Aims To explore the reasons for requesting an emergency ambulance transport to our paediatric emergency department (20,000 attendances p.a.) during office hours from the perspective of the caller.
Methods Use of a questionnaire exploring the reasons for calling an emergency ambulance, applied to children aged less than 16 years brought in by ambulance on 5 consecutive weekdays between the hours of 08.00 to 19.00 and comparison to the clinical outcome. The documentation provided by the ambulance crew was examined for the priority given to the call.
Results 29 patients presented by ambulance during this time period. Data could be obtained for 27. There were 3 main categories of callers: parents (38%), schools (27%) and General Practitioners (19%) accounting for 84% of callers. 50% of all patients were discharged home from the emergency department, the other half admitted either for surgery or to an in-patient ward (short-stay in 8%). All calls from GPs were given the highest call priority by the ambulance service, 80% patients in this group were admitted. A different picture emerges for calls made by parents and schools respectively: parents’ calls were given high priority in about 50% of cases and 40% of transported children were admitted as inpatients. The reason for parents calling an ambulance was their belief that medical intervention was required. However, only in 40% of cases this was necessary (oxygen, bronchodilators and antipyretics). In contrast, 999 calls made from schools were given second and third priority in all cases. Only 28% of these patients were admitted from ED.
Conclusion The appropriateness of 999 calls during daytime hours varies widely amongst groups of callers. Whilst calls from GP surgeries often result in admission, parents seem to be able to make a reliable assessment of their child’s need for urgent medical intervention in only about 50% of cases and in the rest alternative transport may well have been feasible. As far as schools are concerned, the majority of ambulance transport probably is unjustified and poses an area of potential relief for a service stretched to its limits.