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FOR WHAT IT’S WORTH: Emergency response


DR FRANCES CHANDLER

FOR WHAT IT’S WORTH: Emergency response

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What is an emergency? One dictionary defines it as “a serious, unexpected, often dangerous situation requiring immediate action”. But I maintain that Bajans don’t know the meaning of emergency. They seldom  move with any alacrity except to see a fire or to retreat from water. In that regard, I suppose we do have hope that the tsunami response advice now being aired may be taken seriously.
I’m not so sure about handling medical emergencies though, and these are some of the most serious and most frequent. We hear varying reports on treatment at the Queen Elizabeth Hospital’s (QEH) Accident & Emergency Department, so it seems to be a hit or miss situation.
I continue to live in fear of medical emergencies in my family, and rightly so, based on my experiences over the years. That’s why I’m so relieved to hear that Bayview Hospital, according to a Nation report, is to undergo “a major makeover and expansion programme to have it equipped with a full-fledged accident and emergency department and accompanying intensive care unit, along with neurological and radiological services”. Hopefully, the St Joseph Hospital will soon be up and running too.
At present, there are a few modern private clinics offering good health care, but none seems to be fully equipped for emergencies, and few open 24 hours. Since emergencies aren’t planned, this is worrying. Even if you go to a private clinic, you often end up at the QEH, since “they have the best equipment”. But that doesn’t necessarily mean you have a better chance of staying alive, since equipment isn’t everything, nor is a new hospital building the answer.
The first hurdle to be conquered is finding an ambulance, whether public or private. It has always baffled me that there must be ambulances “on standby” for a possible emergency at public events, and when you have a real emergency, it’s often impossible to find one in a timely manner since they are “on standby” at these events.
Why can’t ambulances be in radio contact so that they can respond, if necessary, to real emergencies, then return to the possible emergencies? Similarly, there’s usually a proliferation of police at sporting and other events, but if there’s a break-in at your home or your crops are being stolen, you’re lucky if the police show up the same day.
We might be gearing up for medical tourism which usually deals with planned situations, but we need too to respond well to emergencies, both with our own people and with visitors. In fact, one visitor recently asked me, in case of a medical emergency, was she to call 211 or 511. I advised her to “call me” and I would do my best to help her though the maze which she may find confronting her.
We hear that businessmen are seeking investment opportunities. Now that it seems we will have an efficient emergency clinic, an ambulance service seems like a good opportunity to me. I’m told that some businessmen have retreated from the ambulance business because there are so many regulations now that it’s difficult to comply.
In the past, the major reason for an ambulance was to get you to hospital quickly, although of course, basic training in first aid was necessary. But nowadays, it seems the ambulance is a pre-treatment facility. Although this may be an advantage in some cases, in others it seems to delay the hospital treatment and may be a hindrance. Most treatment or tests done by paramedics should, in my opinion, be done en route.
Of course there is the reported problem of ambulances being used as taxi services for non-emergencies. This should be treated as it abroad, with heavy fines imposed on such persons.
Finally, two critical factors which seem to be overlooked in our so-called emergency treatment are: (1) immediate assessment by competent personnel and (2) experienced doctors who can make a quick judgement based on symptoms, rather than using the academic approach of  extensive testing, the results of which may not be received before the patient dies. Of course, compassion and communication with relatives wouldn’t hurt either.

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