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Under Pressure

'A broken heart, a bad dream about a dog': Ambulance service suffers from non-urgent callouts

The HSE has repeatedly urged people not to call for an ambulance unless in the case of an emergency.

THE HSE HAS urged the public to think carefully when they require ambulance assistance after several were made to the services over low-risk incidents in the last two weeks. 

Correspondence seen by The Journal reveals a number of seemingly non-emergency incidents that people called an ambulance over. 

In one, a woman in her 20s called for an ambulance after her backside was causing her discomfort after lunch. 

Other incidences include: 

  • A woman called 999 because she had a bad dream about a dog;

  • A man called for an ambulance because he was having mood swings – saying he was happy most of the time but sad occasionally;

  • Another man called 999 after a break up and complained of having “a broken heart”.

The personal details relating to the callouts seen by this publication have been redacted to ensure patient confidentiality.

The HSE has repeatedly urged people not to call for an ambulance unless in the case of an emergency.

In all of the above-listed cases, ambulances attended the calls as per protocol.

Many paramedics have consequently asked that a further pre-screening of patients, on top of the usual triage questions posed to callers can be carried out before they are dispatched to calls.

These can include questions about whether patients are breathing or having chest pains.

Staff say they’re aware that many people could be ringing 999 because they are genuinely stressed, but this doesn’t necessarily constitute a medical emergency. 

On some occasions, paramedics say they have attended calls “to be met with a shrug of a shoulder” by the caller. 

The HSE itself has asked people to think before they call 999 but also say that it is vital that genuine emergency callers are not dismissed as time wasters.

A spokesperson said: “The National Ambulance Service (NAS) treats all 999 calls with serious intent. One of the principal rules enshrined in the regulatory requirements is that you do not question the integrity of the caller.

“Each 999 call is a serious call because we will not immediately know precisely what is happening. NAS has in place a clinical triage system the purpose of which is to determine the clinical acuity of the patient’s needs and then determine the level of response provided.”

‘We still had to come’

The Journal spoke to several paramedics about the system under which ambulances are dispatched. All of them argued for a more in-depth triage process over the phone before an ambulance is dispatched. 

“Everyone that calls an ambulance will get one, it might take hours but it cannot be cancelled,” one paramedic said.

“We often get to calls to be told ‘we cancelled hours ago’. We have to tell them we still had to come. This is obviously very frustrating for everyone involved.

“It can also be embarrassing for someone who has requested their ambulance be cancelled but then it still arrives – as it’s protocol for us to do so. 

“The calls you have seen there – the ones about the bad dreams or the big lunch or whatever – we have to go to these calls, even though we might even know the person who is doing it and they’ve called every day for the last week or so.

“There needs to be more joined-up thinking, in my opinion.

“I know there are situations where the call can be a cry for help for people but that’s why we want to see additional triaging beforehand, so we know. I think it’s a winner for everyone.”

The capacity of the ambulance service was brought into sharp focus at the turn of the New Year. 

The Journal reported at the time that messages were sent to paramedics saying the ambulance system was under “major pressure” and a “NASCAP Level 3 has been declared” – effectively meaning there were not enough ambulances and personnel to cover demand at the time.

The HSE and NAS, at that time, had also urged people to be sure their case was an emergency before calling 999. 

A spokesperson at the time said: “NAS are asking the public to help us help you by considering all care options available and only call 999 if it is an emergency.”

Late last year, we also reported how paramedics were put under constant strain by the system the HSE uses to dispatch ambulances. 

The system for dispatching paramedics to emergencies has been called “mind-boggling” and union leaders have warned that changes must be implemented immediately to ensure the safety of those who call for life-saving care.

Under the current system, when someone calls 999 for an ambulance, their call is directed to one of two call centres, one based in Tallaght, Dublin, and the other in Ballyshannon, Donegal. 

If all the resources are already responding to calls, the job is given to the next available ambulance which could be hours away from where the caller is, according to Siptu’s Ted Kenny. 

He said at the time: “It’s a crazy situation in the control centres. A call comes in – someone rings 999 – they will look up and where the next available resource is – you might have all the services allocated and the next available one is in Castletownbere [in west Cork] being sent to Waterford city two to three hours away.”

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