x Abu Dhabi, UAE Thursday 20 July 2017

Gridlocked ambulances cost lives

While measures including an expanded network of ambulance stations may ease matters, motorists are being prompted to give way.

An Abu Dhabi emergency team responds to a car crash.
An Abu Dhabi emergency team responds to a car crash.

Abu Dhabi // While manoeuvring an ambulance from Al Bateen towards an accident on Airport Road, Mohammed al Ghafiri says that being a paramedic on the gridlocked streets of Abu Dhabi is like competing in a slalom race on a crowded ski slope.

"If it were a traffic police patrol, you'd see how quickly [other drivers] give way because they're afraid the police will give them a fine. But no consideration for patients," he said as one car blocked his way for nearly a half-minute. Mr al Ghafiri sees every day that the difference between lives saved and lost often is a matter of half-minutes. Stabilising patients, diagnosing their conditions, deciding what care to offer - any wrong move can be costly.

But often, the biggest challenge for the capital's first-response teams is simply getting to an accident scene. "The first hour in any accident is a golden hour," said Dr Nejeeb Oweis, a rescue worker. "Whatever happens in this hour will affect the outcome. A patient can survive but might be blind or paralysed." Despite the delays created by congestion and selfish motorists, the big picture is that response times have improved in the capital.

Dr Oweis said one of the key moves was the creation of "advanced medical teams," which are more highly trained than the typical ambulance crew and can provide high-level care immediately rather than simply assessing a situation. These teams typically include a doctor, who is the only one allowed to administer cardiopulmonary resuscitation (CPR) and medicine to patients; a paramedic, who is qualified in advanced pre-hospital care; and a rescuer, who is trained to cut metal and extract patients. The rescuer usually drives the ambulance.

Dr Oweis said the teams have reduced reaction times "quite significantly" by eliminating the need for police or firefighters to call for ambulances. Teams arrived in less than 10 minutes in 78 per cent of cases in 2009, he said. The service has also been credited with increasing the resuscitation success rate by 50 per cent in the first quarter of this year compared with the same period last year.

The city is in the midst of a structural change that should shorten reaction times by shortening distances to emergencies. Five ambulance stations now serve Abu Dhabi Island, but more are in the works. New ambulance stations in congested areas such as Tourist Club and Khalidiya are planned, and more paramedics are being recruited to staff an expanded fleet. Lt Ahmed Saleh al Hajeri, the head of the ambulance department, said: "Four more service points are urgently needed to do the job properly now. But we will need more in the future as the city expands."

The current five stations are in Zaafarana, Al Manhal, Al Mina, Al Rawda and Al Bateen. But building new stations can be as cumbersome a process as driving the capital's roads. "It is hard to just demolish buildings and build a new station in the Tourist area, for example," Lt al Hajeri said. "Our new stations will be different from the current ones; they should be larger with gates from all sides."

Even when the new stations are in place, a significant public-awareness challenge still lies ahead, Dr Oweis said. Motorists must learn to give way, people near accident scenes must learn how to deal with the injured and everyone should know how to report an accident, he said. Dr Oweis said people often either exaggerate or underestimate the severity of an accident, or fail to provide essential details about casualties and location.

Each incorrect detail, he said, can delay emergency response or cause a team to be dispatched to a site where it is not needed. He said it shows that, in the end, no matter the time or expense of expanding ambulance coverage and placing doctors in first-response teams, results are all that count. "My team can be really needed once in every 100 cases but if only one case benefits from the service, then it is undoubtedly worth it," Dr Oweis said.