Ambulance block solution !

The rules concerning ambulance crews presenting with a patient at Wollongong hospital emergency department are quite clear.  The crew must remain and be in charge of that patients care until the triage nurse has made an assessment - and that patient has been formally handed over for treatment.

As a result, at times of overload we frequently see " Ambulance block ", and on occasions this city's entire ambulance fleet has been parked waiting for a grossly overworked triage nurse to try and see their patients.  As a consequence, ambulance call outs are being responded to by crews from a far away as Nowra, leading to unacceptable time delays.

That situation will change by mid year.

Ambulance crews will use their own diagnostic skills to determine if some patients can safely be placed in the hospitals emergency waiting room - leaving the ambulance free to respond to other emergencies.   In particular, patients with minor fall damage, diabetic hypoglycaemia and those seeking palliative relief would be treated as if they had made their own way to emergency.

The medical profession has blasted this plan as dangerous and it is inevitable that eventually there will be a fatal outcome, completely dissociated from the reason that person is presenting at emergency.  For instance, a patient waiting for an ankle sprain to be looked at suddenly suffers a heart attack - and dies.

At least it is a step in the right direction to recognise that the ambulance paramedics are skilled people with ability to grade patients on the severity of their ailments.   It also reinforces the argument for keeping an emergency department available at Bulli hospital, because if ambulance crews have this available to treat minor emergencies, then the instances of ambulance block at Wollongong hospital will be reduced.

In a perfect world, every patient would get prompt and effective treatment immediately every ambulance rolls into our hospital emergency department, but in the real world peak demand will create overloads that can not be immediately treated.   The whole point of the triage system is to make sure that the patients with life threatening problems go to the head of the treatment queue.

This change to the system merely adds a filter to ensure that those in desperate need see that triage nurse without further delay !