Tuesday 29 April 2008

Chief Complaints

Depending on the symptoms that the caller gives, each call is put as a 'chief complaint'. For example, if you say 'my daughter's fallen out of a tree', that would go under number 30: Traumatic Injuries.

The 'public' chief complaints go from number 1 to 32.

1. Abdominal pain
2. Allergies/Envenomations
3. Animal bites/attacks
4. Assault/Sexual Assault
5. Back pain
6. Breathing problems
7. Burns, Scalds and Explosions
8. Carbon Monoxide/Hazchem (Hazardous Chemicals)
9. Cardiac or Respiratory Arrest/Death
10. Chest Pain
11. Choking
12. Convulsions/Fitting
13. Diabetic Problems
14. Drowning/Diving/SCUBA accident
15. Electrocution/Lightning
16. Eye Problems
17. Falls
18. Headache
19. Heart Problems/AICD (internal defibrillators)
20.Heat/Cold Exposure
21. Haemorrhage/Laceration
22. Inaccessible/Other Entrapment
23. Overdose/Poisoning/Ingestion
24. Pregnancy/Childbirth/Miscarriage
25. Psychiatric/Suicide attempt
26. Sick person
27. Stabbing/Gunshot/Penetrating Trauma
28. Stroke (CVA)
29. Traffic & Transportation Accidents
30. Traumatic Injuries
31. Unconscious/Fainting
32. Unknown Problem (3rd party) This is mainly used when a careline calls us because a client of theirs has pressed their emergency button but not made verbal contact. We also use it when a caller isn't actually with the patient, for example if they drive past a person who is lying face down. We don't know whether it should be 31 (unconscious), 23 (overdose), 17 (falls), 12 (convulsions) or 9 (cardiac/respiratory arrest)

I have been working for the ambulance service for nearly six months now, and have used every single chief complaint at least once. Some complaints are more common than others: breathing problems and chest pain being among them. But ask any EMD and they will tell you without fail that the most common chief complaint is 17 - FALLS!!!

A guide to the 999 system

Statistically, the average UK resident will phone for an ambulance every 14 and a half years, so it's quite likely that the majority of our callers will be doing so for the first time.

I'm going to guide you through an average 999 call.

Me: Ambulance emergency, what's the address of the emergency?
Caller: 23 Random House, Average Road, Boringsville, Sussex, AB12 3CD
Me: Thanks. What's the problem, tell me exactly what's happened?
Caller: My dad's got chest pain.

I will then find 'chest pain' on the ProQA system and get the screen up.

Me: I'm organising help for you now, I just have to ask a few questions but it's not delaying any assistance to you.

Then I will ask the caller some questions relating to their father's chest pain, such as whether or not he is breathing normally. This determines the severity of the problem at that time, and the call is triaged.

Me: I'm arranging help for you now, stay on the line and I'll tell you exactly what to do next.

I will give some general instructions - called PDIs, or Post Dispatch Instructions - such as asking the caller to gather the patient's medications and writing down the name of their GP, and sending somebody outside to meet the ambulance crew. Usually, that is where the call will end, but if the chest pain is severe enough to pose an immediate risk (such as the patient losing consciousness or going into cardiac arrest) I will stay on the line in case further instructions are required. These are called Pre Arrival Instructions.

I hope you've found this interesting! If you want to know any more about the ProQA system, there is some information at http://www.prioritydispatch.net/index.php?a=products&b=policeproqa_more

Friday 25 April 2008

Child Callers

Today, I had my first (genuine) call from a child. I say 'genuine', because I have had several calls from kids, but up until now they've all been hoaxes.

I was connected to the operator as soon as the call dropped into my ear, and he read out the phone number the child was calling from, before adding that the caller sounded like a child. I'm ashamed to say that as soon as he said this, I was already to prepare myself for explaining to the dispatcher that the call was a hoax. But when the child gave me the address and I asked what the problem was, it sounded pretty genuine.

The child's mother had fallen and hurt her back, she was unable to move properly. While I arranged help, I notified the crew that the caller was a child, and was 7 years old. The child was very calm, and as well as phoning 999 for help, he calmed his little sister down who was a little upset at the commotion. The child's mother was Indian, so he translated my questions into Indian for his mother, and back to English. I was thoroughly impressed, and that call made me change my views on child callers completely. I vowed to initially take all calls like this seriously, unless they seem blatantly obvious that they're hoax. I got a call 3 weeks ago from a couple of kids who claimed that a factory in Barnsley was on fire - "That's strange, how do you know about what's going on in Barnsley when you're calling from a phone box 250 miles away?" I asked. They hung up, horrified that I'd seen through their stupidity.