How
It All Works 
A
999 call is made:-
If someone needs emergency medical assistance following a serious
accident, illness or injury a 999 call should be made straight
away.
The caller will firstly be transfered to the telephone company operator,
who will say to the caller "Emergency, which service to
do you require?".
If the caller asks for the "ambulance service" the operator
will then ask the caller for the telephone number they are calling
from (in case the call becomes disconnected) and transfers the call
to the ambulance control centre.
If the 999 call is made within the East Midlands Ambulance Service
area, which is the entire counties of Nottinghamshire, Derbyshire,
Leicestershire and Rutland, Lincolnshire or Northamptonshire, the
call will then be routed to the one of state of the art EMAS control
centres in Nottingham or Lincoln.
The call is then prioritised and help
is sent:-
 Help
starts as soon as the 999 call is answered by the Ambulance control
room. The first thing asked is the address where the ambulance is
required. As soon as this information is given, a "Control
Dispatch Officer" will immediately start an ambulance en-route.
At this point the Dispatcher also checks to see if there is a Community
First Responder on duty within the area and if there is they will
alert them by sending a pager message via the computer system directly
to the First Responder within seconds of the call being made.
The
Control Dispatch Officer has various resources available, including
Accident and Emergency Ambulances, FRV's which single crewed Fast
Response Vehicles, Community First Responders (CFR's) such as the
Misterton First Responders team or even the Lincolnshire and Nottinghamshire
Air Ambulance.
Control can manage all A&E vehicles through a satellite tracking
system. This means that staff can identify the nearest vehicle by
quite simply looking on a computerised map – which shows where
help is needed and where the nearest vehicles is. First Responders
show on this system as a static resource when on duty, so the dispatcher
can quickly see how near to the incident the First Repsonder is
and how long it should take them to get there, along with the ambulance.
While this is going on in the back ground, the "Ambulance Call
Taker" continues to obtain other important information such
as the nature of the illness/accident, the patient's condition,
age etc. They'll then begin to talk the caller through ways to help
the patient, such as how to curb blood loss, look after an unconscious
patient or perform CPR.
The Government target for UK ambulance services is to reach 75%
of Category A (immediatley life threatening) calls in 8 minutes
and 95% of Category B (urgent but not thought to be immediately
life threatening) calls in 19 minutes.
The pager alerts and the First Responder
goes into action:-
 If
the control centre need a First Responder to attend a call they
will alert them usually via a pager message and a direct phone call
to a dedicated mobile phone held by the on duty responder. The CFR
on duty will also have the emergency medical equipment in their
car boot and a reflective Ambulance First Responder jacket which
has to be worn while on scene. As soon as the on duty First Responder
receives a call out they will drop what they are doing and proceed
to the scene, usually in their own car. If driving is involved,
it will be under the Highway Code and Community First Responders
are expected to comply with the law while driving to incidents -
at all times and do not use blue lights or sirens.
The
call from control tells the First Responder the address of the emergency
and also gives brief details as to the condition of the patient.
First Responders either attend the incident in pairs or alone. They
carry a mobile phone provide by EMAS to allow them to call directly
to the control room to report back once they have arrived on scene
and to relay the condition of the patient, which control can then
pass onto the Ambulance or Fast Response Vehicle who will also be
mobile and travelling to the scene using blue lights and sirens.
Responders can speak to control at any time to ask for directions
to the incident or to obtain medical help or advice if required.
 On
arrival, the First Responder will have all the training and equipment
necessary to manage the patient in those first few critical minutes
before the ambulance arrives. In many cases, the First Responder
may not actually be required to do anything other than asssess and
reassure the patient and make sure that the ambulance is able to
find the location. However, we know that Community First Responders
can and do save lifes, for example, as a result of a simple airway
opening manoeuvre, defibrillation, oxygen therapy or treating choking.
The First Responders will always be backed up by an Emergency Ambulance
as soon as possible.
What happens after the incident?
Support for the volunteers and analysis of the impact of the scheme
in the community is an extremely important aspect. There may be
times when despite all efforts, a patient dies or has already died
before help arrives. This can be distressing for everyone involved
and the Trust has experience in helping people to cope with these
circumstances. Dealing with emergency situations can be stressful,
especially if the patient is known to the Community First Responder.
There will always be someone who can talk through the incidents
and the emotions evoked.
Community
First Responders will record information about the interventions
they performed and their efforts. All of this infomation will be
analysed by the Trust to ensure that the best possible service is
provided to the communities.
What
if a mistake is made?
Community
First Responder Schemes ensure that local people are trained in
simple and safe techniques that can be used to save life. These
techniques are rarely associated with causing harm and in true life
and death situations, there is often little harm that can be done
compared to doing nothing at all. All Community First Responders
are trained to a high standard and will be expected to operate within
a code of practice. Community First Responders will be indemnified
against accidental injury and third party liabilities by East Midlands
Ambulance Service NHS Trust. As agents of the ambulance service,
they are insured against any medical errors arising, providing protocols
are followed.
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