Improving emergency response times

EDITORIAL

IRELAND would need a fleet of jet-propelled ambulances on standby if recommendations from the Health and Information Authority (HIQA) are to be achieved.

In report submitted to the Minister for Health and Children and the Health Service Executive, HIQA says patients with life-threatening conditions should be responded to by advanced paramedics, paramedics or cardiac/emergency first responders in seven minutes and 59 seconds or less, in 75% of cases.
Even the second target put forward by HIQA would seem to be unachievable unless the emergency was close to an ambulance centre. It recommended ambulances should reach patients with life-threatening conditions within 18 minutes and 59 seconds. This, according to HIQA, is in line with “response time indicators” in many countries but in countries or regions within countries, there are time gradings, depending on the population.
At the time of publication of the report last January, HIQA said its recommendations on pre-hospital emergency care should be introduced immediately by ambulance services.
HIQA says achieving the goal would “require significant changes in the organisation and deployment of ambulance services in order to ensure patients with the most serious emergencies receive the fastest on-the-scene response”. This means patients with less urgent needs would wait longer for a response.
National HSE statistics for the first seven months of the year reveal 52.74% of all ambulance call-outs were responded to in eight minutes or less for cardiac or respiratory arrest and this drops to 28.6% for other life-threatening conditions. The percentages are based on a figure of 1,511 for the first category and 40,380 for the latter. Taken together, however, this is a long way short of the overall 75% target.
We must look at the real world and recall many cases around the country where delays in the arrival of ambulances to emergencies, especially in remote areas, have caused major controversies.
The removal of 24-hour A&E services from Ennis and Nenagh hospitals in April 2009 brought greater on focus the need for a quick response times to get patients to the Mid-Western Regional Hospital in Limerick.
What parts of Clare, outside the few roads within a short distance of the ambulance base at Ennis hospital, can be reached by an advanced paramedic unit in less than eight minutes? Very few. If an ambulance is sent from Limerick, how far will it reach into Clare in eight minutes? Not very far.
Also, the 19-minute target for the arrival of ambulance leaves a huge swathe of County Clare neglected should an emergency unfold. In truth, recommendations or not, people in small villages and rural areas shouldn’t hold their collective breaths in the hope of spotting a high-speed ambulance flying by.
Clare councillors say extra staffing and equipment is a key to getting advanced paramedics to patients with life-threatening conditions. They have requested the HSE to prioritise the provision of SAT navigational technology on all ambulances and first-responder vehicles, as well as extra paramedics and vehicles. They also maintain a national postal sort code system for every dwelling is also vital if emergency services are to achieve the response time recommended by HIQA.
The difference between reality and HIQA’s recommendations was illustrated in a Clare Champion story last week. The family of the late Patricia O’Neill from Caherdavin outlined how in the early hours of September 5 last, it took almost 30 minutes to respond to a 999 call, almost four times longer than the recommended HIQA response time. Though living little more than a 10 minutes drive from Mid-Western Regional Hospital, Limerick, it was an Ennis ambulance that responded first.
Mrs O’Neill’s daughter, Emer said the HIQA guidelines should be implemented in the Mid-West by the HSE.
The emergency service response times recommended by HIQA might be out of reach but certainly there is plenty of scope for improvement.

Local Newspaper Week

NEWSPAPERS, it is said, provide the first draft of history. This is why regional newspapers, more so than even daily publications, can be relied upon as portals through which we can explore virtually all facets of social and political history.
Stretching back to the 19th century, some linked to even earlier publications, local newspapers have been very much of the people. They are firmly established as part of the fabric of Irish society and readers have developed an affinity to publications in their county or region.
Regional newspapers give voice to politicians, the judicial system and statutory authorities as well as community and sporting organisations. All of these, and indeed our advertisers, need their message to be heard.
In turn, the wider community is kept informed of what is unfolding, week after week, through extensive reportage and comment on meetings, activities and events.
The important contribution regional newspapers such as The Clare Champion have made to our country is being marked in Local Newspaper Week, which continues until Saturday.
The Clare Champion is among over 30 paid-for regional titles involved in the initiative, which is spearheaded by the Regional Newspapers and Printers’ Association of Ireland (RNPAI).
The Clare Champion, along with all other participating papers, carries a special supplement to showcase how each interacts with readers and advertisers. The supplement, specifically tailored to individual papers, also includes the key findings of a specially commissioned IPSOS/MRBI omnipoll survey on readership trends and preferences.
Clare Champion managing director, John Galvin is justifiably proud of his family legacy in the newspaper industry.
“I am very proud that the newspaper founded by my grand-uncle, Tom Galvin 108 years ago is still going strong as one of the leading regional titles in the country. Also it is very important to me that despite the trend in recent years of forming group titles, The Clare Champion is one of the few regional newspapers still in family ownership,” he said.
Having risen from the ashes of The Clare Man, closed down following a libel action, The Clare Champion, first published in March 1903, has afforded the people of County Clare, South Galway and part of North Tipperary a unique opportunity to have so many aspects of their everyday lives documented for posterity. With the support of its loyal readers and advertisers, it will continue to do so long into the future.