Monday, November 8, 2010

Urgent need to improve emergency response

MY colleague Kamarudin Ahmad’s teenage son underwent surgery to remove his tonsils recently. While the boy was recuperating at home in Kota Damansara, he suddenly coughed up blood.
Fortunately for the family, Kamarudin, a seasoned photo-journalist who has seen all sorts of emergencies in over 20 years of his career, including a stint in Iraq,was at home that Sunday.
Sensing that the boy needed fast medical attention, Kamarudin dialed 999. When the call got through, he briefed the operator and gave the details including his contact number and address. He requested for an ambulance to be sent immediately. However, much to his chagrin, having taken the details, the operator asked what he had given his son to eat and how did the boy cough up blood — questions only a medical personnel would ask and have use for.
Realising that valuable time was being wasted, Kamarudin pleaded for an ambulance to be sent at once. After what seemed to be a long wait, Kamarudin’s phone rang. The ambulance driver was calling to ask for directions to his house despite the details given to the 999 operator earlier. By that time, the boy had gone into a fit.
In the rising tension, Kamarudin still managed to repeat the details he had given earlier. Kamaruddin then asked if his son could be sent to the nearest medical facility, a private hospital in Damansara, which is only a 15 minutes’ drive from his house.
The response shocked Kamaruddin — the man said it could not be done because it was a government-owned ambulance service and that it could only send patients to Sungai Buloh Hospital, which is a good half-hour ride from Kota Damansara.
Kamarudin cancelled his request and drove his son to the private medical centre in Damansara where the boy was immediately warded.
Relating his nightmare, Kamarudin said he was lucky it was a Sunday when traffic was sparse.
Otherwise, he could not imagine what would have happened.
“I had no idea why the 999 operator asked me more than she needed to know instead of sending an ambulance immediately.
I am also wondering why, after having given the details to her, the ambulance driver still had to ask me for the directions to my house,” he said.
“Aren’t ambulances equipped with maps and global positioning systems so that they waste little time in getting to their destinations?” I said I did not know howprepared or well equipped our medical emergency response units are but I had a similar experience in the 1990s.
A neighbour’s house caught fire in the wee hours of the morning and I dialed 999 to ask for the fire brigade.
Instead, a sleepy-voiced operator put me through a similar drill of questions like how the fire started and how bad was the fire when all he needed to do was relay the call to the fire department.
He only relented after I told him to call me back if he was not convinced that it was a genuine distress call.
Perhaps the rising number of fake calls had prompted the 999 operator to ask more than he needed to know to weed out the crank callers.
But in Kamarudin’s case, did the operator need to know more than the nature of the emergency and location before dispatching medical help? Considering howcritical the emergency was, couldn’t the patient be sent to the nearest hospital instead of the pre-approved government hospital?
In emergencies when split-second decisions have to be made, are our emergency response personnel trained to make judgment calls that can save lives, and in this instance, pick the nearest well-equipped medical facility regardless of whether it is a government or private hospital?

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