Frustrated by extended journey times

[UK2USA]

I work part-time for a paediatric retrieval service in the UK. On the whole the distances we cover are quite short so most of our transports are carried out by road. 3 months ago our team were involved in a collision and as a result we have been instructed that we cannot use "blue's and two's" until the investigation is complete and further training given to the drivers. I understand the necessity of this and completely agree, but it is really frustrating to go out in an amblance knowing that a journey that normally takes 1 hour will now take 3! If you add in the time to stabilise the child and make the return journey it can add up to an 'away time' of huge proportions. This week a pick-up that should have taken 3 hours ended up taking 7!!! To make matters worse, we are suffering a mini heat wave in the UK and staff are getting so car-sick that they are puking into bags in the back of an ambulance! Can't wait for the investigation to be complete. Thanks for letting me vent!

[Medic946RN]

I routinely transport "no lights/no siren" though usually my rides are only an hour or two in length. I don't go Code 3 unless it's a true emergency. Even in my practice as a paramedic. If I have the patient under control, we roll to hospital Code 1. Pennsylvania recently passed a law putting the responsibility on the paramedic/nurse for the way pts are transported. Bottom line, if you have an accident, your pt should have been serious to begin with. The state frowns on "cowboys" who use ambulances as a "license to squeal". Have you looked in to using any anti-emetics ( the non-drowsy type) for extended transports. I know of helicopter crews who use them for long transports in unfriendly weather.

[UK2USA]

I absolutely agree with you about reckless speed and yes, we also stabilise our patients and use the safest speed possible.

I think that last night was a bad night and I was feeling pretty cheesed off by the end of the shift - I guess that it was due to the fact that the request for transfer came in so close to the end and I didn't get back till 6 hours into the next shift. Wouldn't have been so bad if I hadn't been back on duty 6 hours later!

There is some good evidence that lights and sirens make for a bad experience for neonatal and paediatric patients and I can see the logic in this.

But, it does not make it easy when the referring centres are screaming at us down the phone because they are out of their depth and we have no option but to tell them to sit tight for 3 hours. It means that when we do arrive we are presented with a child who has deteriorated to the extent that you really have to address the possibility that the patient may die en route, plus of course the local staff are totally traumatised when we arrive!

One good thing that has come of this situation is that we are becoming more assertive with our instructions/advice prior to our arrival.