BY AWAKE! WRITER IN BRITAIN
“WE AIM to reach seriously ill and injured patients within eight minutes anywhere in London’s 620 square miles [1,600 sq km],” explained ambulance operations manager Rob Ashford, of the London Ambulance Service. “We manage this in over 75 percent of the cases, despite an annual rise in the number of incidents.”
I was invited to visit London’s Central Ambulance Control at Waterloo on the south bank of the river Thames. The largest of its kind in Europe, the center handles some 3,000 emergency calls daily. These calls come from a population of about seven million people, who speak over 300 languages. How are the 300 workers who make up the control-room staff organized to meet the challenge?
Grading the Calls
I observed an operator responding to incoming “999 emergency calls,” as they are termed in Britain—999 being the emergency telephone number. Quickly the operator identified the location of a problem and the nearest street intersection. Immediately a road map flashed onto her computer screen. To determine the level of priority, she asked a series of questions: How many people need help? What is their age and gender? Are they conscious? Are they breathing? Do they have chest pains? Are they bleeding?
As an operator enters this information, the computer automatically gives the incident a rating: red—immediately life threatening, amber—serious but not immediately life threatening, or green—neither immediately life threatening nor serious. The operator then transfers this assessment to a colleague who gets help to the victim.
The service has 395 ambulances and 60 fast-response cars. When an emergency is reported, the nearest appropriate vehicle is directed to the scene. Motorcycle paramedics are also on call, for they can more easily weave their way through traffic in congested areas. Additionally, 12 doctors are on call 24 hours a day to help the paramedics.
While I was at the center, local police reported a serious accident on a busy highway. An ambulance was already on hand, but the police called the ambulance headquarters anyway. Why? To alert the staff there to the possible need for their helicopter service. This distinctive red aircraft flies approximately 1,000 missions a year. It is manned by a paramedic and a doctor, who usually transfer the seriously injured to the Royal London Hospital, where they receive prompt attention.
In 2004, yet another initiative was introduced—a trial bicycle ambulance unit at London’s Heathrow Airport, an extension of a service already working in the city’s West End. A team of emergency medical technicians and paramedics share this responsibility, thereby releasing ambulances for other duties. Each bike, fitted with a blue light and a siren, has panniers carrying 77 pounds [35 kg] of equipment, including a defibrillator, oxygen, and analgesics.
Within a few days of its creation, the bicycle unit proved its worth. A 35-year-old woman became ill in Heathrow’s Terminal 4 and stopped breathing. Two paramedics responded to the 999 call within seconds, gave her oxygen, and immediately started resuscitation. An ambulance rushed her to the nearest hospital. After convalescing, she thanked the paramedics in person for saving her life.
An Expanding Service
When 999 callers do not speak English, they are transferred to an interpreter. Determining a caller’s language can, of course, be a challenge, especially when the person is talking fast because of anxiety or stress!
To promote public education in emergency health care, a short film with English subtitles has been made available on DVD. The goal is to encourage Londoners from communities in South Asia “to learn how to perform cardio-pulmonary resuscitation,” says LAS News, a publication of the London Ambulance Service. The DVD also shows what happens when a 999 call is received.
The citizens of England’s cosmopolitan capital are grateful for the prompt response provided for their medical emergencies, whether these involve just one person or many and whether they occur underground or high up in a skyscraper. Concerning the men and women of the London Ambulance Service, a volunteer doctor commented: “They are some of the best medical professionals I’ve worked with.” This is fine commendation for the staff of the largest free ambulance service in the world.
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Problems and Frustrations
Inappropriate calls for personal information and calls about minor illnesses and injuries, as well as calls resulting from people dialing 999 accidentally or just for fun, cause problems for the emergency services. Worse still, some patients and others, including their family members, have abused and even assaulted medical personnel coming to help! The anger these individuals feel may be caused by stress or drug abuse or impatience because they think that aid took too long to arrive. There is no simple solution to these problems, but public education has helped.
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The center handles some 3,000 emergency calls daily
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All photos: Courtesy of London Ambulance Service NHS Trust