How to Patient - ambulance edition
- Dec 30, 2023
- 4 min read
I have had several ambulance trips since my cardiac sarcoidosis diagnosis. I have gone from a complete novice to a bit of a regular ambulance user, sadly.
In this edition of How to Patient I will share my learnings of the New Zealand health system.
Evaluate your symptoms
I have struggled with the decision of weather or not to phone the ambulance service each time that I have done so.
The first time I experienced an arrhythmia, we were hesitant. We had never had to call an ambulance before, and I had no idea what was wrong with me. And how do you decide if what you are feeling is serious enough for some assistance? Most of the time me or my husband have Googled a bit before making the decision. This is probably bad.
Questions I now ask myself to make the decision are:
Do I have trouble breathing?
Do I have chest pain that lasts more than a few seconds?
Did I have multiple ICD treatments within a day or two?
Am I afraid to be alone?
If I say yes to any of the above questions, I phone 111.
Phoning for an ambulance
The first thing the operator will ask is your address, followed by the reason for your call. If your emergency is heart related the operator will ask some additional questions to try and establish if it's a heart attack.
My house is hard to find, so I normally tell the operator how the paramedics can get to my front door.
When my husband has phoned, they normally ask him to put the dog away. They have not asked me that when I have been home alone, probably cause I am the one having the emergency...
Arriving at my house
Most of my paramedic interactions have been at my home. All the crews I have seen have been great and incredibly professional. Paramedics will normally arrive in a pair. One acts as a driver for the ambulance, and the other will manage the patient (me) in the back of the ambulance.
Normally they will ask you to walk through the emergency or what is wrong. And then potentially run some tests, like an ECG for anything heart related. And your blood pressure and oxygen saturation. They will also take a history if you are stable enough to share one, and ask you for a list of medications. This is to help the paramedics make better decisions if they need to give you any medication before you reach the hospital.
The paramedics may also get an IV started. This means that they will put a needle into your arm, ready to connect an IV drip if you need any medicine on the way to the hospital or in the emergency room. With my first ambulance experience, I had not had a lot of experience with my veins and having needles inserted into my arms or hands. The crew had a lot of trouble trying to find veins in my arms or hands to use for an IV. If you do know that you have difficult veins, please let the team know if you can to help make this process as fast as possible.
The paramedics will communicate what they are doing or want to do to for treatment to make sure you are comfortable with what they are doing.
If you have an arrhythmia, the ambulance team may need to defribillate your heart to stabilise you before you can go to hospital. I now have an ICD which defribilates me automatically. But my first ambulance trip I had no ICD, and the paramedics had to do this step. Before they did, they gave me some Ketamine to sedate me. They didn't want me to feel the shock. Bless their hearts.
Having family around with the paramedics can be tricky. Once I had to have a little chat with my young son about who the paramedics are and why I was going to go with them. He saw them taking me away and was so worried to see me go. I tried to make light of it all by pointing out what cool green pants they were wearing...
Arriving at my work
I have had one emergency at work. This was different in a few ways. You don't want to share your full medical history with the the ambulance crew in front of all your colleagues. So the paramedics kindly got me ready to go and took me to the ambulance before we really spoke about my emergency in more detail.
Something else that was different at work was having to manage my coworker's feelings. There were some younger staff, and I tried to make a few jokes as the ambulance crew were loading me in a wheelchair. It was really hard, as normally at work we all tend to have a professional mask.
Trip to the hospital
The paramedics will load you into the ambulance. Sometimes I have been able to walk to the ambulance and get in on my own. Other times I have been taken to the ambulance in a wheelchair.
Inside the ambulance is a stretcher bed which has a seat belt to secure the patient. The paramedic will help you into this bed, and when you reach the hospital you will be wheeled in on the stretcher bed most of the time.
For serious emergencies the ambulance will turn on the blue lights on the way to the hospital. This has only happened for me once, that I know of.
I have had plenty of chest pain, but have only had to have pain killers once. The paramedic administered it while in the ambulance via the IV line. The pain relief took about 10 minutes to work.
The handover at hospital
When you get to the hospital with the ambulance you will be wheeled in to the triage area. Here the paramedics will do a handover to the triage nurse. They will relay the details of the emergency to the nurse and also what they found with various tests and observations.
Then they will wait with you to transfer you to a bed in the emergency department.
Once a bed opens up in the emergency department, the paramedics will say goodbye to you.
Shout out to Wellington Free Ambulance
I have a real soft spot for Wellington Free Ambulance and their team. They have helped me so many times. If you can, please donate to their cause. They are the only free ambulance service in New Zealand.
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Wellington Free Ambulance provides free ambulance and healthcare services for the Greater Wellington and Wairarapa region. Donate today.
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