How
It All Works 
A
999 call is made:-
When a 999 call is made, the caller will firstly be transfered to the telephone company operator, who will say to the caller "Emergency
which service to do you require?".
If the caller asks for the
ambulance service the operator will then ask the caller for the
telephone number they are calling from (in case the call becomes
disconnected) and transfers the call to the ambulance control centre.
If the 999 call is made within the East Midlands Ambulance Service
area, which is the entire counties of Nottinghamshire, Derbyshire,
Leicestershire and Rutland, Lincolnshire or Northamptonshire, the call will then be routed to the
one of state of the art EMAS control centres in Nottingham or Lincoln.
The call is then prioritised and help
is sent:-
 Help
starts as soon as the 999 call is answered by the Ambulance control
room. The first thing asked is the address where the ambulance is
required. As soon as this information is given, a "Control
Dispatcher" will immediately start an ambulance en-route. At
this point the Dispatcher also checks to see if there is a Community
First Responder on duty within the area and if there is they will
alert them by sending a pager message via the computer system directly
to the First Responder within seconds of the call being made.
The dispatcher has various resources available, including Accident
and Emergency Ambulances, FRV's (single crewed Paramedic Fast Response
Vehicles - see left), Community First Responders (CFR's) such as
the Misterton First Responders team or even the Lincolnshire
and Nottinghamshire Air Ambulance.
Control can manage all A&E vehicles through a satellite
tracking system. This means that staff can identify the nearest
vehicle by quite simply looking on a computerised map – which
shows where help is needed and where the nearest vehicles is. First
Responders show on this system as a static resource when on duty,
so the dispatcher can quickly see how near to the incident the First
Repsonder is and how long it should take them to get there, along
with the ambulance.
While this is going on in the back ground, the "Call Taker"
continues to obtain other important information such as the nature
of the illness/accident, the patient's condition, age etc. They'll
then begin to talk the caller through ways to help the patient,
such as how to curb blood loss, look after an unconscious patient
or perform CPR.
The Government target for UK ambulance services is to reach 75%
of Category A (immediatley life threatening) calls in 8 minutes and 95% of Category B (urgent but not thought to be immediately life threatening) calls in
19 minutes.
The pager alerts and the First Responder
goes into action:-
If the control centre need a First Responder to attend a call they
will alert them usually via a pager message or a direct phone call. The Misterton First Responders
often have two First Responders on call and both
will carry an Ambulance Service pager with them, along with the
emergency medical equipment in their car boot and a reflective Ambulance
First Responder jacket which has to be worn while on scene. As soon
as the duty First Responders receive a call out they will
drop what they are doing and proceed to the scene, usually in their
own cars. If
driving is involved, it will be under the Highway Code and Community
First Responders are expected to comply with the law while driving
to incidents - at all times.
The call from control tells the First Responder, where the incident
is (the address) and also gives brief details as to the condition
of the patient. First Responders either attend the incident in pairs
or sometimes alone. They carry a mobile phone provide by EMAS to
allow them to call directly to the control room to report back once
they have arrived on scene and to relay the condition of the patient,
which control can then pass onto the Ambulance or Fast Response
Vehicle who will also be mobile and travelling to the scene using
blue lights and sirens. Responders can speak to control at any time
to ask for directions to the incident or to obtain medical help
or advice if required.
 On
arrival, the First Responder will have all the training and equipment
necessary to manage the patient in those first few critical minutes
before the ambulance arrives. In many cases, the First Responder
may not actually be required to do anything other than reassure
the patient and make sure that the ambulance is able to find the
location. However, we know that the First Responder could save a
life, for example, as a result of a simple airway open manoeuvre,
defibrillation or treating choking. The First Responders will always
be backed up by an FRV or Emergency Ambulance as soon as possible.
What happens after the incident?
Support for the volunteers and analysis of the impact of the scheme
in the community is an extremely important aspect. There may be
times when despite all efforts, a patient dies or has already died
before help arrives. This can be distressing for everyone involved
and the Trust has experience in helping people to cope with these
circumstances. Dealing with emergency situations can be stressful,
especially if the patient is known to the Community First Responder.
There will always be someone who can talk through the incidents
and the emotions evoked.
Community
First Responders will record information about the interventions
they performed and their efforts. All of this infomation will be
analysed by the Trust to ensure that the best possible service is
provided to the communities.
What
if a mistake is made?
Community
First Responder Schemes ensure that local people are trained in
simple and safe techniques that can be used to save life. These
techniques are rarely associated with causing harm and in true life
and death situations, there is often little harm that can be done
compared to doing nothing at all. All Community First Responders
are trained to a high standard and will be expected to operate within
a code of practice. Community First Responders will be indemnified
against accidental injury and third party liabilities by East Midlands
Ambulance Service NHS Trust. As agents of the ambulance service,
they are insured against any medical errors arising, providing protocols
are followed.
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