I Am A Doctor And This Is The Ugly Truth About Ambulances That Nobody Will Tell You

Mohit Garg Mohit Garg in Bakkar. Chai. Sutta on 19 March, 2017

I work in the Emergency Department, and that involves meeting and interacting with many "Ambulance Doctors" on a daily basis who come to transfer patients from some medical facility to our hospital. Over the years, I've observed more things than I would like to admit, and all of them are terrifying. Trust me, every word I'm about to say is true and from real life scenarios. This one is really no big secret, but most ambulances always drive with their sirens blaring even if there is no patient inside. You will seldom come across an ambulance moving at a normal driving speed. I am sure you have used this opportunity to drive bumper to bumper with the ambulance to beat the traffic. I won't deny that I've done it too, and I've seen immature motorists trying to race with the ambulance also.

As a frustrated citizen stuck in the traffic, that is all you get to see. Me being a doctor, I don't just have to see the broken state of patients in the Emergency Department, I also have to see the appalling way in which they are brought and dumped in the hospital. Ambulance personnel are apathetic enough to not care about anything but their "business" and they humiliate the profession in more than one way.

MOST of the doctors who are hired in this money minting ambulance business are Ayurvedic or Homeopathy doctors. They barely have enough knowledge about the medicines we use during emergency situations. So, not surprisingly, there are centers across the country running a 6 month Post Graduate Diploma in Emergency Medical Services. This course makes sure that those doctors can get jobs in such ambulances, and a license to kill. These are the "Qualified Emergency Physicians" in our country.

It honestly makes me wonder why I did an MBBS and continued to pursue ANOTHER 3 year long MD in Emergency Medicine. Let me tell you the truth about these "professionals": Their sole aim is to "dump an alive patient" at the receiving hospital.

These patients may not even have a recordable blood pressure anymore, but they will simply have a pulse. They LIE about the patient's vital stats. The vital parameters of the patient (Pulse, Blood Pressure, Saturation and Respiratory rate) are always "stable" during the journey according to them, but as soon as the patient enters the hospital doors, everything changes. From "stable", the patient becomes "critical" on our hands. When the patient reaches the hospital, they stop caring about everything except for the 'patient transferring sheet'. They make the uncomfortable patient roll right and left as soon as the patient is brought in.

"Arre chain ki saans toh lene do patient ko!" I feel like screaming at them. The doctor too is more interested in helping his attendants pull the stretcher out than briefing us about what is wrong with the patient in the first place. The money can wait for 15 minutes, but the patient transferring sheet is the real treasure for them... A mere mat that they lay on the stretcher! I am ASHAMED to think of how misplaced their priorities are.

It doesn't end there. The ambulance is more deadly than safe for the patient. The oxygen mask used for patients during transit is reused over and over again till the elastic straps on the side of the mask become loose or break. They won't bother to change the mask even if they bring a patient with TB or pneumonia. They always ASK for the mask back. They don't give a damn if the patient gets infected and dies, but they won't spare another rupee on a new oxygen mask. Not to be mean about how ignorant these doctors are, but the ONLY TWO drugs that they are exceptionally good with are Dopamine- to increase the blood pressure, and Nitroglycerine (NTG) to make the blood pressure fall. Depending on what the reading shows on the monitor in the moving ambulance, they don’t even bother to manually check the BP and play with the infusion rates as they like.

If there is any patient who is irritated, non-cooperative, or moving about, there is a high probability that he/she will be injected with Midazolam or Fortwin, and Phenagan which puts the patient to a good sleep. The relatives feel that the doctor has done something, but the doctor will only care about having a quiet journey to the hospital. But the catch here is that with a wrong dosage, the patient can go into a respiratory arrest. These doctors will then "fix" this by inserting a tube down the patient's throat in a moving ambulance, only to damage vocal cords. And if the patient survives by some stroke of luck, he/she will be left a bathroom singer for life.

They have gone even lower than that. These ambulance doctors have been even more cruel than just this. Rarely does an ambulance doctor declare a patient dead at home. These guys are more than happy to rush a patient on a respiratory support system, even if the patient has been dead for more than 1-2 hours. I mean, even a layman can tell that the body is cold and stiff, and that the person is a goner. But they are experts at giving FALSE HOPES to the family of a miraculous recovery, or securing a Death Certificate from the hospital to which the patient is taken to (both of which never happen). To the patient's family, it is a one time emergency. They are so tensed and worried that they might not notice many obvious things when their loved one is being brought to the hospital. But for me, this is a daily reality. I see rampant carelessness with the way patients are handled. There are so many human lives ruined in the process. I despair everyday and I wonder when things might become better. 

Author's Note:

I don't ever want to disrespect any of my fellow medico colleagues, but I can't hide what I see. This is the plight of a very essential and ‘life altering’ (I say altering as it really can change the outcome of the patient, and the future of the family members) service - The Ambulance. It really is disappointing to see such malpractices and I really wish we could have better standards of care one day.