Trolley Block !

When someone falls ill and the symptoms indicate that it may be a heart attack or a stroke it is critically important that person is placed in the hands of someone with the medical training to bring stability and prevent further damage.    The paramedics who crew our ambulance fleet serve that purpose and a call on the 000 number will summon their help.

Once again ambulance response times are coming under the spotlight.   We have a very big ambulance fleet and their intervention runs within a well meshed control system to get the best results.   The paramedics are in radio contact with their controllers and each case gets individual evaluation.   The ambulance may not be directed to the nearest hospital, but to one that has the appropriate testing and treating facilities for that type of emergency.   That controller is also aware of the work load situation at each hospital emergency department.

In past years a lot of money was spent on the hospital system to overcome two glaring disabilities which were slowing the ambulance fleet.   They were called " trolley block " and " bed block ".  In many cases, too many ambulances with too many patients for the emergency department to handle, hence the paramedics and their vehicle was stalled at the entrance caring for their patient - and too few beds to move those treated out of the emergency department to make way for incoming new patients.

Australia's population is rapidly growing and so is the city of Sydney.  Once again we are hearing of trolley block and bed block resulting in backlogs of ambulances held at hospital emergency departments, causing serious delay times in the response to call out arrivals.   The public is aware that when it comes to stroke and heart attack, what is called " that golden hour " is critically important.  The " right " treatment given immediately usually determines how fully the patient will recover - and what disabilities will permanently remain.

Recently, the entire city of Sydney was reliant on just seven ambulances during the lunch break because the rest of the fleet was unable to discharge their patients into emergency room care.   Even ambulance service executives who still retained their paramedic licenses were pushed into service to fill the gap.  The result was delay in crews arriving to attend time critical cases.

The longer term answer is to extend emergency rooms and train the additional staff needed, but that takes time and the important need is to get those ambulances and their crews back on the road to deliver a fast response.   Perhaps the short term answer is to make use of those executives and off-duty staff to relieve the load - at the emergency department door.   Providing emergency response teams to look after patients discharged into their care would allow the ambulances and their crew to provide that urgently needed first response to call outs.

Emergency departments manage to handle the load most of the time.   These load peaks occur infrequently and by sheer chance.  A relief team to share the load at the emergency room door could make all the difference !