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Radio Raises Ambulance Efficiency
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By a Special Correspondent
INCREASED efficiency has been attained without heavy extra cost by Lancashire County Council Ambulance Service. The most important contribution has been made by radio control, which has become a vital feature since it was adopted two years ago.
The first transmitter, at Barnacre, began experimental transmission in May, 1956, to give driving staff experience in this form of communication. Operational control was instituted in the August, and by October the whole of the area was covered.
At the moment, 179 operational ambulances have radio control, but before long it is hoped that the whole fleet will be so equipped. The base transmitters and mobile sets operate on a power output of 25w. and 15w. respectively.
During 1957, the Service dealt with 804,985 patients, comprising 54,051 emergency cases and 750,934 of known origin. Figures for past years show that ambulances take an average of 8 min. to reach an emergency case and
A view of a telephone control room where requests for transport are received and logged. Last year there were 1,552 false
alarms. 241 min. to reach hospital. In 1957 there were 4,792 accidents on the roads, 3,740 in public places. 5,607 in the home, 3,424 in works and factories and 2,271 at collieries.
In addition there were 11,658 maternity cases and 19,549 of general illness, also 395 which were unclassified. There were 1.552 occasions when ambulances were called on false alarms. It Is sur prising the number of small boys who dial 999 just to see what happens! In that year the fleet ran 4,416,176 miles.
Lancashire is divided into five radio areas, each area having its own supervisor. Radio-control centres, main ambulance stations and sub-stations, depots and garages are distributed throughout the county, each station having an adequate fleet of ambulances to meet its requirements. The average radius within which a vehicle operates is usually about 12 miles.
There are over 50 ambulance stations, four-fifths of them giving a round-the-clock service. Each area differs in characteristics, and often ambulances are sent .on long journeys to different parts of the country. The Service does not operate within the county boroughs. Of the 270 vehicles controlled by the Service, 179 are actually operational. The reserve fleet totals 91. The majority of the ambulances has Commer:2-Cwt. chassis and will accommodate sitting patients and one stretcher case, or alternatively two stretchers. A few have provision for carrying a full load of stretcher cases. There are also 12 dual-purpose Bed fordseach for eight sitting cases or one stretcher. Packed beneath the seats is
medical equipment ranging from lint, bandages and dressings to morphia. and a hypodermic syringe. A rule is that every ambulance, even in the summeri shall always go out with filled hotwater bottles.
There are about 100 small Hillman estate cars. They normally carry sitting patients but can be converted to transport a single stretcher case. These vehicles are well equipped but on a more limited scale than the Commers. Lancashire has fopr ambulances, specially designed to carry patients for tong distances. The chassis are Cornmers and the bodywork is manufactured by Rootes. They are equipped with hospital-type beds, with 6-in. Dunlopillo mattresses, which can be moved up or down, at the head and the foot by the turn of a handle, the degree of variation being such that the bed can become a chair. , Beside the bed are two deep, leatherupholstered chairs with wide headrests for the nurses, or the patient's relatives. These ambulances are greatly.
appreciated when patients have to be taken a long way home 1.1 OM hospital.
, Inside all the larger ambulances there is a small cabinet which is kept locked. To open it the front glass panel must be broken and the key extracted from a hook. Inside are oxygen and morphia wh ich must be used only in emergencies. Chloroform and adrenalin are . also carried for serious cases. There have been no major bodywork chariges recently, but details are always being improved with the object that everything shall be as comfortable as possible for the patient.
Fleet Development
The Service in its present form started with be National Health Act, 1948. Before this time facilities were not up to the current standard. From 1948 onwards Lancashire strove to abolish,ottt-of-date vehicles and install the modern red-and-cream outfits with which local people have now become familiar. By 1953 Mr. T. Pearson, the county supervisor, and his staff had developed the fleet into its present form. • As previously stated, Lancashire is formed into five radio groups, the fleet itself being divided accordingly. Each area is in charge of a supervisory assistant who is responsible to Mr. Pearson. There are 17 health divisions, each under a divisional medical officer and his staff, these medical officers being responsible to the county medical officer. The Service works in close contact with the medical officer of each division, and the requests and orders come from them and the hospitals.
When a call is received, either by radio or by telephone, it is recorded immediately and, if not an emergency, logged for the required day. Having received such instructions, the station officer then allocates the duties of the various drivers; as the cases are allotted they are recorded in a log book.
Most drivers are always in direct radio contact with base and radio messages are recorded. If an emergency arises, an ambulance can easily be diverted by radio. In emergencies, the area radio controller gives instructions to the individual officers. When an accident occurs, a nearby hospital, a doctor or even a passer-by may ring for an ambulance, and here again radio control quickly diverts the nearest available vehicles to the scene. Around the walls of the radio-control station there are large maps with magnetic discs which are plotted to show the positions of vehicles as they travel about.
The Service employs 690 driverattendants who are also qualified in first-aid. They usually work in eighthour shifts and have two days off per week. "Recruited drivers are tested by staff instructors and must agree to qualify in first-aid within 12 months. They are expected to obtain the St. John's certificate, and afterwards extra training can be taken in midwifery and the treatment of infectious diseases.
Drivers' Instructions Instructions issued to drivers are in the form of the previously mentioned slips on which each telephone message is recorded as soon as it is received. When the appropriate day for the assignment arrives, the slips are given to the driver, who records the details of each case in his own log. A log is also kept in the control room.
It is rarely that an ambulance breaks down but, if equipped with radio, the driver will get in touch with headquarters immediately and an ambulance will be diverted as soon as possible to take over his patient. If he has no radio, he will use the nearest telephone. Two vehicles are kept in readiness for such contingencies. Qualified technicians with a service van may be sent out to recover a brokendown vehicle.
Lancashire has no special ambulances for carrying children. They are usually accommodated in the eightor 12-seaters, and a qualified attendant travels with them. Mr. Pearson told me that several times in the past they had been requested to carry spastic children. The vehicles used for this purpose were specially adapted to keep the children occupied and as happy as possible. Trained nurses travelled with them. The servicing and maintenance of the vehicles are done on a time-andmileage basis, daily cleaning, and greasing, being performed by the drivers. Broadly, the ambulance personnel are responsible for the internal and external cleanliness of the vehicles, greasing, oiling and minor adjustments, whilst the workshops and mobile service vans undertake all other forms of repair and maintenance.
Monthly, or every 1,000 miles, a service van with mechanics visits the Various stations and performs any running repairs which are necessary. The Council's central workshops are at Eccles, Bamber Bridge and Lancaster, and all major maintenance operations are done here. The vehicles are given a minor overhaul at these depots every six months or 10,000 miles.
Fuelling Arrangements All ambulance stations have their own petrol pumps, and drivers are expected to fill up-in the evening to be ready to start without delay the following morning. When refuelling is necessary away from the home garage, it is usually easy to visit a nearby ambulance station, but if it should be necessary for the driver to obtain supplies at an ordinary filling station, he can get special permits for his petrol.
In addition to the main fleet there are approximately 150 county-owned health service cars of various wellknown makes. Mainly 8-10 h.p. models, they are allocated to district nurses and midwives.
There is little seasonal variation entailed in the general work. The number of long journeys undertaken outside Lancashire varies, but whereever a patient lives, it is the responsibility of the Service to carry him all the way home. The special long-dis lance ambulances are entirely controlled by headquarters and any request for their use is dealt with there. Rail transport may sometimes be arranged, but travel in a comfortable ambulance is obviously much more pleasant for someone recovering from a severe illness.
Mr. M. Buss, radio supervisory officer at Preston, accompanied me to the Fleetwood station which has the reputation of being one of the best in the county. A model of an ambulance, showing drivers and equipment, is given annually by the county for the best station in efficiency and smartness. Fleetwood have won it for many years, including 1957.
Spare-time Gardeners
• The whole premises are attractively decorated in a simple contemporary style and Mr. J. Wright, station officer, told me that the men often worked in the small garden in their spare time. The premises that form the headquarters were taken over only three
years ago. They comprise an old country house which was purchased by the council. After extension and redecoration, equipment and furniture were installed. Approaching along the wide curving drive, it is difficult to imagine that one is really in the centre *of highly industrialized Lancashire.
Mr. Pearson said that he had never appreciated the possibilities of radio control to the full until the recent Winter .Hill. air disaster. With no time to be lost and unprecedented demands coming in, radio control had proved invaluable. The whole fleet is now always ready for any emergency and major disasters. For day-to-day work radio has enabled overtime and mile • age to be reduced although more patients are being carried.