Inside SCDF’s emergency ambulance services: When minutes can mean life or death

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They respond to a variety of 995 calls and are always in a race against time to save lives. But non-emergencies can take precious resources away from critical patients who rely on SCDF responders, depriving them of an earlier ambulance response.

SINGAPORE: The 995 call came in on a Monday morning. An epileptic patient at a residential care home had gone into convulsions.

In the ambulance, she hooked the patient up to a pulse oximeter to monitor his blood oxygen level – then had to dispense more diazepam as he suffered another epileptic seizure. Without such interventions, continuous fits may lead to permanent brain damage or death. But some calls — 46 a day, on average — turn out to be non-emergencies or false alarms. Last year, there were a total of 17,009 such calls.“Consider a scenario where an individual who experiences wrist pain calls 995. This takes vital resources away from life-threatening emergencies such as a cardiac arrest,” said Colonel Hong Dehan, SCDF’s chief medical officer.The nerve centre of this emergency response system sits in an underground facility in the heart of Ubi, at SCDF headquarters.

On another line, a frantic caller sobbed: “There’s an uncle, my neighbour, he’s not moving. I don’t know what to do.” The call-taker calmed her down and asked for details. In such cases, while the ambulance is en route, the call-taker guides the caller through the steps of administering cardiopulmonary resuscitation . It is critical to keep blood flowing to the brain.“Every minute that nothing’s done, the chance of survival actually drops by 10 per cent,” said Warrant Officer 2 Kenneth Foong, an advanced paramedic from Marina Bay Fire Station.

The day shift typically sees more medical emergency cases, ranging from seizures to chest pains to road accidents. The weekends, including Fridays and eves of public holidays, bring more cases at public entertainment outlets — often involving intoxicated revellers or fights.

Zuhaili examined the man and assessed that the matter was not life-threatening. But as the patient had complained of chest pain, he was conveyed to hospital, where he was triaged as a P2 or moderate emergency.

“When our paramedics arrive at the scene, and they assess the patient and deem that it’s a non-emergency, they won’t convey to the nearest hospital,” said Quah.The list includes: Traffic and worksite accidents, uncontrollable bleeding, broken bones, sudden severe chest pain or breathlessness, drug overdose or poisoning, choking with difficulty in breathing, sudden abdominal pain that doesn’t subside, loss of consciousness, and head injuries with bleeding, drowsiness or vomiting.

 

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