Illawarra paramedics worked through another horror night on Wednesday, with more than a dozen ambulances queued outside Wollongong Hospital into the early hours of the morning.
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Paramedics say it was so busy that they ran out of room for stretchers in the emergency department corridor, and - with more than half the region's ambulances off the road waiting to unload - there was at least one "lights and sirens" Triple-0 call where a patient waited more than five hours for an ambulance.
A paramedic who worked Wednesday night said her colleagues and emergency department nursing staff were burnt out, but expected "bed block" and delays to become even more frequent as winter begins.
"It was bad last night because we had no room for any more ambulance stretchers in the corridor, so we had to get family members who were support people for our patients to go and wait in the waiting room - and that caused anxiety for them that they couldn't be with their loved one anymore," the paramedic said.
"At the moment, this is not unusual - and it's not from COVID, it's not from colds and flus, it's just since Christmas, we've been getting more and more delays. If we get out of [emergency] within two hours now, that's a good day."
She said the delays left sick patients in uncomfortable situations for hours.
"Our beds aren't made to be sat on for a number of hours, and a lot of the time we are dealing wit the elderly and their skin is already fragile, so then we're also dealing with prolonged pressure care," she said.
Health Services Union delegate Tess Oxley said there were 12 ambulances - out of 21 on shift or on call from Helensburgh to Bomaderry - parked in bays at about 8.30pm on Wednesday night.
"Wollongong had been experiencing delays throughout the afternoon, and then at night it started to escalate," she said.
"We say they are delayed if they have to wait more than 30 minutes, but we had cars stuck there for more than three hours. It continued until about 1am, when they were starting to offload patients but then I was getting messages at 7.30am to say that it was building up again."
She said the hospital system was so overwhelmed that there was not enough time for pressure to ease between shifts.
"The hospital is absolutely full, so there are no beds left for emergency department patients to move up to the wards, and that means there are no beds for patients in ambulances to get into emergency," she said.
She said paramedics were increasingly concerned by reports from other parts of NSW and around the country where patients have died outside hospitals waiting for emergency department beds or waiting for an ambulance.
"It's getting to point where paramedics are saying it's only time before this happens to one of us," she said.
Ms Oxley said almost all the ambulances which would normally service the northern part of the Illawarra had been left waiting at the hospital on Wednesday night.
"In this situation, ambulances respond to the to highest acuity patients as soon as they can, but it means responses to high acuity patients - so strokes and acute chest pains - are starting to get delayed responses," she said.
"In the low acuity cases, it means patients who might have had a fall are being stuck on the ground for four or five hours because of the flow on effects of the delays. If that was my family, I would be devastated."
Ms Oxley said the delays at the emergency department were becoming more frequent because the entire health system was under pressure.
"If you're waiting for four days to see a GP, there are going to be a lot of people who can't get that low acuity care that they need," she said.
"They either delay treatment, which then makes them quite unwell, or they are having to use the emergency department as their first line of treatment."
The Illawarra Shoalhaven Local Health District acknowledged the hospital had been experiencing high demand for emergency care and patient admissions in recent months.
"At the same time, teams have been managing the impacts of COVID-19, including the unavailability of staff due to illness," a spokesperson said.
"We activate well established workforce surge and demand management plans during periods of high demand, including increasing bed capacity in hospitals where possible, ensuring all available clinical staff are deployed to the care areas with the highest demand, and improving the timeliness of patient discharges with appropriate community follow-up support where required."
The district said patients who present to the ED with serious and life-threatening conditions, like heart attack and stroke, would always be seen immediately.
"With the support of our NSW Ambulance colleagues, we work collaboratively to ensure all patients are seen and treated as quickly as possible," the spokesperson said.
"Regardless of the mode of arrival to ED, all patients are triaged and seen by a doctor according to the seriousness of their condition. This means that patients with less urgent conditions may need to wait longer during periods of high demand, even those arriving via ambulance."
The district said people with "minor conditions" should go tomedical centres or GPs, the Urgent Care Centre at Bulli Hospital, pharmacies or call HealthDirect on 1800 022 222.
If the situation is life-threatening, people should always call Triple Zero (000) immediately go straight to the Emergency Department, the spokesperson said.
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