Ambulance is not an easy decision

On the other hand, almost 50 percent thought a woman in labor deserved such a ride to the hospital — just one of many scenarios found to be illustrative of inappropriate use of ambulances, Helen Kirkby, BS, and Dr. Lesley Roberts, of the University of Birmingham in England, reported online in the Emergency Medicine Journal.

“Most people would call for an ambulance appropriately when a real emergency occurred, but there are high levels of inappropriate calls when emergencies are not present,” they wrote.

Those also include a toddler bumping its head, a child with Lego blocks stuffed up the nose, or a drunk friend who is conscious but ill.

 

Abuse of ambulance services is high, the researchers said, with previous work suggesting that between 16 percent and 52 percent of calls to request one are inappropriate.

So Roberts and Kirkby conducted an online survey listing 12 common scenarios that may require medical attention, and asked participants to identify when they would request an ambulance.

Seven of those situations did not require an ambulance, while five did. Among the 150 respondents who completed the questionnaire, 66 percent were women and 96 percent were white.

Because the researchers sent it to family, friends, and colleagues, 25 percent of the survey population had some medical training, and 45 percent had some first aid training.

Almost all of the respondents correctly identified the need for an ambulance in three of the five scenarios — a patient having a heart attack, a drug overdose, and a motorcyclist thrown more than two meters from his bike.

However, far fewer identified the need for an ambulance for a child with symptoms of meningitis (53 percent said they wouldn’t call) or in a suspected stroke (25 percent said they wouldn’t call if an elderly patient started slurring their words without having consumed alcohol).

“This [stroke] statistic is concerning, given the current government FAST [face, arm, speech, time to call 999 (the U.K. ambulance hotline)] campaign to raise awareness of the signs of stroke,” they wrote.

When it came to conditions that didn’t require an ambulance:

  • 48 percent incorrectly thought that a woman in labor should ride to the hospital in the emergency vehicle
  • 16 percent wanted to call an ambulance for a toddler who bumped his or her head hard
  • 8 percent would call for a 3-year-old with a Lego block up the nose
  • 7 percent would call for a man with chronic back pain who has run out of painkillers

In subgroup analyses, the researchers found that those with first aid training were less likely to make an inappropriate decision, but in further regression analyses, no characteristics were predictive of calling an ambulance inappropriately, they said.

However, when they analyzed the data by individual scenarios, they found that the ambulance was more likely to be called inappropriately if the caller was female or single).