Selasa, 02 September 2014

Leaked documents show ambulances held up at Sydney emergency wards, unable to transfer patients (ABC)

The mother of a two-month-old baby was forced to give her child mouth-to-mouth in the back of the family car while her husband drove them to the hospital because there was no ambulance free to help.

The baby survived the ordeal and remains in a critical but stable condition, however the child's mother was distressed to find a backlog of ambulances outside the hospital upon arrival.

After inquiries from the ABC, NSW Health Minister Jillian Skinner announced an investigation into the incident.

"There's a thorough investigation underway that looks from the beginning of the call right through to the treatment," Ms Skinner said.

"I'm sure we'll come up with some answers. I am very sorry for the distress caused to these parents."

Paramedics say this is just one case out of possibly hundreds that are happening across Sydney because ambulances are being held up at emergency wards unable to transfer their patients.

Leaked documents obtained by the ABC show a snapshot of ambulance movements over a four-hour period as reported by paramedics on duty.

According to the ambulance logs, seriously ill patients have been left for hours on ambulance stretchers waiting to be seen by hospital staff and admitted. It is known as trolley blocking.

"While a patient is on a trolley, it's the responsibility of the paramedics to look after that patient because they haven't been handed over to the hospital emergency," said Wayne Flint, president of the Australian Paramedics Association.

"There's not enough beds, there's not enough nurses to look after people in the beds and there's a flow-on effect."

The documents reveal that a patient with chest pains who was "not alert" waited for for over three hours before being admitted to Bankstown Hospital.

The standard response time in emergency is supposed to be 15 minutes.

Another patient suffering from a stroke waited for almost two hours at Liverpool Hospital.

"If ambulances are waiting outside and they can't unload their patients it clearly highlights that there's a problem inside the hospital itself that they're not moving patients," Mr Flint said.

Ms Skinner has admitted trolley blocks were occurring.

"It's primarily because ward beds aren't available to take the patient admitted from the emergency department. We've increased the work force to cope with increased demand," Ms Skinner said.

"I am told this is the worst flu since 2009. The attendances at our emergency department are much higher than in previous years."

NSW Opposition health spokesman and paediatrician at Liverpool Hospital, Dr Andrew McDonald, said the practise was putting lives at stake.

"If you are on a trolley in a corridor of an emergency department you are at great risk," he said.

"These people get forgotten because they are not on an allocated bed. They are on a trolley.

"It's not clear who's looking after them and these medical emergencies can go wrong amazingly quickly.

"Putting somebody on a trolley in an emergency department in a corridor is completely unacceptable and really dangerous."

Leaked documents show stroke patient waited almost two hours

The documents, recorded last month, show ambulance status, hospital arrival times and vehicle availability in the Sydney metro area. 

They show eight ambulances were delayed with patients on trolleys for more than an hour at Campbelltown hospital. Five of those patients had chest pains and another two were unconscious.

At Bankstown Hospital five ambulances were delayed, including the patient with chest pains waiting three hours.

At Blacktown Hospital, two ambulances waited for nearly three hours before they could offload their patients.

Three patients were left on stretchers at Liverpool, including a stroke patient who waited for almost two hours.

A source told the ABC that this patient was delayed because there were not enough beds in the emergency department.

"Strokes are a medical emergency. Modern stroke care is all about urgent treatment. That's why if you have a stroke you need to be seen within 15 minutes of arrival at a hospital. Strokes are a medical emergency," Dr McDonald said.

But the Health Minister said there had been a dramatic reduction in the hours that ambulances and paramedics had to wait.

"It was a constant problem in years past. We've made dramatic improvements," Ms Skinner said.

Time is critical, say doctors

Emergency medicine physicians say time is critical when it comes to conditions like heart attack and stroke.

"We know that time is muscle when it comes to heart attacks. We know that time is brain when it comes to strokes, we want to get on and treat these people as soon as possible," said Dr Anthony Cross, president of the Australian College of Emergency Medicine.

Dr Cross said it was becoming an increasingly common problem and that it is not uncommon for up to four ambulance officers lined up waiting for their patients to be admitted..

"We know that it's happening in Sydney but it's also happening across Australia. It's a terrible and worrisome problem," he said.

Patient care falls under the supervision of paramedics while they are lying on a trolley waiting for a bed. Paramedics say there are limitations on what they can do.

"It generally consists of monitoring their blood pressure, their respiration and oxygen saturations and just try and keep that person stable," Mr Flint said.

"There's a high demand there particularly during winter so I think the taxpayer and the Government need to weigh up: do we have a workforce of paramedics who should be on the road all the time being 100 per cent productive and moving patients around?

"Every year there's no preparation for it and every year trolley blocks happen. They need to prepare for this."

NSW Government accused of hiding figures

Dr McDonald accused the NSW Government of doing very little for western Sydney hospitals and accused them of hiding the figures on trolley blocking.

"The hospitals at greatest risk are those with the greatest demand. That's hospitals in western Sydney where people wait far longer than they need to," he said.

"The Government is deliberately hiding the figures for trolley block and acute bed occupancy because they just don't want the public to know how dire things are.

"Three hours of chest pain without treatment is a medical emergency. Everyone knows when it comes to chest pain time is muscle.

"Every second that is lost in not assessing a person with chest pain puts their life at enormous risk and makes them at permanent risk of heart damage."

But Ms Skinner was sceptical that any patient with chest pains would be left waiting to see medical staff. 

"I'd be very disappointed if in fact there were any patients with chest pains waiting because I have every confidence in our doctors to triage every patient that arrives in an ambulance to a hospital," Ms Skinner said.

"Those doctors make sure those with most clinically urgent condition are seen first. So I would be very disappointed with anyone if that kind of condition was left waiting."

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