ER24: Paramedic Rapid Response Car - Michael Bradfield

At 7am I was dropped off at Bloemfontein Medi-Clinic and after a quick (accidental) walk through ICU found my way to the ER24 offices, where I met Paramedic Rohan Steyn. He gave me a quick tour of the hospital, which included visiting a couple of patients that he had previously treated and brought in. In London, due to the size of the area we cover (in population density, if not geography) and number of hospitals we go to, it is rare that we get to follow up on patients we meet and it was interesting to see how the care had progressed from the Emergency Department. We then met some of the ER24 ambulance crews and had the obligatory cup of coffee in the crew room, and I will repeat my remark here that I made about the metro service in Queenstown, I felt very much at home. Having previously been out with a state-funded service that had less equipment and less trained staff, it was a marked contrast here where Paramedics having a greater number of skills and use of drugs than we do in the UK (boring technical details available by request). Rohan took me for a drive around town and we went in search of something unhealthy to eat for breakfast. It was a relatively quiet morning which gave us time to compare and contrast the differences between the way in which the NHS works and how EMS functions in South Africa. ER24 is a private service, but will still respond to any calls and treat and convey patients irrespective of their ability to pay. Those with insurance will opt to be taken to one of the private hospitals, those without will be taken to the state hospital and the costs are written off. ER24 work closely with the state services here, in particular providing Paramedic support to their crews when required. During the course of the day we attended a range of medical and trauma calls and I got to meet crews from other services, the police, doctors and nurses, many of whom had some connection to the UK and were keen to chat.

I was told that to really see how EMS works in South Africa, I needed to be out on a weekend night. After some negotiation with the powers-that-be and courtesy of my kind hosts Wolf and Muriel (who gave me a spare key and an assurance they would not wait up) I was able to return to work with Rohan on Friday night, after we had given our team presentation. Just after 11pm we headed back out and I got to see Bloem at night. Word of my presence had spread and when we met the police flying squad at a petrol station they kindly offered to keep us informed of any calls they were attending. Rather than coming through a 999-type system, calls are picked up from a range of sources, including other ambulance services, the police, breakdown tow-trucks for car accidents (often on scene before anyone else) as well as direct calls. After much coffee and chasing calls around town I got home at 4.30am and had really enjoyed all the exposure I had to calls in the town and the level of enthusiasm I encountered.

Thanks to everyone who let me get involved and get in the way and I still blame the different type of cannulae used here rather than my clumsiness for getting blood on the passenger seat of a car during an extrication, but at least I got it in...national pride and all that. It was great to work with ER 24 in Bloemfontein and I am looking forward to going out with them again in Bethlehem.