INEM investigates why local firefighters were not sent to man in cardiac arrest

INEM, the country’s institute of medical emergency has launched an internal investigation after a 48-year-old man died following a cardiac arrest in Caldas das Taipas, over which emergency responders from a more distant fire brigade were dispatched instead of the local unit.

The incident occurred just one day after the Union of Pre-Hospital Emergency Technicians (STEPH) warned that INEM’s new emergency call management system is failing – alleging it has slowed the dispatch of ambulances and other emergency resources.

INEM denies the union’s claims, but this latest incident seems to uphold them.

Local brigade left out

According to INEM, the emergency call was received at 12:52pm on Saturday, reporting that the 48-year-old man was in cardiac arrest.

The institute said CODU, the Urgent Patient Guidance Centre, immediately classified the incident as a highest-priority emergency and dispatched a physician-led emergency and resuscitation vehicle (VMER) from Guimarães at 12:55pm, followed by an ambulance from the Guimarães Volunteer Fire Brigade at 12:58pm.

Telephone-guided cardiopulmonary resuscitation (CPR) instructions were also provided to the caller while emergency crews travelled to the scene.

At 1:26pm, the VMER team confirmed the man’s death.

However, the decision to send firefighters from Guimarães rather than the nearby Caldas das Taipas Volunteer Fire Brigade has prompted questions.

The Taipas brigade, whose operational area includes the location of the incident, said it could have reached the victim within three to five minutes. By contrast, firefighters from Guimarães had to travel around nine kilometres, taking approximately 14 minutes to reach the scene.

José Augusto Ferreira, acting commander of the Taipas Volunteer Fire Brigade, said the local station had personnel and vehicles fully available when the emergency occurred.

“We were astonished when we saw on social media that Guimarães had been sent into our operational area by CODU (…) we had all the necessary resources ready and were never notified,” he said.

Ferreira suggested the incident may have resulted from an error in geolocation or dispatch procedures, and said the brigade was awaiting a detailed explanation from CODU.

Ironically, Taipas firefighters were only called after the man’s death had been confirmed—to remove the body, acting commander Ferreira added.

INEM has said the dispatch decision will now be the subject of an internal review to verify all procedures and determine why emergency resources were allocated as they were.

In the meantime, the institute has said: “The activation of emergency resources is carried out by CODU based on the clinical assessment of the incident and the operational information available at the time of dispatch, with the aim of ensuring the fastest and most appropriate response.”

Union claims new system is slowing responses

This worrying incident came just a day after STEPH publicly criticised INEM’s new emergency call management platform, claiming the software had effectively “collapsed” during Friday’s operations.

Union president Rui Lázaro said operators experienced severe delays and intermittent system failures that forced some staff to record emergency call information manually on paper.

According to the union, problems have persisted since the new platform was introduced in June, reaching their worst point on Friday.

Lázaro added that, at one stage, 57 emergency calls were waiting to be answered. To relieve pressure, INEM temporarily reassigned two emergency medical technicians from an ambulance in Lisbon to answer calls inside the CODU operations centre.

The union argues the difficulties extend beyond technical glitches.

Under the previous dispatch system, operators could activate emergency resources with just two mouse clicks, said Lázaro. The new software requires nine separate steps, increasing the time needed to dispatch ambulances and other emergency units during potentially life-threatening situations.

STEPH has urged INEM to suspend the new platform and temporarily return to the previous system until the problems are resolved.

INEM rejects allegations

INEM however has categorically rejected the union’s description of events.

The institute said claims that staff had been forced to carry out paper-based triage were “categorically false” and insisted that all clinical and operational records on Friday were processed through the official digital systems.

It acknowledged that call volumes have risen sharply in recent weeks but said operational capacity has been reinforced, with all CODU workstations fully staffed and resources adjusted according to demand.

INEM also confirmed that two emergency medical technicians had been reassigned from ambulance duties to the Lisbon operations centre, but said this was part of a pre-planned operational strategy for periods of exceptionally high call volumes and was unrelated to any software malfunction.

The institute also pointed to its callback system, which allows operators to return missed emergency calls if callers disconnect before being answered.

Source material: SIC Notícias/ healthnews.pt