Anaesthetists’ report seeks ambulance service upgrade

THE provision of a seven-day, 24-hour ambulance service to allow critically ill patients to be transferred between hospitals for treatment is called for in a new report prepared by the Association of Anaesthetists in Ireland.

An estimated 1,000 such critical transfers take place in this country every year.

Medical specialists say many hospitals do not have enough resources to provide the modern standard of care required for these patients prior to transfer. They also say the service run by Dublin hospitals is limited to weekdays and only to certain patients.

Because of manpower problems the report says hospitals transferring patients often lose their only in-house anaesthetic doctor for long periods as this doctor must be present in the ambulance.

Mr Eamon Tierney, committee chairman, said the service should be provided for critically-ill patients suffering from major trauma and those with head injuries who needed to be transferred on a life support machine.

He said they had a meeting with Tánaiste and

Health Minister Mary Harney last year to provide such a service for children and a further meeting to deal with extending such a scheme to adults is planned.

Pending the establishment of full retrieval teams for all patients, extra arrangements for the continuation of the anaesthetic service need to be put in place in the event of a transfer, he said.

Mr Tierney said care of the anaesthetist-accompanied patients during transfer is the responsibility of the referring anaesthetic team and there should be excellent communication between the referring consultant anaesthetist and the transfer team en route.

The report also says a garda escort should be available if requested to facilitate travel through traffic black spots or other delays. However, it adds there is little to be gained by speeding between hospitals and transfers should take place calmly.

Hospitals around the country have large variations in their ability to deal with acute cases, and while many have a 24-hour accident and emergency service many do not have the staff or facilities to cater for more complex emergencies.

The report says it is difficult to justify having an A&E department open for emergencies, such as a major head injury or a brain haemorrhage, without a CT scanner being immediately available and the ability to transfer the CT images to a specialist hospital for advice.