Lengthy transfer times for severe spinal injury patients criticised

Lengthy transfer times for patients with severe spinal injuries have been criticised by the director of the National Spinal Injuries Unit.

Orthopaedic and trauma surgeon Keith Synnott said the spinal injuries unit was sometimes notified early in the morning to expect a patient with severe spinal injuries, but the patient was not delivered until late at night, with potentially catastrophic outcomes.

The HSE said its inter-hospital transfers were dependent on the use of emergency ambulances. However, call-outs from the 999 emergency services were given priority over “inter-hospital transfers”. A new system of separating transfer patients from emergency services was being developed .

Mr Synnott said the waiting times had very serious repercussions for paralysed patients, allowing the development of saucer-sized pressure sores that increase the risk of infection and sepsis, and even death.

Victims of spinal injuries in the Republic are brought to a unit at Dublin’s Mater hospital. The unit is equipped with facilities to lift and turn patients and deal with conditions such as pneumonia which can be brought on by a patient’s inability to cough and clear the chest.

In the last five years, the HSE has stopped using search and rescue helicopters as emergency ambulances, since journey times by road to Dublin from most parts of the State have been substantially improved.

Mr Synnott said this was understandable, but that lengthy delays were extremely frustrating for the unit. “People are aware of the stricture that you must not move a patient with spinal injuries, and so the patient ends up on a trolley lying in the same position for hours, waiting to be taken to Dublin.”

Asked if he believed the fault lay with the ambulance service, hospitals or a lack of ambulances, Mr Synnott said he really could not say. “All we see is the delay,” he said.

In a statement, the HSE said: “In the majority of the country, the National Ambulance Service continues to use emergency ambulances staffed by paramedics for inter-hospital transfers.”

It said the NAS was developing a dedicated tier of service known as the Intermediate Care Service to support transfers.

“However, until the NAS can discontinue the use of emergency ambulances for transfers, 999 emergency calls will continue to take precedence in relation to the prioritisation of resource utilisation.”