What is it about?
Delays in offloading ambulance patients in emergency departments place a strain on the ability of ambulance services to respond to the 'next' patient in the community. Delaying transfer to hospital care is often seen as the 'right' thing to do as the patient remains in medical care while waiting. This article considers the ethical argument from the paramedic point of view and suggests that delaying offloading may not be as ethically justifiable as generally thought.
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Why is it important?
At the time of writing, the issue of delays in offloading patients was very topical. As a result of the global pandemic, starting in 2019, the issue has resurfaced. Ambulance services in Australia and the UK have drafted in additional assistance to cope with demand, due in large part to delays at the emergency department. In Scotland, delays in community response have potentially resulted in harm or death.
Perspectives
This article challenges the default position that delaying offloading patents (ramping or stacking) is an ethically justifiable position to take when emergency departments become overwhelmed. The article suggests that this needs to be re-thought and a better solution than simply moving the problem onto a service that is not designed for medium to long term care should be found. At the time of writing the issue was largely an Australian based one, however this is no longer the case during the Covid-19 pandemic.
Matt Perry
University of Gloucestershire
Read the Original
This page is a summary of: The ethics of ambulance ramping, Emergency Medicine Australasia, July 2016, Wiley,
DOI: 10.1111/1742-6723.12625.
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