THE FRONT LINE OF THE NHS
The Ambulance Service of today is very different from that of just a few years ago. There has been a significant investment in the training and development of ambulance crews resulting in more effective patient care than ever before, particularly in the Accident and Emergency Service.
The NHS Ambulance Service is actually provided by 38 “local” ambulance services including the Isle of Man, Isle of Wight and the Channel Islands. Often referred to as the “Front Line of the NHS”, the Ambulance Service plays a vital part in the community. Each year, about one in twenty people in the United Kingdom will use the Accident and Emergency Ambulance Service and the number of 999 calls has risen steadily, year on year, for some time. The ambulance, with blue lights and sirens working, is the familiar image of the Service – but responding to 999 calls amounts to only 10% of the total workload of a typical Ambulance Service.
Most patients attended by the Ambulance Service are transported by the Patient Transport Service (PTS).
This branch of the Service transports a wide range of patients, including:
- Out Patients
- Disablement Service Centre Patients
- Routine Discharges and Admissions
- Geriatric and Psycho-Geriatric Day Care
- Non-Urgent Inter-Hospital Transfers
- Comprehensive First Aid
- Specialist Driving Skills
- Patient Moving and Handling Techniques
In some Services, a number of PTS crews are specially trained as “high dependency” teams. These are available for patients with particular clinical needs during transport.
Specially designed vehicles, usually incorporating a tail lift, are often used to enable PTS crews to provide optimum levels of patient comfort. The attendant travels with the patients and is frequently able to relieve anxiety during the early stages of hospital admission.
Accident and Emergency Work
The Accident and Emergency Service deals with emergency and urgent cases, as well as the more complex non-emergency admissions, discharges and transfers. Typically, emergency ambulance crews comprise an Ambulance Technician and a Paramedic. Emergency ambulance vehicles are designed to provide a clinical workplace with maximum mobility. The crews are highly trained in all aspects of pre-hospital emergency care from crush injuries to cardiac arrest. They aim to treat and stabilise patients before movement – but not to delay hospital admission unnecessarily in order to achieve this. They have to be highly skilled, quick thinking and decisive, yet able to provide a calm and reassuring environment for the patient and relatives.
Emergency ambulances are equipped with a wide range of emergency care equipment including a heart defibrillator, spinal and traction splints, rescue equipment, intravenous drips, oxygen and a range of drugs for medical and traumatic emergencies. They carry sophisticated patient monitoring equipment such as a pulse oximeter and cardiac and blood pressure monitors. All have communications links to the Ambulance Control centre and some have telephone, computer data or video links to a hospital.