Ambulance Evacuation for Accident Victims and Seriously Ill Patients

7 Dr Tan Wu Meng asked the Minister for Home Affairs what are the measures that the Ministry is considering to put in place to ensure accident victims and seriously ill patients continue to receive timely ambulance evacuation to hospitals

The Parliamentary Secretary to the Minister for Home Affairs (Mr Amrin Amin) (for the Minister for Home Affairs): Singapore Civil Defence Force (SCDF)'s Emergency Medical Services (EMS) responded to more than 155,000 calls in 2014. This means that there are more than 400 calls a day. Despite the high volume of calls, SCDF has responded to 83% of these cases within 11 minutes in 2014. This was an improvement from 78% in 2013. The 2015 figures are still being finalised and will be released in February.

The number of emergency ambulance calls has been increasing at a rate of about 5% a year. At this rate of growth, we can expect the number of calls to double in 15 years' time. However, it will not be possible to grow our number of ambulance and ambulance crew at the same rate. So, SCDF has adopted a number of strategies to cope with this trend.

First, SCDF will be increasingly adopting a tiered response model so that resources are channelled to areas of greatest need. For example, to ensure swift response to critical cases where time is of the essence, SCDF deploys Fire Bikers in addition to emergency ambulances. Equipped with Automated External Defibrillators (AEDs) and other medical equipment, these Fire Bikers have been effective in ensuring that cardiac arrest patients receive prompt medical attention before the arrival of the emergency ambulance. In the case of industrial accidents or road traffic accidents, fire fighting vehicles may arrive earlier than an ambulance. These fire fighters would be able to render the initial assistance to stabilise the patient before the arrival of the emergency ambulance.

Second, SCDF has been implementing initiatives to equip and train members of public to render assistance. This is important as every minute counts for certain time-critical cases, such as cardiac arrests. For example, SCDF's "Save-a-Life" initiative trains and mobilises volunteers to respond to cardiac arrest cases. As part of this initiative, SCDF has begun installing AEDs in public spaces for use during medical emergencies and created a mobile app to alert the Community First Responders should a case happen nearby where they are.

Together, these strategies will allow SCDF to optimise its limited resources to deliver swift medical support to critical cases and calibrate its response for non-critical cases.

Dr Tan Wu Meng (Jurong): I thank the Parliamentary Secretary for his comprehensive answer. If I may just ask a supplementary question: he has mentioned the time criticality and indeed, as a medical professional, we are often aware of time critical situations such as acute myocardial infarction, which lay persons understand as a heart attack. There is data showing that the door-to-balloon time – the time from getting the patient evacuated to getting the angioplasty – can be important, in such cases. So, in a situation where the ambulance crew has a working diagnosis of an acute myocardial infarction, would the ambulance prioritise evacuation to a hospital with the facilities and staff for coronary artery angioplasty?

Mr Amrin Amin: In a medical emergency, the timely arrival of patients at the nearest hospital with the appropriate facilities can make the difference between life and death and that is very important. Based on this principle, SCDF conveys patients requiring emergency medical treatment to the nearest available MOH-designated hospital based on the fastest possible route.