From care home to A&E Terry Healy and Vicki Hirst
About us Busiest ambulance service in the UK Demand increase year on year. 1.9m calls received 2015-16 3,500 calls treated over the phone per week 5,000 staff, 71 per cent are frontline 70 ambulance stations Croydon 6,000 calls per month Most seriously ill and injured calls compared to London boroughs 2
How we care for the capital Our major service areas: Call taking and clinical triage Hear and treat services 999 emergency and urgent care response delivered using traditional and innovative means e.g. Cycle Response Unit 111 Services South East London Emergency Preparedness Resilience and Response (EPRR) major incidents and events 3
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Our vehicles 5
What to do when a resident becomes ill Consider On-site qualified nurse or district nurse GP or GP out-of-hours service 111 Always call 999 if someone is seriously ill or injured, and their life is at risk difficulty in breathing, unconsciousness severe loss of blood Stroke or heart attack 6
Making the call Dial 999, ask for an ambulance and stay calm If possible, remain with the patient Cordless phone If you can t stay with the patient make sure you know if the patient is alert, conscious, breathing You could be offered advice over the phone, or a call back from our paramedics in the clinical hub 7
How we prioritise your call Ask a series of questions and run through a triage tool Are they conscious, alert, breathing? Location is important Seriously ill and injured patients eight minute response London Ambulance Service NHS Trust 8
Sepsis Blood poisoning or septicaemia Can affect all age groups Bigger killer than myocardial infarction (MI), stroke, COPD or chronic lung cancer The total number of patients developing sepsis within the UK every year is now over 100,000 37,000 people die of sepsis per year Caused by bacteria, rarely viruses & fungi London Ambulance Service NHS Trust 9
Sepsis Sepsis is defined as a systemic inflammatory response to an infection and involves three distinct stages: 1. Uncomplicated simple sepsis (often referred to as sepsis) - Suspected or known infection, in the presence of Systemic Inflammatory Response Syndrome; 2. Severe sepsis sepsis with any sign of organ dysfunction, and 3. Septic shock Continued evidence of severe sepsis (organ dysfunction) despite adequate fluid resuscitation. London Ambulance Service NHS Trust 10
London Ambulance Service NHS Trust 11
London Ambulance Service NHS Trust 12
Case study one You walk into a resident s and find they are on the floor. It was an un-witnessed fall. How would you address it? Discuss London Ambulance Service NHS Trust 13
Case study two Walk into a resident s room and they are collapsed and not breathing What would you do? London Ambulance Service NHS Trust 14
What could delay us from getting to a patient? Not met at door, can t get in no access code Unsure which resident is the patient Large home, many patients, different floors IMPORTANT let others know you have called for an ambulance 15
Information to prepare for ambulance arrival Full name, date of birth, next of kin & contact details GP details (hospital needs these for referrals) Address of the home Medication drug chart, medical history & any obs DNAR in place? Copies of information for us to take away Patient s personal belongings Escort 16
Patient report form (PRF) 21
Where we take the patient Nearest or usual hospital Croydon University Hospital Princess Royal University Hospital Specialist centres Hyper acute stroke unit (HASU) Heart attack centre 25
Emergency stroke care 26
Heart attack treatment When an artery becomes blocked and restricts the blood supply to the heart If patient is having a heart attack we will take them to a specialist hospital Nearest hospitals King s College Camberwell St George s Tooting 27
Contacts Vicki Hirst Tel: 07585 966630 Email: vicki.hirst@londonambulance.nhs.uk 28