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Ambulances fail on heart attacks

Date

Richard Baker and Nick McKenzie

'Mobile Intensive Care Ambulance crews have been diverted to handle less serious incidents.'

'Mobile Intensive Care Ambulance crews have been diverted to handle less serious incidents.' Photo: Angela Wylie

Senior paramedics claim patients have suffered cardiac arrests because Ambulance Victoria's computer dispatch system is struggling to cope with increased demand caused by the state's growing and ageing population.

Internal Ambulance Victoria records seen by The Age reveal some patients have recently gone into cardiac arrest because the specialist Mobile Intensive Care Ambulance teams equipped to treat heart attack cases were not dispatched properly or diverted to less urgent jobs.

Ambulance Victoria operates a ''medically approved dispatch grid'' designed to match ambulance crews to patient need based on the symptoms described by the person calling for assistance.

Under the system, MICA crews equipped with electrocardiogram machines transmit patient data directly to cardiologists at a nearby hospital. However, senior paramedics have told The Age this system has been overridden for extended periods - several days in extreme cases - in recent months.

When the dispatch system is overridden, controllers direct the nearest ambulance to attend an incident without first making sure it is the most appropriate crew to handle the situation.

''This means MICA crews that have been dispatched to attend a cardiac arrest case have been diverted en route to handle a less serious incident simply because they are the closest available car,'' said a senior paramedic, who asked not to be identified.

''All of the work to design this world-leading system was done by medical people and the Ambulance Medical Board. But it can be turned off in a second by a single person in the control room.''

Several reports detailing problems with the dispatch system have been submitted to the Ambulance Victoria quality review team over the past seven months.

But senior paramedics say they have yet to receive any response to their reports from Ambulance Victoria.

Paramedics have also lodged reports with the Department of Health about having to wait for as long as six hours at hospitals before patients were admitted. The delays have made it impossible for crews to attend other incidents and had added to pressure on the dispatch system.

Ambulance Victoria general manager of regional services, Tony Walker, said no adverse patient outcomes had been identified by clinical reviews over the past 12 months.

But he acknowledged the medically designed dispatch grid was being overridden in some cases.

''When there is high workload or demand we will send the closest ambulance … so that people in the community who need paramedic expertise get it as quickly as possible,'' Mr Walker said.

He said non-MICA ambulance crews were trained and equipped to treat cardiac arrest patients.

Ambulance Employees Association Victorian secretary Steve McGhie said the dispatch system needed an overhaul and called for more staff with medical experience to monitor the control room to ensure patients receive the appropriate ambulance response.

Got a tip?

Investigations@theage.com.au

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