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Putting Things Right - Frequently Asked Questions

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It is sometimes difficult to know whether or not you need an ambulance.

You should dial 999 immediately for emergencies such as:

  • Unconsciousness or not breathing
  • Penetrating injury to the neck, chest, abdomen or thigh
  • Severe allergic reaction
  • Uncontrolled bleeding
  • Asthma attack and is unresponsive to medication
  • Severe chest pain (heart attack)
  • Fitting (if this is unusual for the patient)
  • An overdose
  • Has been submerged in water for more than one minute
  • Has fallen more than 10 feet
  • Traumatic back/spinal/neck pain

Find out more information about when you should call 999

When you call 999, a British Telecom operator will ask you which emergency service you need. You should say “ambulance”.

You will initially be asked if the patient is conscious and breathing, once this information is obtained you will be asked for the incident address (so we know where to send an emergency vehicle) and telephone number (so the call handler can call you back if the line clears), these questions do not delay help being arranged.

You will then be asked for the details of what has happened and some questions to determine the level of care required. The reason for your call will determine which questions we ask and the priority of response assigned for the patient’s condition, so it is important to answer them as clearly as possible. The call priorities that can be assigned are:

  • Red - Immediately life-threatening.
  • Amber 1 - Serious and life-threatening.
  • Amber 2 - Serious but not immediately life-threatening.
  • Green - Not immediately serious or life-threatening.

Calls received by the Welsh Ambulance Services NHS Trust are processed via the computerised Medical Priority Dispatch System (MPDS). Our call handlers are not medically trained and receive accredited training in the use of MPDS. They are required to ask scripted questions generated by MPDS. 

Although, some of these questions may seem irrelevant at the time, the answers you provide will establish the type of help that is required for you or the person you are calling for. Our call handlers ask key questions to ensure emergency medical help is sent to life-threatening incidents as quickly as possible.

Asking these questions will not delay any help being arranged - it is important that the assessment is completed to ensure the patient receives the appropriate response. 

We may ask you to avoid calling us back for an estimated time of arrival for an ambulance. This helps to ensure our call handlers are available to answer emergency calls. Every 999 call must be processed through MPDS, this ensures the most up-to-date information regarding the patient’s condition is captured and that the correct priority is in place at the time of that call.

If a GP or health care professional arranges for an ambulance to take you into hospital, then the length of time you will wait will vary depending on their request as this will be based on your condition.

There may be times where there will be a delay in an ambulance reaching you. We will always do our absolute best to arrive as quickly as possible however, there may be times when delays are beyond our control.

If we are aware of a delay, we will provide the GP or health care professional with an approximate timeframe for the emergency ambulance to arrive with you.

If we are experiencing high levels of demand, then it can take longer for the emergency ambulance to arrive.

When you call 999, our aim is to provide you with care that meets your clinical need and admission to hospital is not always required. There are alternative pathways of care in our communities that we can access for you. This may be a referral to your GP, other health care professional (HCP), referral to a minor injuries unit, a walk-in centre or mental health facility.

Alternatively, the provider of care may be brought to the patient through the use of specialist nursing teams like community matrons, district nurses, out of hours’ services or other specialist providers.

We receive many enquiries relating to lost personal items which are later found. Please thoroughly check your pockets, bags and other items in the first instance before contacting us about lost items. 

If you travel in an ambulance, any personal items will transfer with you to the staff at the receiving unit. We would recommend checking with the hospital department you attended whether they have found your items.

Once a patient has been transferred from the ambulance, the crew will clean the ambulance and equipment. If personal items are found, the crew will usually return to the patient’s location with the items.

When you call 999, you will speak to a trained Emergency Medical Dispatcher. They will ask a number of questions about your condition in a process called triage. The electronic triage system that the Emergency Medical Dispatchers use captures the answers you provide to the questions, and the system will make the decision regarding what help you require from the ambulance service. This response will meet your clinical need.

Depending on your clinical need, you may need an ambulance or you may be called back by a highly skilled health care professional from our service. They may recommend you visit 

Sometimes this will be an ambulance, but sometimes you may be called back by a highly skilled Health Care Professional from our service. They may recommend you attend a minor injuries unit, a walk-in centre, a GP or another NHS provider.

Periods of high demand

If your condition is less urgent and does not require an emergency response, you may be asked if you can make your own way to hospital. If you can’t and you do require an ambulance, we can still get to you, but you may be waiting much longer than expected

Emergency ambulances are prioritised to patients depending on the severity of their condition. Patients with an immediate or serious threat to life will always be responded to first.

There are times when our emergency ambulances are held for long periods outside hospital emergency departments, waiting to transfer patient care to hospital staff. This reduces the number of emergency ambulances we have available to send to waiting 999 calls.

Additionally, there are days when 999 call volume can be high and as a result of there being fewer ambulances available (for the reasons provided above), patients who do not have an immediately life-threatening condition can sometimes, regrettably, experience extended waits

If there are delays in sending emergency ambulances, 999 callers may be provided with an approximate estimated time of arrival (ETA) for an ambulance. The ETA will be based on the average response time to that priority of call, in that regional area, at that time. However, if demand increases, i.e. the number of life-threatening 999 calls increases, it can take longer.

ETAs allow callers to make an informed choice whether to wait for the ambulance, or if appropriate, seek alternative care pathways or make their own way to the nearest hospital emergency department.

Not all ambulances are staffed all of the time. Sometimes this may be down to staffing levels, but the majority of the time, the vehicles which are kept on station are for resilience. This is so that should there be an issue with an ambulance which is active, such as a breakdown or if it requires scheduled maintenance, there is another ambulance for our crews to use.

We also have Make Ready Depots and sometimes, ambulances require a deep clean following an incident, or may require repairs and maintenance.

The ambulance environment is designed to take you safely to hospital. The ambulance crew are unable to carry excessive amounts of luggage due to the space confines and the inability to safely secure the item during the journey, this is particularly important if they are required to drive at speed under emergency conditions.

We understand that it might be upsetting to travel without a piece of equipment that you rely on. However, if you require a small mobility aid that can be stored safely during the journey, the ambulance crew will try and accommodate this. However, the crew’s priority is to get you to definite care as quickly and safely as possible.

During the COVID-19 pandemic, we had to limit the instances of people escorting their loved ones to hospital. We will normally only transfer an escort for reasons such as the patient having a sensory loss or severe impairment, language barriers, or has diminished capacity.

The privacy and clinical need of our patients is of paramount importance to us. There is limited space available in our vehicles to enable additional passengers to travel safely. It is for this reason that during normal times, escorts for patients are kept to a minimum, usually only one person, who is ordinarily a relative, carer or friend. However, this will depend on the circumstances of the event. The safety of the patient and ambulance crew will be considered prior to agreeing any additional escort.

The decision on which hospital you go to is based on multiple factors, including (but not limited to):

  • Your current condition,
  • Your current location 
  • Pressures faced by the local hospitals

There are many specialist hospitals which deal with very specific conditions, so if you meet the criteria for these hospitals, this will be confirmed with you and any family members present by the ambulance crew. This ensures you receive the best and most appropriate possible care for your condition.

If your condition does not require specialist care, but you are in need of emergency treatment, you will always be taken to your nearest emergency department. If your local hospital is experiencing an increase in demand and you need hospital treatment for a condition which is not immediately life threatening, you may be taken to an alternative hospital to ensure you are seen as quickly as possible.

Our staff will always try to avoid obstructing other road users whether this is when parking a vehicle or during transit.

If you discover that your vehicle has been blocked, this could be because the condition of the patient being attended requires immediate intervention. As soon as the patient’s condition allows, the ambulance crew will move the vehicle. On these occasions we understand how frustrating this may be, but we ask you to please be patient and the vehicle will be moved as soon as possible.

In any emergency situation the patient will always come first. If you have a guide or assistance dog a decision on whether they can travel with you will be made on a case by case scenario. Please be assured that ambulance staff will do all they can to ensure the safety of your assistance dog while they provide you with treatment.

Ambulances are allowed to park on white or yellow lines providing they are engaged on official duties, e.g. it was necessary to park at that point to carry out essential duties or to be as close as possible to the patient they are treating.

Our ambulance crews are trained to ensure that they park vehicles in such a way that will not cause a nuisance to other road users, but also ensure that there is no delay in attending the patient.

Frontline ambulances are very specialist and complex vehicles. They carry essential items of clinical and diagnostic equipment that can provide life-saving treatment to patients and also transmit ‘real time’ information to the hospitals regarding a patient’s condition. Vehicles also require advanced tracking and mobile data technologies to ensure ambulances can be on scene within minutes of a 999 call. All this equipment requires significant power from the batteries on board. Failure to keep these batteries fully charged can result in equipment not working correctly or at worst shutting down which may pose a significant threat to lives. In order to keep the battery charged the vehicle must be left running during some periods of rest.

Ambulance engines may also be left running to ensure the patient compartment, medications and equipment remain at a regulated temperature. In many cases patients are on board requiring urgent medical attention. During this time, regulated power supply to all medical and diagnostic equipment is critical. Turning the engine off may result in a break to the real-time diagnostic information feed into the hospital or vital patient life support systems failing.

Vehicles can often be seen idling on the roadside or at a scene for the reasons identified above. If a power supply is not available, regular charging is required by keeping the engine running. Idling also allows for a rapid departure from a scene.

In cold weather, leaving an ambulance running allows the diesel engine to operate more efficiently. When vehicles are on station, they do not need to run their engines as they are plugged into charging units that ensure the vehicle maintains a state of readiness.

The Welsh Ambulance Service is going greener and has introduced more eco-friendly vehicles into our fleet, replacing some of our older diesel-powered vehicles. We are committed to continuously reducing our carbon footprint and we regularly review systems and practices to ensure this happens.

Our ambulance crews are trained to drive the vehicles under emergency conditions. They drive with care and attention however, they need your help to move through the traffic as quickly and safely as possible.

Here are some tips that will help you stay calm and safe and help our emergency vehicles get to their destination without delay.

  • Look and listen – check your mirrors regularly and make sure your radio is not too loud.
  • Consider the route and size of the vehicle – you may need to move over even if the emergency vehicle is traveling in the opposite direction.
  • Signal your intentions using your indicators – this will help the emergency vehicle and other road users know what action you are taking.
  • Pull in or move over safely – you may not need to stop completely.
  • Don’t stop opposite any obstructions – this will make the road narrower.
  • Avoid mounting kerbs/pavements where possible – be aware of pedestrians, cyclists and other motorists.
  • Signal when you are pulling away – motorists behind you may still be moving, be careful when re-joining the road.
  • Stay alert – more emergency vehicles may be on the way.

Ambulance staff can activate the vehicle sirens at any time of day or night. They will only use the sirens when it is appropriate and necessary to make other road users and those on foot aware of the presence of an ambulance.

As an emergency ambulance approaches a residential area, with no traffic congestion, they may turn off the lights and siren. 

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