Lucky patient survives 11-hour delay getting to surgery
ILUKA resident Kerren Heilpern knows she is lucky to be alive.
After a burst brain aneurysm felled her at home one February afternoon, a mix of ambulance delays and hospital procedures delayed vital surgery for 11 hours.
This has led to a call this week by Greens MP and health spokesperson Dawn Walker for more ambulance services.
On February 2, the apparently healthy woman in her 50s experienced a crushing headache and began vomiting blood.
"Ten minutes later I was virtually unconscious," she said. "I only fully regained consciousness several days after the surgery."
Her partner PhiI Young was with her when she collapsed. He called the ambulance and was able to administer first aid while they waited about 45 minutes for the paramedics to arrive.
"Everything they did was great. Basically they told me to do everything I could to keep her conscious." he said. "The only real issue were the delays because ambulances were not available at the time."
In the middle of the drama Ms Heilpern's parents, who are almost 80, arrived to spend a weekend with their daughter's family, only to find her fighting for life.
Mr Young said fast treatment was vital for treating aneurysms.
"The stats aren't good," he said. "Roughly 30% of cases result in death before the patient reaches hospital.
"In another 30% of cases the patient dies on the operating table. And among the 40% who survive, 60% of those experience varying degrees of brain damage."
Instead they waited at Maclean Hospital for three hours for an ambulance to take Ms Heilpern to Grafton Base Hospital for a CT scan to diagnose what was wrong with her.
"The paramedic who treated her first basically diagnosed what had happened straight away," Mr Young said.
"But he said it was their procedure to take her to the nearest hospital.
"Kerren's parents were pretty vocal about getting her to the right places pretty quickly, but nothing they said had any effect."
The scan confirmed the paramedic's assessment and Ms Heilpern's family was given the option of a transfer to the Gold Coast University Hospital, or Newcastle.
Again luck was against her as the Westpac Rescue Service helicopter was unavailable, so she was taken by road ambulance to the Gold Coast.
Mr Young said she arrived on the operating table at 5am the next day.
Ms Heilpern's story has alarmed Greens MP and health spokesperson Dawn Walker, who has called for an increase in ambulance services in the Lower Clarence area.
She said the delays were worrying signs of problems for patients and paramedics.
"These delays are the latest example of the insufficient ambulance services in the Lower Clarence region, which are putting residents and tourists at risk and causing paramedic fatigue," the MP said.
"A three-hour wait at Maclean Hospital for an ambulance is totally unacceptable and demonstrates that emergency services are stretched beyond capacity in this growing region."
Member for Clarence, Chris Gulaptis said the issues were complex but said the protocols around life and death cases needed to be looked at.
"I will be asking the health minister about this this afternoon," he said yesterday.
"I think the community places a great deal of trust in the competency of the paramedics.
"People would be happy to see them have a degree of discretion in these sort of emergencies."
Mr Gulaptis will also be recommending a 12-month trial of a second ambulance at Maclean.
"I've met with the paramedics unions and support what they say about the need for a second ambulance at Maclean," he said.
"From what I've been told the cost of a second vehicle is just $45 a day if it's not being used.
"And if it is used, it saves a life."
The Northern NSW Health District and NSW Ambulance acknowledged there were some unfortunate issues in this case.
NSW Ambulance spokesperson said the service is committed to ensuring that communities across Northern NSW have timely access to paramedic care in the case of a medical emergency and is always apologetic of any lengthy response to a patient.
"When NSW Ambulance received a Triple Zero (000) call in this instance, the closest available ambulance was sent to attend the patient under lights and siren." he said.
"Following the on scene medical assessment by paramedics, the patient was initially transported to Maclean Hospital."
The spokesperson said a NSW Ambulance review determined the attending paramedics treated the patient in accordance with NSW Ambulance clinical protocols, and the primary hospital destination decision was consistent with established transport destination procedures.
Northern NSW Local Health District confirmed decisions to refer patients for neurosurgery cannot be made until a definite diagnosis is obtained using CT imaging.
"In this case the patient remained under the care of medical staff before being transferred to Grafton Base Hospital to undergo medical imaging, which revealed the patient required retrieval to the Gold Coast University Hospital, which is the nearest neurosurgical unit," a spokesperson said.
"Northern NSW Local Health District is in discussions with Gold Coast University Hospital to provide follow up clinics for patients within the Clarence district, following discharge from the neurosurgery unit at Gold Coast University Hospital."
NSW Ambulance said it would implement a 24-hour roster operation at Maclean Ambulance Station, incorporating an additional seven paramedics for a total of 12 staff.
The more than doubling of staff will also provide an increase in relief coverage over periods of leave and training and also assist reducing fatigue by not requiring paramedics to respond to emergencies from their homes after completing duty shifts.