A STROKE victim's two-hour wait for an ambulance could have been avoided had his physician followed correct procedure and the severity of the problem been better communicated to emergency dispatch staff, department head Edward Schultz said last night.

Dr. Schultz, the hospital's Emergency Services director, spoke out in defence of his team after Mid-Ocean News writer Jessie Moniz, complained in her Major Irritants column last week about the slow response time of ambulances in two separate incidents - a grandfather who suffered a mild stroke waited two hours, and a young man, tossed through a car windscreen, lay bleeding for 60 minutes.

According to Dr. Schultz, the dispatch system performed successfully on both those occasions, but, recognising it has failings, it is now being restructured by medical personnel.

"Ms Moniz failed to reveal in her account that the stroke patient was initially examined at home by a general practitioner who actually made the call for assistance," the doctor said.

"That physician chose to use the direct seven-digit Emergency Department phone number which is generally reserved for routine transports instead of the 911 system. We realise at King Edward VII Memorial Hospital, that there's room for improvement with the dispatch system, and we are working on that. It is in the process of being civilianised and we're looking at 12 as being the optimal number."

In her article, Boston-based Ms Moniz wrote that although the patient rang KEMH for assistance at his St. George's home at 3.45 p.m., the ambulance did not show until 6 p.m. - with another patient in it.

According to Dr. Schultz, the ambulance left KEMH at 4.22 p.m. as a routine call but was diverted en route to another patient in the East End with an acute medical emergency. Hospital staff, he said, called the stroke patient and advised him of what was happening and the two were delivered to KEMH at 5.53 p.m.

Had the stroke victim's GP used the 911 system to call the hospital, or explained that it was an acute rather than a routine case, his patient would have been collected faster.

The second incident, in which Ms Moniz wrote of a young man being forced to wait an hour for an ambulance, is even more misrepresented, according to Dr. Schultz (pictured right). In that instance, documented by Fire Service Personnel times, the ambulance arrived at the accident scene within nine minutes.

On average, said Dr. Schultz, the dispatch centre - manned by two operators - receives between ten and 12 acute calls for emergency medical assistance each day. Acute cases, he explained, are those requiring emergency medical attention while routine cases do not.

"We get a lot of routine calls," he explained. "We might, for example, be asked to transport someone from Lefroy House to the hospital for (general tests). But that's not an acute medical condition."

The procedure the general practitioner should have followed is one that has been in place since February of 1999, Dr. Schultz said.

"Since (then) all acute calls for emergency medical assistance are supposed to be vetted through the 911 system which then transfers the call to the Emergency Medical Dispatcher at the Fire Control Centre of Bermuda Fire Services.

"Had the call (for the stroke victim) been made in this manner, not only would the KEMH ambulance have been dispatched immediately, but Bermuda Fire Service EMTs at the East End would have been dispatched simultaneously - assistance reaching the patient virtually within minutes.

"It's not the first time we've been accused unfairly," he added, referring to a stabbing incident where it was alleged the victim waited 20 minutes for an ambulance to arrive when in fact the response time was seven minutes.

"The public takes it as verbatim if it appears in the newspaper. We always seem to be the fall guys. (In the case of the stroke victim), I am somewhat restricted in what I can say, but I think one of the problems here was that no sense of urgency was communicated to the dispatcher.

"I can say that what I intend to do as a result of this is to put out a notice to physicians to remind them that if they have an acute medical call, not to use the seven-digit Emergency Department phone number."