AMBULANCE INCIDENTS

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					August – November 2008 AMBULANCE INCIDENT LOGS Date 1 August 6 August 7 August Location / Branch MICA Regional Melbourne Situation 1700-0700 Shift dropped Branch one officer short due to course attendance. No backfill 13 month old with severe respiratory distress Comments

Case referred to other centre as single officer crews all busy 42 minute wait for ambulance from other town as crew on fatigue break and unable to be covered. 24 minute wait for ambulance from other town as local car covering in another town Transported by police to hospital after 30 minute wait due to no ambulance available to respond

Regional

Woman fell from horse

Regional Regional

Patient suffering chest pain and with abnormal breathing Psychiatric patient suffering from medication overdose and behaving aggressively 0700-1700 shift run as general purpose ambulance 1700-0700 shift not run 0800-1800 shift dropped 1700-0700 Shift dropped 1700-0700 shift run as general purpose ambulance 0800 shift unable to be covered 5 cases with waits of 70 minutes or longer. 0700-1700 shift run as general purpose ambulance 1700-0700 shift dropped 1700-0700 run as PRU 1700-0700 shift dropped 1700-0700 shift run as general purpose ambulance 0800 shift not covered 1700-0700 shift dropped

8 August 11 August 12 August 13 August

MICA MICA Regional MICA MICA (2 units) Regional MICA

14 August 15 August

MICA MICA (2 units) MICA Regional MICA (2 units)

16 August

Regional Regional

Patient with chest pain 18 month old male, breathing difficulties

Single officer response Patient initially assessed and left in care of mother. Later, officer called to medical Centre where patient was receiving nebulised adrenalin. Patient required transport to other hospital. No other officer available to crew. Ops centre asked if medical centre had a nurse who could escort. Patient had to stay at medical centre, past closing, until transport crew arrived. Reduction of Melbourne’s MICA coverage by 3 units Reduction in level of available clinical care

17 August

MICA (5 units) MICA (3 units) MICA (2 units) MICA Regional

1700-0700 shift dropped 0700 shift. Running as general paramedics 0700 shift. Running as single officer crews. 1700 shift. Running as general purpose ambulance No coverage in town between 2335 and 0315, other town crew cover a code 1 here, second time other town’s crew covered code 1s in the town that day 11 ambulances ramped up at Royal Melbourne Hospital Code 3, inter hospital transfer has to Single Student officer unable to respond. Incorrect team dispatched to Werona Nearly 3 hours without coverage in area Running as general purpose ambulance Code 1, on call crew not used Code 1, no coverage (no other details) Unconscious diabetic patient with a history of combative behaviour

18 August

21 August

Melbourne Regional Regional Regional Regional MICA Regional Regional Regional

Waiting times of up to 90 minutes wait 6h46m patient waits 3 hours 45 min drive from scene 4 Times in week without coverage 23 minute dispatch time Officer dispatched from single officer branch with back up dispatched from branch 45 km away. 40 minute response time for second officer

22 August 25 August

26 August

28 August 29 August

MICA Regional Regional Regional Regional Regional Regional

1700-0700 shift run as single responder I entire day shift short Code 1 – 55 y.o. male, chest pain, clammy Code 3 – 73 y.o. female, sick Code 1 – 79 y.o. female chest pain, cardiac hx Code 1 – 76 y.o. female breathing problems, severe shortness of breath Code 1 – 40 y.o. male unconscious in police custody

19 minute wait 61 minute wait 21 minute wait 24 minute wait 95 minute wait

30 August 31 August

Regional Regional Regional Regional Regional MICA Melbourne (6 units) Regional MICA Regional

1 September

Code 3 – IHT post infarct (no air available, taken by road) Code 3 – femoral embolism (no air available, transported by road) Code 2 – 94 y.o. female, neck of femur Code 3 – 27 y.o. sick person Code 1 – unconscious, police on scene 1700 shift. Running as single officer crew 1700 Shift not in service Code 1 – very sick patient to be transferred from small to larger hospital Single officer crew 4 y.o. male with cardiac arrest.

90 minute wait 5 hour wait 45 minute wait 68 minute wait 14 minute wait Reduction in level of available clinical care 50 minute wait. Crew had to be recalled.

2 September

Melbourne Regional

Meal break Vehicle rollover. 4 Occupants

3 September 4 September 5 September

Regional Regional MICA (2 units) MICA Regional Regional MICA (5 units) Melbourne Melbourne (6 units) Melbourne (2 units) Regional

63 y.o. unconscious female with head strike Code 3, back pain 1700-0700 Shift dropped 1700-0700 Shift dropped Branch not covered from 1800-0800 1800 shift covered by single officer 1700 shift. 5 MICA units out of service 10 cars not running on night shift due to staff shortages 1700 shift. Shift not in service 1700 shift. Running as single officer Half day-shift crew down. Code 1 patient with chest pains - drive themselves to hospital 0800 shift at town covered by single officer. No day or night shift at other branch 1700 shift. 3 MICA units out of service 1700 shift. Running as general ambulance 1700 shift. Shift not running 1700 shift. Running as single officer Nightshift unfilled 0800 and 1800 shift covered by single officer

Due to no local ambulance service, 18 minutes response time. Localised service could have reduced this to 5 minutes. Crew worked 9.5 hours without a meal break, finally receiving break at 0233. Time from call received to crew arriving – 39 minutes. By time job was completed, crew had first meal break at 0233 hrs. 22 minute response time 79 min dispatch time

Severe reduction in Melbourne’s MICA coverage

6 September

Regional MICA (3 units) MICA Regional Regional Melbourne Regional

Greatly reduced coverage for area. Severe reduction in Melbourne’s MICA coverage

7 September

Regional MICA Regional 8 Sept 9 Sept 10 Sept 11 September 12 September Regional Regional Regional Regional Regional

No crew available due to fatigue break Night shift not running Ran out of crews, code 1s waiting longer than should. 2 person crew recalled to cover Ran out of crews code 1 waiting long time Unable to replace 0800 shift Code 2, imminent birth. 94 y.o. male with lacerations to arm 80 y.o. patient waiting on floor for ambulance

Covered from other town

12 and 13 September 13 September

Regional Regional Regional Regional MICA MICA (3 units) Regional Melbourne (3 units) Regional Melbourne Regional Regional Regional Regional Regional

Night shift covered by single officer Night shift covered by single officer. Crewing not available for required additional crew. 22 y.o. with abdominal pain 1700 shift. Not in Service 1700 Shift. MICA units running as general ambulance units 1700-0700 shift. Single officer only 1700 shift. Shift not running 1700 shift. Running as single responder Night shift not filled Code 1, unconscious No meal breaks for staff working day shift No meal or toilet or rest breaks for staff working between 1700-0900 Code 2, fall. 87 y.o. with dizziness Patient transported from regional hospital to Royal Melbourne Hospital

44 min dispatch time Wait of 1 hour and 3 minutes for ambulance to arrive due to ramping up at hospital 1 hour wait between call reception and ambulance dispatch. On arrival, crew discovered that patient had been on the floor for 3 hours prior to calling ambulance Reduction in level of care Reduction in level of care Reduced coverage in area Ambulance cancelled after wait of 1 hour Reduction in Melbourne’s MICA coverage

14 September

15 min dispatch time Increase in fatigue for staff Caller cancels after 12 minute wait , no dispatch 57 minute wait for ambulance 1 hour and 50 minute wait at hospital to unload patient, inability to print VACIS report due to equipment failure. Nearly 6 hours spent on 1 job 84 minutes Caller cancelled after 23 minute wait and transported in private car

16 September 16 September

17 September

Regional Regional Regional Regional Regional

IHT psychiatric patient 89 y.o. female with chest pain. Code 1 Not covered during day 1200 shift dropped 1 person sick on night shift. Paramedic from 1000-2000 shift volunteered to work until 0800. 22 hours straight!!

Regional Regional MICA Regional Regional Melbourne Regional

Code 2 sick person – back and neck pain Code 1, 50 y.o. female with breathing problems Run as general ambulance unit One night-shift unable to be filled Branch left covered by ALS and ACO Night shift running as single responder 87 y.o. female with abdominal pain

60 minute wait. Cancelled and transported by own means 53 minute wait for ambulance

18 September

19 September

MICA utilised as back up, diverting MICA resources Transferred from regional hospital to one a greater distance because local hospital full. Arrived at 2310. Family very distressed. All hospitals on bypass, no ICU beds available anywhere in Victoria. Patients on trolleys for 1 hour and 40 minutes. No coverage for area 10 min dispatch time 5 min dispatch time 24 min dispatch time

20 September

Regional Melbourne

Night shift dropped 10-11 ambulances ramped up at Royal Melbourne Hospital

23 Sept 24 September 25 September 26 September

27 September

Regional Regional Regional Regional Regional MICA Regional Melbourne Melbourne Regional Regional Melbourne Regional Regional Regional Melbourne Regional Regional Regional Regional Regional Regional

Officer off work on fatigue break Code 2, psychiatric patient Code 1, cardiac arrest (call received 8.56am) Code 1, unconscious 1300- crew sent to Melbourne, not replaced 1700 shift dropped Child, interhospital transfer 9 ambulances ramped up at Monash Medical Centre 9 ambulances ramped up at Frankston Hospital Dropped day shift Sent to other town for 5 hours, not replaced (no crew in other town) 3 crews dropped Dropped day shift Dropped day shift Single officer crew 12 ambulances ramped at Royal Melbourne Hospital 0700 crew sent to Melb, not replaced Single officer crew Person not replaced when called in sick Only 1 1300 shift – 1 crew down until 1600 No second day shift crew Code 2, 5.30am.

32 min dispatch time More than 1 hour delay 30-60 minutes delay

15 nightshift crews did not obtain first meal break until second meal break window

28 September 29 September 30 Sept 1 October 2 Oct 4 October

Normally a 2 officer crew branch

Normally a 2 officer crew branch

Reduced coverage in area Ambulance finally dispatched to cover at 9am , 3h30m delay

Regional 5 October 6 October 9 October Regional Regional Melbourne Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional

Code 1, another town’s crew beat local crew to case. 74 mins without cover in crew’s home town. No second day shift crew Another branch’s crew called over for the day cover missing day shift Headache, speech problem (possible stroke victim) Code 1 - 70 y.o., unconscious Code 3- 90 y.o. – x-ray appointment Code 2 - Fall victim Code 2 – sick person Code 2 – 71 y.o. sick person Code 1 – 82 y.o. female – haemorrhage and lacerations Code 3 – 88 y.o. female - hip pain Code 3 – 76 y.o. sick person Code 2 – 75 y.o. female, problem unknown Code 3 – 64 y.o. male – pulmonary embolism Code 1 – 76 y.o. male – abdominal pain Code 3 – 91 y.o. female – bowel obstruction Code 2 – assault / knife wounds Code 2 – 74 y.o. female - back pain Code 1 – 70 y.o. female – shortness of breath Code 1 –female 60s– shortness of breath Code 1 – 36 y.o. male – chest pain Code 1 – 30 y.o. male – Fitting Code 1 – 78 y.o. female – shortness of breath Code 1 – 35 y.o. male - diabetic Code 1, assault Code 2, unconscious patient in police care Code 1, road accident, multiple casualties Code 2, abdominal pain Code 2 – 90 y.o. female – neck of femur (broken hip) Code 1 – 68 y.o. male - haemoptysis Code 1 – 83 y.o. female - stroke Code 1 – 54 y.o. male – chest pain No staff available to cover town due to argument about how to pay for overtime worked – management wanted ambo to work on recall rather than overtime to save money 0700 sent to next town

Reduced coverage in area Dispatch delayed 10 minutes to avoid spoilt meal break 57 minute wait 2 hr. 38 minute wait 33 minute wait 78 minute wait 47 minute wait 32 minute wait 40 minute wait 63 minute wait 45 minute wait 78 minute wait 30 minute wait 37 minute wait 66 minute wait before being transported by police 74 minute wait 54 minute wait 24 minute wait 51 minute wait 42 minute wait 52 minute wait 44 minute wait 14 minute dispatch time 18 minute dispatch time 24 min dispatch delay 9 min dispatch 95 minute wait 32 minute wait 38 minute wait 21 minute wait No service from town on 17 October

10 October

11 Oct 12 Oct 13 Oct 14 October

17 October

Regional

18 October 19 October

Regional Regional Regional Regional Regional

No coverage in town No staff available in town 0800 MICA shift not able to be covered Code 3, IHT peritonitis Inter hospital transfer postroad accident pedestrian No coverage at town for 10 hours Paramedic worked from 0800 to 1600 and then recalled at 1630 to work until 2330. That is a 16.5 hour day. Night shift required to go to Melbourne with a job Melbourne transfer. Shift not covered, Control room to busy, said not their job to cover shift. Two shifts combined due to an inability to cover for staff on leave / training No 8am crew

Town not covered 2 code 1’s needed to wait 30-35 minutes for response 25 min dispatch 36 min dispatch

20 Oct 22 October 23 October 23 Oct 24 October 26 October

Regional Regional Regional Regional Regional Regional

No coverage for town

town left one ambulance crew short Due to response to fatal collision, whole of large town covered by 1 unit for a period of time. 3h25m (no unit available) 61m 22m 1h46m (crew recalled) 30m

Regional Regional Regional Regional Regional Regional

code 3, 30yo male, IHT appendicitis Code 2, 81yo female, fall- not dangerous Code 1, 83yo female, unconscious Code 3, 77yo female, interhospital transfer to Melbourne Code 2, 31yo male, back pain Truck stalls in 3rd gear, cannot exceed 60km/h. Worked correctly after re-start, stuck again in 3rd on Code 1. No fault found by mechanincs, crew refuse to re-use truck. 202,000km on clock. Code 1, 85yo male, breathing problems Code 1, cardiac arrest Code 2, abdo pain 0700-1700 shift, sent to Melbourne at 1030. Away all day, not replaced, one shift down in town Hospital transfer to Melbourne, no cover at town for 5h30 1 person sent to cover at other town to cover shortfall there. Only 3 of normal 4 staff. Recalled crews that had worked in the day, Very very busy. 2300 onwards, only 1 nightshift

28 Oct

29 Oct

Regional Regional Regional Regional Regional Regional

21m 27m 32 min dispatch time

31 Oct

1 Nov

2 Nov

3 Nov 5 Nov

6 Nov 6 Nov

Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Regional Melbourne Regional Regional Regional

Code 1, 52yo male, asthma Code 2, 83yo female, back pain Code 3,cardiac problems, 80yo male, IHT Code 2, 78yo male, fractured NOF (in hip) Town’s day shift uncovered Dropped shift, covered by 14hr recall Code 1, severe short of breath Code 1, road accident Town day shift not covered Town’s crew sent to cover at other town 60 kms away – then to on to another town (45mins further away) Dropped shift in morning, only one vehicle Dropped shift (pm) single officer No coverage for 2 hours, at accident in another area Code1, road accident Code 1 Officer sick, replacement sent over from other branch No coverage for town during 2 hr period then later during a 3hr period Eight ambulances not on road due to staff shortages Code 2, abdo pain Another town’s crew cover night shift Overload of code 1 cases, all crews in area on code 1s. Volunteer paramedics called in from out of area, as had to make some response Day shift and manager cover night shift No crew for nightshift Day shift covered by single officer from 1300 – 1600 (should be two). Other on 8-hr rest break. Officer attends emergency solo. 2nd crew needed to come with back-up. Transports patient solo. Schoolies Saturday night, and no nightshift. Another town’s crew moved in to cover, no coverage during large area of one hours drive Code 2 Five ambulances not on road due to staff shortage Man, code 1, cardiac arrest 0700 crew sent to another town, not covered in home town. No MICA coverage in area. Crew sent to other town (about 40km away) twice, not covered at home town Recalled crew at 1400 to cover. 0800 crew never got to actually have

23m 65m 1h55 1h21m

21 min dispatch time 5 min dispatch time

10 Nov 13 Nov 14 Nov 17 Nov 20 Nov 21 Nov

12 min dispatch 30 minutes

42 min dispatch delay

22 Nov 22 Nov

Regional Regional Regional

22 Nov

Regional Regional Melbourne Melbourne Regional Regional Regional

42 min dispatch delay 20min plus response time

23 Nov 25 Nov 25 Nov 25 Nov

26 Nov 27 Nov 27 Nov 27 Nov 27 Nov

Regional Regional Regional Regional Regional MICA

28 Nov 28 Nov 29 Nov 29 Nov 29 Nov

Regional Melbourne Regional Regional MICA

proper meal break. 0800 crew finished 2000. No night crew. Ambos off due to fatigue Afternoon crew sent to Melb, no-one to replace them town crew split to cover another town as well. No ACO back-up. Single office response for 2 towns, one hour apart. No meal break in 14hr shift. Common occurance. Officer told by management “get used to it”. No extra shift to cover meal breaks. Very busy 1500-2300 shift. MICA units receive message from main centre: “Hi to all MICA…Thanks for you tolerance…There are 18 jobs waiting on the screen, dual car is suspended and we are still drowning. Only 2 MICA units are available in all of MAS…is one you?” 0900-2100 shift not covered, Melton there for back-up No Saturday night shift. MICA 11 runs as PRU as well. Again, 0900-2100 shift not covered, Melton there for back-up Only one officer in morning, and them transferred to cover other town. town moved across to cover another branch for most of day. Night shift ran as single MICA, with student on truck with very limited experience.


				
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