fine Gael can spout on about budge surplus but what's the **** point when none of that translates into better services. Spoofers.

An uncle died some years back from a heart attack in a similar situation in Mayo. Ambulance took hours to arrive.

We just don't invest properly and people are dying.

French Toast

I had an experience with the ambulance service in the past week. From now on I'll be ringing the hospital directly to forewarn them we're on the way and high-tail it down the road myself.

No gripe whatsoever with paramedics or drivers. Our ambulance service is inadequate, overstretched.

Guys there's a real problem with healthcare efficiency in this country and Robert Watt and all the other civil servant managers holding up the show need to be held accountable. It needs feet on the streets.

Jinglejangle69

Amazing we can suddenly find billions under the couch and get to work finding accommodation quickly for other certain projects.

riclad

I was at a incident months ago an ambulance was called it was not needed. 1 o clock in the morning eg no one was hurt or in danger or in a serious medical danger , if there's a limited no of ambulances there needs to be a system of sending ambulances out to the most urgent serious incidents

I saw an incident today a man lying on the ground beside a car sitting up talking to medics there was a fire brigade and an ambulance there it looked as if he was knocked down by a car he was sitting on the ground talking to the medics

The problem I see is in your case if they get a report a man collapsed they don't know how serious it is until a medic gets to examine the patient

people can blackout due to many reasons which can minor or due to a serious health condition eg someone forgot to talk their medication

When someone calls 999 they may not know how serious the situation is unless they are up to date with the specific health status of the person who collapsed

It can also depend on what info was reported to the emergency service when the 999 call was made

There's probably alot more 999 calls made

after 9 pm when people go out to pubs people get into fights or they drink to excess versus daytime calls to 999

Someone who lives in a rural area is likely going to be waiting longer than say someone who lives in a city closer to hospitals and emergency services

It also depends on the age of the person who blacked out eg did they have a pre existing medical condition which would make them vulnerable to serious medical issues if they were to collapse

riclad

I think in many cases the medical services are understaffed theres not enough doctors or nurses in er to deal with the no of patients they have to deal with in an average day eg if you go to er you could be waiting hours before you see a doctor

Geuze

The HSE headcount is rising all the time.

Added 2,000 doctors since Dec 2019.

Thousands more nurses.

riclad

if this is whats it like in dublin i wonder whats its like in small rural towns . i many cases it may be better to go to the hospital in a car or taxi and phone er to say you are on the way.

mikethecop

90 something lady in rural area falls and cant get up , one ambo about 40 mins wait time

40s very drunk man falls outside puband hits head one ambo 90 mins wait time

18 year ld cocaine OD two ambo plus AP car about 20 min

all last night , ambulance base withing 2 km of each a call

maybe we need to look at how we use the resources we have

Ambulance service like Gardai and in some areas Fire service aren't up to their nuts or chins anymore , they are already underwater holding their breath waiting for the inevitable collapse .

If your want some one to blame look to the excessive and bloted admin and the interference by upper political management who have no experience in what is actually required to run these services

banie01

In a small update here, on my brother's condition 1st of all. He is still on a ventilator and in ICU. He is not sedated but is still very much in a serious condition. Much of the time he is still comatose but he is having longer bouts of consciousness, up to a few minutes at a time of responsiveness. Be that hand squeezes or eye contact.

We played him messages today from his nieces and nephews and the strength and determination he showed in letting us know he could hear them and that he knew, has been the brightest moment my family has had since this kicked off.

There is a long, long road ahead of him with some hard days still to come. Knowing that he is still there, that he knows we are all with him too, has really brought a sense of hope back to the family.

chiefwiggum

I'll get shot down for this probably but sure here goes..

I was in St Vincent's ER a few months ago for a kidney stone..bloody worst pain ever..the amount of ambulances that came in with elderly,mostly ladies, strapped into a stretcher yapping and chatting away to the paramedics was beyond belief. I mean the "patients"looked genuinely thrilled to be the center of attention and have someone to talk with..not one looked or sounded like they needed to be carried around in an ambulance..it was nearly like a social outing for them.

Yes there are plenty of elderly emergencies but not one of these warranted an ambulance as far as I could see!

banie01

The 2nd update which I forgot to add.

The ambulance left my brother's residence and headed towards CUH, with no blue lights on. One of our other brother's was behind that ambulance driving in to CUH when near Mallow, the ambulance pulled over, stopped and met with a 2nd ambulance. EMTs were conversing on the roadside as my brother passed. Shortly afterwards the ambulance resumed its journey with blue lights on.

I do know that on occasion a 2nd ambulance attends an incident to offer assistance and for various other reasons.

I am a bit stumped as to why the Ambulance that arrived so late,managed to meet with a 2nd ambulance at all and will be trying to ascertain what the stop was for.

Witcher

Probably to meet an advanced paramedic in the other one. Some medication can only be administered by an AP.

thomas 123

I'm not sure if this has been raised here yet - I am in and out of hospital regularly. One thing I have observed is Paramedics having to wait with people they bring in, sometimes for hours, until the A&E people take over. This practice in my mind is insanity. I appreciate there is a duty of care to the person but the hospitals should be doing their upmost to free the ambulance ASAP, which appears in my experience at least, not to be the case.

Cluedo Monopoly

https://www.boards.ie/discussion/comment/120760652#Comment_120760652

This has been a known problem for years. The paramedics have to wait until there is a bed available for the patient. It's a bed capacity issue as always.

Ambulance turnaround times exceed an hour at Cork and Kerry hospitals (irishexaminer.com)

Ambulances are waiting 52 minutes on average at hospitals across Ireland before being able to declare themselves ready to accept another call, an increase of almost 10 minutes on the previous year.

Ambulance turnaround times involve the amount of time from the ambulance arrival time to when the crew declares the readiness of the ambulance to accept another call.

L.Ball

https://www.boards.ie/discussion/comment/120753859#Comment_120753859

We get the doctors and nurses who don't make the grade in Australia UAE etc. thousands more doctors and nurses but A&E times are just as long, standard of care is garbage, and we've still 10-12 ambulances for a city of 2 million people, what does that tell you.

banie01

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banie01

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arctictree

When you ring 999 for an ambulance, do they ask for your eircode? How do they get directions to your house?