Report of the Ambulance Committee.

  • Great Britain. Departmental Committee on the Ambulance Service in the Metropilis.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Report of the Ambulance Committee. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    28/348 (page 16)
    Cabs. Wheeled litters. Par. 24. Conclusion from the Returns. Rapid ambulances. Advantages claimed for rapid ambulances. James, 84G-850. Nott-Bower, 1064-1087. Collie, 1724. means such as by tramcar, 'bus or carrying, and (2) 86 serious cases (including the same kinds of cases as are named as serious just above) conveyed to hospital in a cab, motor car or such vehicle, 46 in a cart, van, or barrow, and 22 by some other ordinary vehicle, not an ambulance or wheeled litter. 58. These returns give a good deal of support to the grave indictment of the cab as a means of conveyance of injured people, which was made by witnesses who appeared before us. In two-thirds of the serious cases in which a cab was used it is stated to have been calculated to prejudice the condition of the patient, and in over one-third of the cases actual harm was considered to have been done. The corresponding proportions in the case of the other ordinary vehicles—carts, vans, tramcars, etc.—were about one- half and one-third respectively. 59. We have already referred to the information furnished by the returns as to the extent to which use is made of wheeled litters, rapid ambulances (which, however, were very rarely used) and stretchers, by the pohce and the public respectively. Injury or danger from the use of wheeled litters was suggested in comparatively few cases—only 16 out of the 168 cases in which they were used, and in only 12 out of the 68 serious cases. In most of these cases it is specifically stated that it was the sloumess of transit of the litter or stretcher in a case of extreme urgency that occasioned the detriment or risk of detriment to the condition of the patient, for example, in three cases of poisoning and three cases of dangerous haemorrhage. In this connection it may be noted that in one of the few cases in which a horsed ambulance was used complaint was made as to the period (some 45 minutes which was occupied before the patient, whose injury is described as fractured ribs, dangerous, arrived at the hospital. The distances which often have to be traversed in bringing patients from scattered and outlying districts to a hospital present one of the many difficulties in the organisation of an ambulance service for London. As respects the suitability of the wheeled litter we have further information from these returns, for we find that the litter is named about twice as frequently as the rapid ambulance in reply to the question what mode of conveyance would have met the require- ments in those cases where the actual mode of conveyance by cab, cart or other such vehicle was considered unsuitable or prejudicial. This, of course, must not be taken as meaning that the litter would have been preferred in these cases to the rapid ambulance, but is, we think, worthy of consideration as against the view urged by some witnesses that the wheeled litter is fit only to be entirely superseded by the rapid ambulance. 60. The results of the above analysis appear to point strongly to the conclusion that much too frequent recourse is had to the cab or other inappropriate vehicle in severe cases, and that it is very desirable that the use of some type of special vehicle should be largely extended. IV.—SUGGESTIONS FOR ADOPTION OF IMPROVED METHODS OF CONVEYANCE. We have now to conside * the suggestions which have been made to us for (1) im- provement in the character and equipment of the vehicles for the transport of street cases and (2) the organisation of a system ca^.culated to lead to a more general use of vehicles specially adapted for this purpose. (1) Character and Equipment of Vehicle. 61. With very few exceptions the witnesses <?alled before us are agreed that where it is necessary or desirable that a patient should be removed to hospital in a recumbent position a rapid (motor or horsed) ambulance is for various reasons preferable to any other mode of conveyance. The principal advantages claimed for the rapid (horsed or motor) ambulance are :— (1) That the removal of the case from the place of the accident or seizure is more speedy, (2) That the use of properly equipped ambulances enables skilled assistance to be brought to the aid of the sufferer, and that the necessary treatment can be applied by a skilled attendant with greater discrimination and efficiency than can be expected from an ordinary constable. (3) That greater privacy is secured and that any necessary treatment can be applied without exposure or publicity : this is of particular advantage in the case of female patients.