LCQ12: Deployment of ambulances
15.6.2022

Following is a question by the Hon Edmund Wong and a written reply by the Secretary for Security, Mr Tang Ping-keung, in the Legislative Council today (June 15): Question: During the peak of the fifth wave of the Coronavirus Disease 2019 epidemic, ambulance service of the Hong Kong Fire Services Department (FSD) was severely overloaded. In April 2010, the Government proposed to introduce a Medical Priority Dispatch System (MPDS) to categorise the priority for ambulance deployment in accordance with the degree of urgency of injury and sickness. Nevertheless, after seeking funding approval from this Council in April 2015 for the development of a new computer system for ambulance deployment, the Government has not put forward any proposals for the implementation of MPDS. In this connection, will the Government inform this Council: (1) of the following information on the provision of ambulance service by the FSD in each month from January to April this year: (i) the number of ambulance calls received, (ii) the shortest, longest and average response times for an ambulance to be sent to the scene, and (iii) the reasons for the ambulance calls in respect of the cases with the shortest and longest response times; how such figures and information compare with those of the same period last year; (2) as I have learnt that during the peak of the fifth wave of the epidemic, the FSD prioritised ambulance deployment in the light of the acuteness of ambulance service calls, of the time when the FSD implemented and ended such arrangement; during the implementation of such arrangement, whether the FSD deployed ambulances in accordance with MPDS; if so, of (i) the number of ambulance calls, and (ii) the shortest, longest and average response times for an ambulance to be sent to the scene, for the various priorities; if not, the criteria adopted by the FSD for determining the priority of ambulance deployment; and (3) whether it has plans to implement MPDS; if not, of the reasons for that; if so, whether it will study implementing the system after improving the relevant proposal put forward in 2010; if so, of the details of the study (including the commencement and completion times, as well as the estimated expenditure), and the implementation timetable of MPDS? Reply: President, Having consulted the Fire Services Department (FSD), the reply to the Hon Wong's question is as follows: (1) It is the FSD's performance pledge to have the arrival of ambulance at the scene within 12 minutes of target response time for 92.5 per cent of emergency ambulance calls. Since the outbreak of the epidemic in 2020, apart from attending to a large number of daily emergency ambulance calls, the ambulance personnel of the FSD have also provided emergency treatment to confirmed and suspected COVID-19 patients, as well as be responsible for conveying them and relevant close contacts to hospitals/isolation facilities. Under the fifth wave of the epidemic, the department's manpower was very stringent as there was a large number of FSD personnel who were infected or had to undergo compulsory testing in compliance with the requirements of the compulsory testing notices. In addition, if the ambulance personnel have performed high-risk medical procedures for patients or handled suspected/confirmed COVID-19 patients, the ambulance personnel must return to the ambulance depot to thoroughly disinfect the ambulance, equipment and individuals, and dispose of medical wastes, before responding to the next call. The abovementioned special situations affected the number of ambulances available for dispatch and the response time. From January to April 2022, the information regarding the emergency ambulance service that the FSD provided is tabulated as follows: January 2022 February 2022 March 2022 April 2022 Number of emergency ambulance calls 59 170 54 478 59 935 43 406 (Note 1) The shortest arrival time for emergency ambulance call (reason of the call) 0 second (Note 2) (drunkenness) 0 second (Note 2) (unconsciousness) 0 second (Note 2) (unconsciousness) 3 seconds (Note 2) (unconsciousness) The longest arrival time for emergency ambulance call (reason of the call) 51 minutes (bicycle accident) 39 hours (sore throat) 36 hours (sore throat) 1 hour (fall) From January to April 2022, the FSD received a total of 216 989 emergency ambulance calls, 79.42 per cent (Note 1) of which were responded to within the 12-minute target response time. With the recent development of the epidemic, and the ambulance personnel who were earlier confirmed COVID-19 patients or defined as close contacts have returned to work, the situation of emergency ambulance service has improved significantly recently. Taking April as an example, the rate of meeting the target response time by the FSD's emergency ambulance service call is maintained at 92.5 per cent or above on a daily basis. For the same period of last year (from January to April 2021), the information regarding emergency ambulance service that the FSD provided is tabulated as follows: January 2021 February 2021 March 2021 April 2021 Number of emergency ambulance calls 54 654 48 069 58 524 56 765 The shortest arrival time for emergency ambulance call (reason of the call) 2 seconds (Note 3) (shortness of breath) 1 second (Note 3) (dizziness) 3 seconds (Note 3) (convulsion) 3 seconds (Note 3) (shortness of breath) The longest arrival time for emergency ambulance call (reason of the call) 51 minutes (dizziness) 45 minutes (chest pain) 1 hour (dizziness) 57 minutes (dizziness) From January to April 2021, the FSD received a total of 218 012 emergency ambulance calls, 93.83 per cent of which were responded to within the 12-minute target response time. (2) Due to the raging fifth wave of the epidemic, the ambulance resources were extremely tight. In order to handle the critical patients with priority, the FSD categorised patients of all emergency ambulance calls since February 22, 2022. The Fire Services Communications Centre (FSCC) personnel would first create a case for the incoming emergency ambulance call in the computerised mobilising system and prioritise the patients according to their situations of injuries and sicknesses, so that the critical patients could be given priority. For cases categorised as non-serious, the FSD would dispatch ambulances as soon as when ambulance resources became available. Meanwhile, FSCC personnel would use the post-dispatch advice (PDA) computer system to provide emergency ambulance callers with comprehensive and appropriate PDA to help stabilise the injury or condition of the patients. FSCC personnel would also remind the emergency ambulance callers to call FSCC again for assistance in case of any change in the patients' conditions. Moreover, depending on the patients' conditions, the FSD would dispatch fire appliance with fire personnel possessing the qualification of first responder on board to the scene for providing immediate basic life support services to the patients before the arrival of ambulances. With the number of emergency ambulance calls starting to come down, the FSD ceased categorising patients of emergency ambulance calls since March 16, 2022, and resumed the usual arrangement for handling emergency ambulance calls and instantly dispatching ambulances. The arrangement of dispatching ambulances according to the severity and priority of patients was a temporary and special measure adopted by the FSD in response to the serious epidemic situation, and was not based on the proposed criteria in the "Medical Priority Dispatch System" (MPDS) of 2010. (3) The Government proposed in July 2009 the introduction of MPDS to enhance the emergency ambulance service and provide quicker response to patients in critical or life-threatening conditions as soon as possible. Under the proposal, emergency ambulance calls were categorised into three response modes. Critical or life-threatening cases were categorised as "Response 1" calls. Serious but non-life-threatening cases were categorised as "Response 2" calls, and non-acute cases were categorised as "Response 3" calls. The target response time for the three response modes were 9 minutes, 12 minutes and 20 minutes respectively. The Government launched a public consultation on the above proposal and explained the outcome of the public consultation to the Panel on Security of the Legislative Council (the Panel) in April 2010. Some members had reservations about the Government's proposal to set the target response time at 20 minutes for "Response 3" calls. Some members expressed concern on whether the callers could provide the necessary information for effectively ascertaining the patients' conditions through the MPDS questioning protocol. After the discussion, the Panel did not agree to the relevant proposal. Currently, the FSD does not have plan to further study MPDS. The FSD has been reviewing the emergency ambulance service and implementing enhancement measures. Since May 2011, the FSD has gradually provided ambulance callers with simple PDA in respect of six common types of injuries and sicknesses (i.e. bleeding, fracture/dislocation of limbs, burns, convulsion, heat exposure and hypothermia) to stabilise the patients' conditions. In view of the favourable response from implementing the PDA service, the FSD put in place a new computer system in 2018 to assist FSCC operators, after dispatching ambulances, in providing callers with immediate, comprehensive and appropriate PDA. The types of advice has also been extended to cover over 30 types of injuries and sicknesses, including physical trauma, loss of consciousness, cardiac arrest and more. The FSD will continue to explore different measures to enhance emergency ambulance service. Note 1: The figure is provisional. The FSD generally needs one to two months to consolidate the record and figures to come up with exact figures. Note 2: In respect of the relevant cases, during the performance of their duties, the ambulance personnel learned that other members of the public in the vicinity were in need of emergency ambulance service, and they immediately provided service at the scene. Therefore, the arrival time of the relevant emergency ambulance calls was from 0 to 3 seconds. Note 3: In respect of the relevant cases, during the performance of their duties, the ambulance personnel learned that other members of the public in the vicinity were in need of emergency ambulance service, and they immediately provided service at the scene. Therefore, the arrival time of the relevant emergency ambulance calls was from 1 to 3 seconds.