Ambulance – options

Practice Leads

  • Doctors: Ramesh Mehay & Sudhir Krishnan
  • Admin: Chris Rushton

Date Reviewed

November 2016

Date of Next Review

November 2017

Ambulance services: types of responses

IMMEDIATELY LIFE THREATENING

PURPLE RESPONSE (≤8 MINS)
PHONE 999

eg Cardiac arrest, Respiratory arrest, Unconscious, Analphylaxis, Suspected/Ruptured AAA, Obstetric emergency

 

SERIOUS BUT NOT LIFE THREATENING

YELLOW RESPONSE (≤40 MINS)
PHONE 0300 330 0295

eg Frail elderly rapidly deteriorating. Condition not immediately life threatening but requires transport in under 1 hour

LIFE THREATENING BUT NOT IMMEDIATE

AMBER RESPONSE (≤19 MINS)
PHONE 0300 330 0295

eg Acute asthma/COPD, Acute FAST +ve stroke, suspected MI, Acute Coronary Syndrome, Meningitis, Red Flag Sepsis, Blocked catheter in severe pain, NEWS score ≥ 5

NON EMERGENCY BUT TODAY

GREEN RESPONSE (1-4h: specify 1, 2, 3 or 4h)

PHONE 0300 330 0295

eg stable pneumonia, cellulitis needing iv abx, x-ray of acute minor injury, palliative care unit admissions

An immediate life-threatening response

Is for patients who require resuscitation or emergency intervention on scene from the ambulance service. It must never be used for any other reason such as a GP practice is closing or a HCP is unable to remain on scene. Where a life-threatening emergency response is requested the HCP must remain on scene with the patient until arrival of that

NEWS: National Early Warning Score

Six simple physiological parameters form the basis of the scoring system.  This helps you to work out the clinical risk of the patient deteriorating significantly.

1  respiratory rate
2  oxygen saturations
3  temperature
4  systolic blood pressure
5  pulse rate
6  level of consciousness.

The AVPU scale for level of consciousness = "alert, voice, pain, unresponsive"

Work out the score for each parameter. Then add them up.   Then Uplift the score for people needing oxygen.  See interpretation below.

news
*RED score refers to an extreme variation in a single physiological parameter (ie a score of 3 on the NEWS chart, coloured RED to aid identification and represents an extreme variation in a single physiological parameter).
The consensus of the NEWS Development and Implementation Group (NEWSDIG) was that extreme values in one physiological parameter (eg heart rate ≤40 beats per minute, or a respiratory rate of ≤8 per minute or a temperature of ≤35°C) could not be ignored and on its own required urgent clinical evaluation.
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COPD patients: For patients with known hypercapnoeic respiratory failure due to chronic obstructive pulmonary disease (COPD), recommended British Thoracic Society target saturations of 88–92% should be used. These patients will still ‘score’ if their oxygen saturations are below 92 unless the score is ‘reset’ by a competent clinical decision-maker and patient-specific target oxygen saturations are prescribed and documented on chart and in the clinical notes.
news-interpretation

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