Oli: Out of hours part 2

As my night with Out of Hours (OOH) continued we received two more calls. Both of these patients were at the request of the ‘admissions avoidance scheme’ GP in the 999 control room, a GP which ambulance crews can contact in order to discuss alternative options to A&E for their patients. The first of these patients presented with shortness of breath and an elevated respiratory rate, but with no pain or abnormalities in her observations. We entered the patient’s room and were passed the paperwork, which the ambulance crew had completed. This document did not provide us any information about what the crews concerns were or what they had assessed- just that the patient was not time critical, that they had taken one set of observations, and that they had contacted the ‘admissions avoidance’ GP prior to leaving the patient at home.

When we had fully assessed the patient again, we were unable to find any abnormalities and the patient’s respiratory rate fell to a normal range when she had relaxed. The patient was left at home with the diagnosis of having had an anxiety attack and was given ‘worsening’ advice to herself and her son in law.

The final patient we saw had been referred to us with a possible urinary tract infection (UTI). The ECP was able to perform a urine dip test which confirmed the patient indeed had a UTI. He was then able to give her a short course of antibiotics and referred her on to her own GP for a follow up appointment.

Overall this observation shift was highly beneficial for me. It allowed me to see how OOH referrals can reduce pressures on A&E. How they continue the care journey of patients referred to them from ambulance crews, and how important in depth paperwork is. I was also treated to the novelty of a bed (well- examination couch) and 4 hours sleep, something you never get the time to do on an ambulance shift!



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