mnementh wrote: ↑Mon Nov 28, 2022 9:27 pm
More often than not, a first-responder is
not proper medical personnel; they are just emergency rescue with first eyes on the scene, and they relay what they see to dispatch or their CO who makes the decision whether the scene is
likely desperate enough to need air evac. We are all trained to observe and report as accurately as possible; but that ultimate decision to launch has to be made by those further up the chain.
You're being a bit parochial there as that's nothing like the situation here. All UK ambulance crews are "proper medical personnel".
Someone calls 999. The emergency operator asks "Which service do you require, fire police or ambulance?" For completeness you can also ask the emergency operator for the coastguard or mountain rescue if you're in a bit of the country where that makes sense but the operator doesn't normally cue you for them. You say which services you require, and if you've enough nouse what order you need connecting to them in. The operator will then connect you in turn to each service, take the call back at the end, and pass you onto the next.
When talking to the ambulance service they will conduct an initial triage and if it sounds like it merits it dispatch an ambulance with paramedics onboard and/or a paramedic in a car, or on a motorcycle or bicycle (don't laugh, it's the fastest response in a dense city centre). Target response time will depend on the telephone triage, which follows a surprisingly rigid yes/no protocol. There are certain questions which if you give the right response result in an immediate Cat I blue light callout with a target time of 7 minutes. In very exceptional circumstances, if the caller is an actual medic they might scramble an air ambulance, but the normal protocol is to wait for the paramedics to arrive and triage the scene.
Basic UK paramedics are all well trained and,
national health service remember, consistently well trained. The minimum standard is ALS trained, where ALS is "Advanced Life Saving" which means full resuscitation trained including the full panoply of intravenous drugs, running exactly the same protocols as you would in "resus" in the emergency room. They carry those drugs and a range of other drugs that are used in urgent care with them, some of which they need a doctor's approval over the radio to administer, many they are competent to prescribe themselves. There are advanced paramedics with more training who can carry out a range of field surgery, these are the boys and girls who are likely to be single crewed in/on a car/motorbike/bicycle.
The entry route to paramedic in the UK used to be more apprentice like, but currently new paramedics will either come onto the job with a degree in Paramedical Science, or will join as a student paramedic, get initial training and then work with a fully qualified paramedic while studying for a degree on day release/evenings.
All of the grades of paramedic have the same protocol to follow to triage a scene and it's at this point that if they deem it necessary they will talk to the nearest hospital with a specialist trauma team who will get an air ambulance scrambled (which will have a trauma medic onboard) and get a full trauma team on stand by at the hospital. There are three reasons a chopper may get scrambled and then stood down: (1) the paramedics stabilised the patient quickly and sufficiently to move them, and the nearest treatment centre is acceptably close, (2) a trauma medic is on scene and assesses that they won't be needed, (3) the patient died.
Whatever order you spoke to them if you ask for all three emergency services you will almost always get the Fire Brigade, Ambulance Service and Police arrive in that order. I've made the callout often enough to make that prediction with some confidence. At every shout I've instigated the London Fire Brigade have been there within 5 minutes. Situations that justify a Cat I response from the Ambulance Service and they will be there within 10 minutes.
You're lucky if you see a copper within 15-20 minutes (if they bother to turn up at all) and that includes, from experience, a semi-major crash on the A13/A4020 junction (busy, busy, roundabout on the main route east from London), a "suspects on premises" burglary I watched happening (they did at least turn up mob handed when they arrived, including a dog and handler), a call to a very violent disturbance at the house opposite mine that I later discovered they had "red flagged" because it was the residence of a victim of repeated abuse by an ex, a suspected arson at a school, and a mini riot.
The only emergency services in the UK who aren't fully professional are the police and mountain rescue. The police have "special constables" aka "Hobby Bobbies" who are volunteers. Mountain rescue are all volunteers, even the dogs.
