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Flaw In Emergency Response System May Have Killed Hundreds
Hugh Pickens writes "The Telegraph reports that a flaw in the way emergency response software was set up to handle Category A responses in Great Britain may have cost hundreds of lives over the past ten years. Most ambulance services use an international computerized system designed in America and in the US version, a fall of more than 6 feet receives the maximum priority response. However, the government committee which governs its use in Great Britain decided that such cases should be deemed less urgent, and excluded from an eight minute category A target response time. If a call involved a fall of more than 6 feet it was designated a lower priority 'category B response' despite the presence of life-threatening conditions which were supposed to receive the most urgent category A response. The flaw came to light after Bonnie Mason, 58, fell 12 feet down the stairs and died from a head injury after emergency controllers in Suffolk failed to identify her situation as 'life-threatening.'"
The summary sounds like "we underestimated how dangerous a medium distance fall can be, so we didn't have the correct priorities and more people died than could have". That isn't really a flaw in the algorithm, it's just a flaw in one specific parameter in the algorithm.
There is an inherent risk to allowing operators of software to override the systems rules.
I like to call it the "Red Exclamation Point Problem" or the "High Priority Problem." To a not insignificant portion of the population, opportunity to elevate, upgrade, bold, underline, highlight, or change the font red is taken at nearly every opportunity. This defeats the priority system that was set out with the intention of reducing costs, and in this case, saving more lives by better prioritizing the use of a finite resource in emergencies.
While I agree there are a number of industries and professions in which not allowing user intervention is mistaken, and while I agree that the administration who altered the system in place poorly are at least somewhat to blame for the needless deaths, I don't think dispatchers should have the ability to arbitrarily override the priority system either. It looks like the software handled everything it was told to do correctly, but the administrators made a mistake in designing and testing alterations to it and perhaps did not even consult medical professionals. As a result, people died.
And lastly, the problem isn't that most falls should probably be category B. That's already taken care of, but falls over six feet being category A must have made sense to someone, and apparently it cost lives changing it.
The title of this thread is "Flaw In Emergency Response System May Have Killed Hundreds"
The first sentence contains the following: "... a flaw in the way emergency response software was set up to handle Category A responses in Great Britain may have cost hundreds of lives over the past ten years"
BOTH ARE VERY MISLEADING !!
The FLAW of the whole thing is the BRITISH GOVERNMENT COMMITTEE which decides that a fall of more than six (6) feet SHOULD BE DEEMED LESS URGENT, AND EXCLUDED FROM AN EIGHT (8) MINUTE CATEGORY A TARGET RESPONSE TIME " !!
Why blame the software or the emergency controllers when it's the idiotic British bureaucracy which has fcuked up in the first place?
Muchas Gracias, Señor Edward Snowden !
I've worked as a Paramedic under the Advanced Medical Priority Dispatch System (AMPDS).
Whether you are given a Cat A or B generally makes no difference in the response time of the crew to the scene - i.e. they always drive as fast as they safely can no matter what the emergency.
Incorrect triage by the communications centre is routine. This is usually not the comcen's fault - it is almost always incorrectly reported information from the caller. Things like whether there is a pulse or not, whether they are breathing or not, whether they are bleeding or not, are often incorrectly reported from panicky callers.
Or you can get correctly triaged responses with totally different results. You might get a call saying a patient has severe gastric pain which ends up being a myocardial infarction.
You might get a call from a patient with severe difficulty breathing (which is a cat B emergency) only to find they are having a panic attack or have a sore knee (patient lie all the time to get either free drugs, attention, a free trip to hospital, etc.).
In regards to the height of a fall problem consider this. A 6 foot plus tall person falls 6 plus feet to the ground when they pass unconscious from standing - yet the person reporting won't usually think of saying they fell six feet (we're talking head impact here - not much else matter until you're falling from really big heights and can start shattering lots of bones). A very common example of misreporting from callers.
Hmmm
I am sorry but that does not sound plausible. An ambulance will always be dispatched for that type of injury, it may be not always be classed as an emergency response and so may be delayed due to higher priority incidents but an ambulance will always arrive.
My mother fell and broke her hip in 2005. A neighbour heard the fall, went in to the house saw my mother on the floor and called the emergency services, the neighbour then rang me.
I left work, got on my motorcycle and did a high speed dash from my place of work to my mothers house (about 15 miles on the motorway), luckily there were no police on that portion of it. By the time I arrived at my mothers, the ambulance had arrived, had assessed her and were in the process of transferring her to the ambulance.
The NHS has a number of problems, but I have never known the ambulance service to out-right refuse to attend a scene. Mistakes can and have been made by dispatchers wrongly categorising injuries, but generally elderly people that fall are classed as high priority regardless of the symptoms.