State EMS Crews 'Dumping' Patients
by Pam Fourie
In email correspondence in Tabletalk's possession, Metro Emergency Services (EMS) managers admit crews are dumping patients needing advanced tertiary level care at primary level health facilities like clinics and day hospitals which are woefully ill equipped to treat them.
Cases downplayed to make mission times 'look good'
One of the managers said the crews were doing this because they wanted their mission times to look good. This alarming disclosure by high ranking officials follows the death of Charlotte Orlyn 39, from Richwood Informal Settlement. She was taken by ambulance to Elsies River Community Health Centre on Sunday July 4. She was given oxygen and discharged on Tuesday July 6. On Tuesday July 6 she was taken to Goodwood day hospital where she died. ("Women sent home to die," Tabletalk July 21).
In the correspondence which follows an enquiry by Dr Cleeve Robertson, the Director of Metro EMS, from community worker Toni Tresandern about Ms Orlyn's triage score, they admitted that Ms Orlyn's triage score was fudged and that she needed urgent hospital care. The wording of the correspondence suggests that under triaging is a frequent occurrence and one the ambulance service has been aware of for some time.
Ambulance Crews use the South African Triage Score (SATS) to gauge how ill a patient is based on blood pressure, heart and respiratory rates, temperature and level of consciousness.
The score is categorised as green, yellow, orange and red. Red is critical. It is policy that patients in the top 3 categories are taken to a tertiary hospital and not a clinic.
Metro EMS Quality Improvement Manager Michael Lee reviewed Ms Orlyn's records. In an email to Dr Robertson and other department officials, he said her triage score on July 4 was recorded as green (delayed priority) when in fact it was orange (very urgent).
"It is quite evident that the patient should have been conveyed to a secondary/tertiary facility." he wrote.
Stating that under triaging patients was 'a risk', Dr Robertson said despite training, SATS was not being implemented.
In response to the email, Metro EMS's deputy director of operations Pumzile Papu said the ambulance crews were under triaging patients "so that they do not have to go to secondary hospitals."
"There is no proper handover at hospitals or the CHC, doctors and nurses are accepting patients without checking whether those patients were supposed to to be seen there or not," he said.
When Ms Tresadern asked why crews did not take patients to tertiary hospitals, the reply from Mr Papu was, "They want to drive short distances and for their mission time to look good."
