The Royal Commission to Enhance the Operation and Management of the Royal Malaysian Police and the key performance indicators (KPI) are good moves by the government to improve the services to the public. Among the many public services that is in dire need of improvement is the Emergency Ambulance services.
On 16th May 2005, at about 10pm, I came upon a scene of a motor vehicle accident. The victim, a self fallen Chinese, male motorbike rider, in his 30’s was unconscious with head injuries. Members of the public had called the ambulance by the time I arrived. Being an Emergency Medical Technician I accessed the victim and found him still breathing but gasping for air, so I proceeded to provide the “Jaw Trust”, a method used to keep the victim airway open when spinal injury is suspected. Shortly an ambulance from the local hospital arrived. I briefed the responding medical assistant on the condition of the victim and requested for oxygen and a cervical collar, a device used to immobilize the neck to protect and prevent further injury to the spine. While the Medical Assistant went back to the ambulance to get the collar, the Hospital Assistant brought a folding stretcher which is a collapsible device suitable only to carry victims with no suspected history of spinal injury.
Since the victim was suspected to have spinal injury, I requested that we use the much appropriate scoop stretcher in which he agreed and retrieved the stretcher from the ambulance. At this point the Medical Assistant returned and said that there was no cervical collar in the ambulance. The victim was precariously scooped up only with manual cervical immobilization (which is an absolute no-no in a suspected spinal injury), transferred to the ambulance and rushed to the hospital.
I feel sad that despite the much advancement in the Medical industry in our country the Ambulance Services are still very poor. One can be easily be fooled by the impressive looks of the new, well designed ambulances we have in our hospitals but most of the time they are ill equipped and the standard of care provided by the crew remains poor. The confidences in our ambulance services have long been lost. Public resort to use their own vehicles or taxis to transport injured victims to the hospital. The awareness that this action is dangerous and does not necessarily help the victim is ignored. On arrival at the hospital, the Emergency Department staff is faced with a patient whose condition has worsened. Improving the standard of care would be imperative to strengthen the Emergency Medical Services in order to help lower mortality rates in road accidents.
Back in the late 90’s an article was published in the local daily titled “Scoop and Run” or “Stay and Play”, explaining the future development of the emergency medical services in Malaysia. Scoop and Run describes a philosophy in which the patient is transported as fast as possible to the hospital without spending much time at the scene of the accident. The stay and play on the other hand is a strategy based on providing maximum care before transportation which includes basic life support, immobilization and intravenous drip. But from my experiences for many years as a volunteer and the recent incident on the 16th May 2005, I find that there has been no improvement on the standard of care at the scene of the accident. Large amount of fund is being spent to acquire modern ambulances and equipments but they not properly maintained or even put to the necessary use, sighting the missing cervical collar and scoop stretcher as appose to folding stretcher as an example in this incident. Poor guidelines and monitoring system, I believe is cause that the ambulance services in Malaysian fail to improve and are unable provide even the basic care needed by the unfortunate victim.
I feel sad that despite the much advancement in the Medical industry in our country the Ambulance Services are still very poor. One can be easily be fooled by the impressive looks of the new, well designed ambulances we have in our hospitals but most of the time they are ill equipped and the standard of care provided by the crew remains poor. The confidences in our ambulance services have long been lost. Public resort to use their own vehicles or taxis to transport injured victims to the hospital. The awareness that this action is dangerous and does not necessarily help the victim is ignored. On arrival at the hospital, the Emergency Department staff is faced with a patient whose condition has worsened. Improving the standard of care would be imperative to strengthen the Emergency Medical Services in order to help lower mortality rates in road accidents.
Back in the late 90’s an article was published in the local daily titled “Scoop and Run” or “Stay and Play”, explaining the future development of the emergency medical services in Malaysia. Scoop and Run describes a philosophy in which the patient is transported as fast as possible to the hospital without spending much time at the scene of the accident. The stay and play on the other hand is a strategy based on providing maximum care before transportation which includes basic life support, immobilization and intravenous drip. But from my experiences for many years as a volunteer and the recent incident on the 16th May 2005, I find that there has been no improvement on the standard of care at the scene of the accident. Large amount of fund is being spent to acquire modern ambulances and equipments but they not properly maintained or even put to the necessary use, sighting the missing cervical collar and scoop stretcher as appose to folding stretcher as an example in this incident. Poor guidelines and monitoring system, I believe is cause that the ambulance services in Malaysian fail to improve and are unable provide even the basic care needed by the unfortunate victim.
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