1 00:00:03,069 --> 00:00:05,269 Speaker 1: You're listening to a CNA podcast. 2 00:00:07,070 --> 00:00:10,430 Speaker 2: Hi everybody, uh, warm welcome back to another episode of 3 00:00:10,430 --> 00:00:12,629 Speaker 2: Deep Dive. Now today we are going to be talking 4 00:00:12,630 --> 00:00:14,750 Speaker 2: about something that you might need to use it at 5 00:00:14,750 --> 00:00:16,709 Speaker 2: some point in your life or you have. Uh, we're 6 00:00:16,709 --> 00:00:20,709 Speaker 2: talking about medical emergencies and ambulances. And speaking of which, Steve, 7 00:00:20,790 --> 00:00:23,909 Speaker 2: have you ever tried dialing 995? Yes, I have actually. Yeah. 8 00:00:24,069 --> 00:00:27,149 Speaker 2: So sometime back my dad fell down. He was 85 9 00:00:27,149 --> 00:00:27,549 Speaker 2: at the time. 10 00:00:27,836 --> 00:00:29,996 Speaker 2: down, you know, cut his head. There was blood, he 11 00:00:29,996 --> 00:00:32,116 Speaker 2: was semi-conscious, so we're a bit worried, didn't know what 12 00:00:32,116 --> 00:00:34,995 Speaker 2: to do. So we called 995 and the ambulance came. 13 00:00:35,296 --> 00:00:37,076 Speaker 2: And I think that's one of the most immediate responses 14 00:00:37,076 --> 00:00:40,436 Speaker 2: right because we are very familiar with 995, but there 15 00:00:40,436 --> 00:00:43,354 Speaker 2: is actually another option. It's called nurse first. So that's 16 00:00:43,354 --> 00:00:44,915 Speaker 2: what we want to talk about. There's a new helpline 17 00:00:44,915 --> 00:00:47,745 Speaker 2: called Nurse first so that if you have a non-emergency 18 00:00:47,745 --> 00:00:48,525 Speaker 2: case and you 19 00:00:48,601 --> 00:00:51,361 Speaker 2: Call up 995, they may divert you to this number 20 00:00:51,361 --> 00:00:53,762 Speaker 2: who can then address your concerns and point you in 21 00:00:53,762 --> 00:00:56,631 Speaker 2: the right direction to get medical help. Yeah, so we 22 00:00:56,631 --> 00:00:58,992 Speaker 2: are here to learn more about Nurse first. It's actually 23 00:00:58,992 --> 00:01:03,481 Speaker 2: a 6 month trial nationwide. And here with us today 24 00:01:03,481 --> 00:01:07,291 Speaker 2: we have Colonel Doctor David Fluke, Chief Medical Officer, Singapore 25 00:01:07,291 --> 00:01:09,281 Speaker 2: Civil Defense Force. Nice to meet everyone. 26 00:01:09,709 --> 00:01:13,300 Speaker 2: We also have Dr. Jadeua, a senior consultant in emergency 27 00:01:13,300 --> 00:01:16,540 Speaker 2: medicine department in Woodlands Health and also clinical lead for 28 00:01:16,540 --> 00:01:19,220 Speaker 2: the nurse first helpline. Hi guys, thanks for having me 29 00:01:19,220 --> 00:01:19,619 Speaker 2: here today. 30 00:01:19,930 --> 00:01:22,839 Speaker 2: OK, welcome guys. So let's give some people some idea 31 00:01:22,839 --> 00:01:25,720 Speaker 2: of just how crazy the number of calls are, you know, 32 00:01:25,879 --> 00:01:30,000 Speaker 2: because we were surprised. So SCDF responded to 245,000 calls 33 00:01:30,000 --> 00:01:37,029 Speaker 2: last year, which amounts to about 672 calls in a day. Wow, 34 00:01:37,360 --> 00:01:39,319 Speaker 2: there's a whole lot. David, can you share with us, 35 00:01:39,430 --> 00:01:42,430 Speaker 2: I mean, are all these calls emergency, what's the percentage 36 00:01:42,430 --> 00:01:44,360 Speaker 2: of them? What are some of the most bizarre calls 37 00:01:44,360 --> 00:01:46,550 Speaker 2: that you get? Well, I don't think it's so much 38 00:01:46,550 --> 00:01:48,669 Speaker 2: that they're bizarre. The first thing is to 39 00:01:48,722 --> 00:01:51,071 Speaker 2: The highlight is that there's been a very big difference 40 00:01:51,071 --> 00:01:53,192 Speaker 2: from just 10 years ago. I mean 10 years ago 41 00:01:53,192 --> 00:01:57,241 Speaker 2: we were seeing about 450 calls per day and suddenly 42 00:01:57,241 --> 00:02:01,101 Speaker 2: now it's ramped up to about 670, 680 calls per day. 43 00:02:01,431 --> 00:02:04,152 Speaker 2: Of that, of course, there are a lot that definitely 44 00:02:04,152 --> 00:02:08,382 Speaker 2: require emergency care, but there's a certain percentage, um, and 45 00:02:08,382 --> 00:02:10,792 Speaker 2: this is about 5 to 10 calls per day, which 46 00:02:10,792 --> 00:02:15,221 Speaker 2: are non-emergency and actually would not benefit from being evacuated 47 00:02:15,222 --> 00:02:17,391 Speaker 2: to hospitals through the EMS. 48 00:02:17,964 --> 00:02:21,184 Speaker 2: SCDF. So you're saying again out of 672 calls a day, 49 00:02:21,304 --> 00:02:24,003 Speaker 2: roughly 5 to 10 are just non-emergency calls. That's right. 50 00:02:24,304 --> 00:02:26,184 Speaker 2: What are they calling about? Give us an example. Well, 51 00:02:26,304 --> 00:02:28,744 Speaker 2: I mean, one example that I personally faced as emergency 52 00:02:28,744 --> 00:02:32,264 Speaker 2: physician at NUH was an elderly lady who called 995 53 00:02:32,264 --> 00:02:34,703 Speaker 2: who really needed help because she had ran out of 54 00:02:34,703 --> 00:02:38,304 Speaker 2: a prescription. There was nothing actually wrong with her in 55 00:02:38,304 --> 00:02:41,373 Speaker 2: terms of her physical health, but she just didn't know 56 00:02:41,623 --> 00:02:44,423 Speaker 2: where to get the help she needed out basically like 57 00:02:44,423 --> 00:02:46,184 Speaker 2: just maybe um oh no, you know. 58 00:02:46,305 --> 00:02:49,315 Speaker 2: What should I do next? Exactly. So what happened was 59 00:02:49,315 --> 00:02:52,136 Speaker 2: because this program wasn't in place at that time, she 60 00:02:52,136 --> 00:02:55,095 Speaker 2: was referred and came over to the emergency department and 61 00:02:55,095 --> 00:02:57,936 Speaker 2: we filled up her prescription. She ended up sitting in 62 00:02:57,936 --> 00:03:01,856 Speaker 2: the A&E for 2-3 hours before she's being seen because 63 00:03:01,856 --> 00:03:05,055 Speaker 2: it's a non-emergency case. All in all, she didn't really 64 00:03:05,055 --> 00:03:08,095 Speaker 2: get the appropriate help that she required. And now that's 65 00:03:08,095 --> 00:03:10,576 Speaker 2: what we're hoping to address some of these situations where 66 00:03:10,576 --> 00:03:13,416 Speaker 2: truthfully she needed some help, but probably just not from 67 00:03:13,416 --> 00:03:14,975 Speaker 2: the 995 number, right? 68 00:03:15,258 --> 00:03:16,960 Speaker 2: OK, so, so Jay, can you tell us a bit 69 00:03:16,960 --> 00:03:19,720 Speaker 2: about nurse first, you know, the idea behind it is 70 00:03:19,720 --> 00:03:21,960 Speaker 2: supposed to help alleviate some of that burden on the 71 00:03:21,960 --> 00:03:25,550 Speaker 2: emergency call system, right? And it's been around since 2022, 72 00:03:25,559 --> 00:03:28,720 Speaker 2: but it was just focused in the northern part of Singapore. 73 00:03:28,800 --> 00:03:31,399 Speaker 2: So now it's going to be nationwide. So um nurse 74 00:03:31,399 --> 00:03:34,559 Speaker 2: first is a medical triage helpline. So triage is a 75 00:03:34,559 --> 00:03:37,759 Speaker 2: concept of sorting out. We help the caller. 76 00:03:38,059 --> 00:03:41,580 Speaker 2: To understand how severe the condition might be and therefore 77 00:03:41,580 --> 00:03:44,580 Speaker 2: where they should seek help. So this could range from 78 00:03:44,580 --> 00:03:48,139 Speaker 2: going to the emergency department, it could range from going 79 00:03:48,139 --> 00:03:51,059 Speaker 2: to the urgent care center, going to a GP or 80 00:03:51,059 --> 00:03:55,169 Speaker 2: simply staying home and doing some self-care. So this is 81 00:03:55,169 --> 00:03:58,259 Speaker 2: really important work, it needs to be done quickly enough 82 00:03:58,259 --> 00:04:00,119 Speaker 2: so that the caller can get the right help that 83 00:04:00,119 --> 00:04:03,179 Speaker 2: they need, but it needs to be safe enough so 84 00:04:03,179 --> 00:04:04,889 Speaker 2: that the caller knows where to go. 85 00:04:05,279 --> 00:04:09,539 Speaker 2: So this concept of a medical triage helpline is something 86 00:04:09,539 --> 00:04:12,529 Speaker 2: that other countries do as well. So this already exists 87 00:04:12,529 --> 00:04:15,570 Speaker 2: in the UK, in Japan, and Denmark, and we're very 88 00:04:15,570 --> 00:04:18,339 Speaker 2: proud to do this now in Singapore. But help us 89 00:04:18,339 --> 00:04:20,700 Speaker 2: understand how it actually works. So when they call 995, 90 00:04:20,738 --> 00:04:24,149 Speaker 2: they say I've got this situation and then the person 91 00:04:25,130 --> 00:04:28,130 Speaker 2: Taking that 995 call will then do the first level 92 00:04:28,130 --> 00:04:31,609 Speaker 2: of triage, so to speak, as an evaluation, right? So 93 00:04:31,609 --> 00:04:33,920 Speaker 2: if you were to call the nurse first helpline itself, 94 00:04:33,950 --> 00:04:39,369 Speaker 2: which is 626-26262, then our trained nurses would assess what 95 00:04:39,369 --> 00:04:42,089 Speaker 2: the situation is and through a series of questions, guide 96 00:04:42,089 --> 00:04:43,649 Speaker 2: you on where to go. Can you give us some 97 00:04:43,649 --> 00:04:46,369 Speaker 2: examples like what kind of questions? So let's take a 98 00:04:46,369 --> 00:04:48,049 Speaker 2: typical example of chest pain. 99 00:04:48,410 --> 00:04:50,359 Speaker 2: So if a caller calls up and says, I have 100 00:04:50,359 --> 00:04:52,820 Speaker 2: chest pain, then our nurses are trained to ask them 101 00:04:52,820 --> 00:04:56,578 Speaker 2: a series of questions based on validated protocols and which 102 00:04:56,579 --> 00:05:00,820 Speaker 2: have professional medical oversight, and they'll ask them some questions 103 00:05:00,820 --> 00:05:04,049 Speaker 2: to determine that this is not a life threatening condition. 104 00:05:04,260 --> 00:05:06,570 Speaker 2: If it were a life threatening condition, we would say 105 00:05:06,820 --> 00:05:08,859 Speaker 2: you should call 995 so that an ambulance can take 106 00:05:08,859 --> 00:05:09,899 Speaker 2: you to the emergency department. 107 00:05:10,220 --> 00:05:12,279 Speaker 2: Um, and then down the line, right? So are the 108 00:05:12,279 --> 00:05:14,320 Speaker 2: questions that would help them to decide whether they should 109 00:05:14,320 --> 00:05:16,399 Speaker 2: go to an urgent care center or whether they can 110 00:05:16,399 --> 00:05:18,600 Speaker 2: go to a GP or stay home. So this is 111 00:05:18,600 --> 00:05:20,920 Speaker 2: the same process whether they come in for chest pain 112 00:05:20,920 --> 00:05:22,440 Speaker 2: or whether they call and say I've got back pain, 113 00:05:22,570 --> 00:05:24,239 Speaker 2: I've got tummy pain, I've got fever. 114 00:05:24,720 --> 00:05:28,269 Speaker 2: And so that's when people call 62626262. Is it a 115 00:05:28,269 --> 00:05:30,109 Speaker 2: nurse on the other side? That's right. So this is 116 00:05:30,109 --> 00:05:33,738 Speaker 2: a trained nurse she's trained in emergency and telephone triage 117 00:05:34,070 --> 00:05:36,970 Speaker 2: and um it's very, very safe and what we're actually 118 00:05:36,970 --> 00:05:40,070 Speaker 2: piloting this time around, what we're announcing is our collaboration 119 00:05:40,070 --> 00:05:44,029 Speaker 2: with 995. So if you were to call 995 and 120 00:05:44,029 --> 00:05:45,829 Speaker 2: the 995 dispatcher. 121 00:05:45,980 --> 00:05:50,250 Speaker 2: Discovers that this is not a life-threatening emergency, then they 122 00:05:50,250 --> 00:05:52,000 Speaker 2: would transfer the call to us at nurse first. So 123 00:05:52,000 --> 00:05:54,160 Speaker 2: I'm curious to know what has the public reaction been 124 00:05:54,160 --> 00:05:58,170 Speaker 2: for this pilot, right? They call 995, perhaps expecting ambulance, 125 00:05:58,250 --> 00:06:00,220 Speaker 2: you know, right at their doorstep, but then didn't happen, 126 00:06:00,410 --> 00:06:03,130 Speaker 2: you sort of redirected them to nurse first. What sort of, 127 00:06:03,170 --> 00:06:05,409 Speaker 2: have you got any, you know, sort of negative feedback 128 00:06:05,410 --> 00:06:10,730 Speaker 2: or really like irate uh patients? The EMS system provides 129 00:06:10,730 --> 00:06:14,529 Speaker 2: a certain level of certainty and uh Singaporeans do expect that. 130 00:06:15,269 --> 00:06:18,470 Speaker 2: So there is some change management required, but the assurance 131 00:06:18,470 --> 00:06:20,549 Speaker 2: that we give is this is really safe. We have 132 00:06:20,549 --> 00:06:23,910 Speaker 2: our own triage systems internally with the op center. There's 133 00:06:23,910 --> 00:06:26,549 Speaker 2: also further triage by nurse first and it's really about 134 00:06:26,549 --> 00:06:28,700 Speaker 2: making sure that you receive the care that you need, 135 00:06:28,769 --> 00:06:31,790 Speaker 2: that's matched according to your needs. We expect that it 136 00:06:31,790 --> 00:06:34,390 Speaker 2: will take some time for Singaporeans to accept this. 137 00:06:35,174 --> 00:06:37,614 Speaker 2: of the nurse first. But in general, we do have 138 00:06:37,613 --> 00:06:41,174 Speaker 2: positive cases and feedback and for things like um one 139 00:06:41,174 --> 00:06:44,334 Speaker 2: case I recall is one of a small amount of 140 00:06:44,334 --> 00:06:46,454 Speaker 2: burns because when you burn something, of course, your first 141 00:06:46,454 --> 00:06:47,695 Speaker 2: reaction if you don't know what to do is to 142 00:06:47,695 --> 00:06:51,015 Speaker 2: panic and then call 995. But honestly, most burns are 143 00:06:51,015 --> 00:06:53,135 Speaker 2: very small when you touch like a hot handle or 144 00:06:53,135 --> 00:06:53,734 Speaker 2: hot pan. 145 00:06:54,190 --> 00:06:57,880 Speaker 2: And that was something that nurse first can provide the reassurance, 146 00:06:57,928 --> 00:07:00,709 Speaker 2: the advice on the treatment and subsequent care plan about 147 00:07:02,470 --> 00:07:05,450 Speaker 2: that burn is like in your press release, you mentioned 148 00:07:05,450 --> 00:07:08,299 Speaker 2: burns which are like 15%. I mean, to the average person, 149 00:07:08,450 --> 00:07:12,290 Speaker 2: what is 15%? Yeah, and do you have video calls 150 00:07:12,290 --> 00:07:14,410 Speaker 2: to see like, oh, OK, this is actually a 20% 151 00:07:14,410 --> 00:07:19,209 Speaker 2: burn or like what sort of the actual protocol is 152 00:07:19,209 --> 00:07:20,260 Speaker 2: to describe to the 153 00:07:20,309 --> 00:07:22,339 Speaker 2: A person on the other end of the line, uh, 154 00:07:22,540 --> 00:07:24,820 Speaker 2: what is the size in terms of coin size and 155 00:07:24,820 --> 00:07:27,660 Speaker 2: palm size, and they would just estimate something that they 156 00:07:27,660 --> 00:07:30,500 Speaker 2: would understand and communicate and from there we do the 157 00:07:30,500 --> 00:07:34,380 Speaker 2: back-end medical processes. So we want to simply be able 158 00:07:34,380 --> 00:07:38,130 Speaker 2: to understand what the situation is like through the questions 159 00:07:38,130 --> 00:07:40,730 Speaker 2: that are on the protocol and just to answer your question, 160 00:07:40,820 --> 00:07:46,059 Speaker 2: your palm is 1%. 1%, that's right. 161 00:07:46,440 --> 00:07:47,779 Speaker 2: So 15% is like I freak out, right? So if you, 162 00:07:53,470 --> 00:07:56,040 Speaker 2: so just to highlight, if you did feel like something 163 00:07:56,040 --> 00:07:58,269 Speaker 2: bad is happening and you did feel like you were 164 00:07:58,269 --> 00:08:01,420 Speaker 2: freaking out, no one's saying that you shouldn't be calling 995. 165 00:08:01,910 --> 00:08:04,750 Speaker 2: So if you know that you say you're calling on 166 00:08:04,750 --> 00:08:06,510 Speaker 2: behalf of your grandpa and your grandpa looks like he's 167 00:08:06,510 --> 00:08:09,619 Speaker 2: having a heart attack, we're saying it's appropriate to call 995. 168 00:08:09,790 --> 00:08:11,750 Speaker 2: But if you weren't sure, let's say you sprained your 169 00:08:11,750 --> 00:08:12,519 Speaker 2: ankle and 170 00:08:12,570 --> 00:08:14,399 Speaker 2: You weren't sure, is this a fracture, is this a sprain? 171 00:08:14,510 --> 00:08:17,359 Speaker 2: Should I just put some rubbing ointment on it? Then 172 00:08:17,359 --> 00:08:20,670 Speaker 2: if you call the nurse was helpline, our nurses would 173 00:08:20,670 --> 00:08:24,630 Speaker 2: guide you on where to go. If you had called 995, 174 00:08:24,839 --> 00:08:28,399 Speaker 2: then the 995 call center would say, OK, this sounds 175 00:08:28,399 --> 00:08:31,200 Speaker 2: like this is not a life-threatening emergency. We're going to 176 00:08:31,200 --> 00:08:33,520 Speaker 2: now transfer the call to nurse first and nurses can 177 00:08:33,520 --> 00:08:37,000 Speaker 2: take it from there. Why? Because the 995 call center 178 00:08:37,000 --> 00:08:38,650 Speaker 2: is so busy and they 179 00:08:38,700 --> 00:08:42,829 Speaker 2: are highly trained professionals to be able to handle life-threatening situations. 180 00:08:42,840 --> 00:08:46,569 Speaker 2: They ask you a few questions to Mr. Tan, you 181 00:08:46,570 --> 00:08:49,450 Speaker 2: can actually call nurse helpline. They can help you with this. Well, 182 00:08:49,609 --> 00:08:51,530 Speaker 2: in this particular situation, what will happen is they will 183 00:08:51,530 --> 00:08:54,919 Speaker 2: transfer the call. That's right. So it makes it easier 184 00:08:54,919 --> 00:08:58,010 Speaker 2: process for the caller. So nurse first, you had one 185 00:08:58,010 --> 00:09:01,968 Speaker 2: single operator before this nationwide trial, two nurses that are 186 00:09:01,969 --> 00:09:04,690 Speaker 2: manning the line at any point in time, manning the lines. 187 00:09:04,859 --> 00:09:08,419 Speaker 2: 8 to 11, that's 8 to 11 every day including weekends, 188 00:09:08,539 --> 00:09:14,969 Speaker 2: public holidays, but just sounds so. Well, at the moment 189 00:09:14,969 --> 00:09:17,939 Speaker 2: it's enough, but we're monitoring the situation carefully. So should 190 00:09:17,940 --> 00:09:20,858 Speaker 2: we have to upscale the whole operation, we're ready to 191 00:09:20,859 --> 00:09:24,340 Speaker 2: do that. How does this compare to 1777? We've heard 192 00:09:24,340 --> 00:09:27,439 Speaker 2: about those that non-emergency number which you are also supposed 193 00:09:27,440 --> 00:09:30,098 Speaker 2: to call in a non-emergency situation. Is it the same 194 00:09:30,099 --> 00:09:30,830 Speaker 2: thing or is it different? 195 00:09:31,380 --> 00:09:34,960 Speaker 2: Well, I think in comparison, this is a nurse, a 196 00:09:34,960 --> 00:09:37,319 Speaker 2: clinician on the other end of the line. They can 197 00:09:37,320 --> 00:09:40,000 Speaker 2: provide advice not just on the right sighting, but also 198 00:09:40,000 --> 00:09:43,559 Speaker 2: on first aid, can advise appropriate management on site, uh, 199 00:09:43,599 --> 00:09:47,000 Speaker 2: on what they should do, and it's slightly different from 177. 200 00:09:47,039 --> 00:09:48,489 Speaker 2: That being said, 1777. 201 00:09:48,549 --> 00:09:51,289 Speaker 2: is going to be one of our alternative care pathways 202 00:09:51,500 --> 00:09:55,049 Speaker 2: that can be routed through nurse first if it's deemed 203 00:09:55,049 --> 00:09:58,359 Speaker 2: that it's appropriate for that patient. It's more for conveyance, 204 00:09:58,460 --> 00:10:01,140 Speaker 2: let's put it that way, whereas nurse first is a 205 00:10:01,140 --> 00:10:04,380 Speaker 2: medical triage helpline, so we'll be able to help you 206 00:10:04,380 --> 00:10:05,609 Speaker 2: to decide where to go. 207 00:10:06,359 --> 00:10:08,709 Speaker 2: How to get there and uh if you can stay home, 208 00:10:08,719 --> 00:10:10,479 Speaker 2: what sort of first aid you should do. What we 209 00:10:10,479 --> 00:10:13,839 Speaker 2: really want to do is to raise medical literacy in Singapore, right? 210 00:10:13,960 --> 00:10:16,559 Speaker 2: We want people to be able to figure out what's 211 00:10:16,559 --> 00:10:19,079 Speaker 2: going on with their bodies to understand, you know, what 212 00:10:19,080 --> 00:10:21,909 Speaker 2: kind of medication to take, how to do first aid 213 00:10:21,909 --> 00:10:24,750 Speaker 2: at home for things like burns, but that's super important. 214 00:10:24,919 --> 00:10:27,880 Speaker 2: We want to make sure that the paramedics who are 215 00:10:27,880 --> 00:10:31,839 Speaker 2: trained to handle life threatening situations and the emergency physicians 216 00:10:31,840 --> 00:10:35,200 Speaker 2: who are trained to handle life-threatening situations are able to 217 00:10:35,200 --> 00:10:35,760 Speaker 2: do that. 218 00:10:35,872 --> 00:10:39,372 Speaker 2: The work efficiently without them seeing maybe the kinds of 219 00:10:39,372 --> 00:10:42,083 Speaker 2: cases that we better suited for a GP for instance. 220 00:10:42,293 --> 00:10:43,913 Speaker 2: But here's one other question. So we have to come 221 00:10:43,913 --> 00:10:46,492 Speaker 2: back to the operating hours of nurse first. It ends 222 00:10:46,492 --> 00:10:49,002 Speaker 2: at 11 p.m. at night. What is the peak for 223 00:10:49,002 --> 00:10:52,802 Speaker 2: emergency calls like like you know like 5 to 7 224 00:10:52,802 --> 00:10:55,843 Speaker 2: or like morning time when families are rushing their kids. 225 00:10:56,692 --> 00:10:59,093 Speaker 2: I mean, in general, when people are up, they're busy, 226 00:10:59,192 --> 00:11:01,802 Speaker 2: they're traveling, that's when we have a lot of emergency 227 00:11:01,802 --> 00:11:05,093 Speaker 2: situations occur peak in the in the 7 to 9. 228 00:11:05,995 --> 00:11:07,825 Speaker 2: 5 to 7. That's right. So we tend to see 229 00:11:07,825 --> 00:11:10,625 Speaker 2: peaks then we usually have reduced load during when it's 230 00:11:10,625 --> 00:11:14,856 Speaker 2: after dark, and we cater manpower for that as well. 231 00:11:15,995 --> 00:11:19,306 Speaker 2: So now after office hours, so after 11 p.m. if 232 00:11:19,306 --> 00:11:22,106 Speaker 2: there's no nurse first hotline to call, what happens then? 233 00:11:22,265 --> 00:11:26,245 Speaker 2: So the default, of course, 995 is available for 24/7, 234 00:11:26,666 --> 00:11:32,905 Speaker 2: we have no public holidays off. OK, OK, OK, so 235 00:11:32,905 --> 00:11:35,296 Speaker 2: can call you anytime. Yeah, no, I switch off my phone. 236 00:11:35,969 --> 00:11:39,159 Speaker 2: And I remember I read somewhere this guy, he drank 237 00:11:39,159 --> 00:11:41,429 Speaker 2: 3 cans of beer and I think he couldn't urinate 238 00:11:41,429 --> 00:11:44,469 Speaker 2: and then he called up 995 for instance. So what, 239 00:11:44,580 --> 00:11:47,500 Speaker 2: what I mean what sort of unusual calls do you get, 240 00:11:47,580 --> 00:11:50,619 Speaker 2: you know, the most recent one you can recall. I 241 00:11:50,619 --> 00:11:56,380 Speaker 2: don't be shy. More critically, to every single patient, their challenge, 242 00:11:56,419 --> 00:11:58,978 Speaker 2: their medical problem is of course of utmost importance to them. 243 00:11:59,460 --> 00:11:59,799 Speaker 2: We need 244 00:11:59,844 --> 00:12:03,275 Speaker 2: To see things from a systems perspective and which means 245 00:12:03,275 --> 00:12:06,744 Speaker 2: we need to hear our response accordingly. So yes, everyone 246 00:12:06,744 --> 00:12:09,715 Speaker 2: who feels that their situation is an emergency can call 995, 247 00:12:09,994 --> 00:12:12,635 Speaker 2: and we need some flexibility which Nurse first provides for 248 00:12:12,635 --> 00:12:15,895 Speaker 2: us to hear that response accordingly. I'm not saying the 249 00:12:15,895 --> 00:12:18,593 Speaker 2: example you really shouldn't call 995. In fact, if I 250 00:12:18,594 --> 00:12:21,354 Speaker 2: couldn't pass urine, I'd be very worried. I would definitely 251 00:12:21,354 --> 00:12:23,965 Speaker 2: call 995 because the guy already. 252 00:12:24,539 --> 00:12:27,510 Speaker 2: That's why this brain wasn't, you know, telling the thing 253 00:12:27,510 --> 00:12:29,900 Speaker 2: what to do. So give us more examples, right? Like 254 00:12:29,900 --> 00:12:36,520 Speaker 2: 995 and then versus you know nurse first headache toothache. Yeah, 255 00:12:36,530 --> 00:12:38,599 Speaker 2: define what is considered an emergency and when is it 256 00:12:38,599 --> 00:12:41,069 Speaker 2: not considered an emergency. I know it's very hard, but 257 00:12:41,070 --> 00:12:42,080 Speaker 2: give us some idea. 258 00:12:44,340 --> 00:12:47,549 Speaker 2: So an example. So there was a case where someone 259 00:12:47,549 --> 00:12:51,309 Speaker 2: was eating crap and then bit down and then subsequently 260 00:12:51,309 --> 00:12:56,468 Speaker 2: had tooth pain and then my mom actually lost. This 261 00:12:56,469 --> 00:13:00,869 Speaker 2: happens pretty frequently to that individual. It is severe pain 262 00:13:00,869 --> 00:13:05,409 Speaker 2: and extremely uncomfortable and for sure it seems like an emergency, 263 00:13:05,590 --> 00:13:06,299 Speaker 2: but from a 264 00:13:06,362 --> 00:13:09,913 Speaker 2: Medical perspective, from a systems perspective, this will be more 265 00:13:09,913 --> 00:13:12,793 Speaker 2: appropriate place by giving first aid advice through nurse first 266 00:13:12,793 --> 00:13:15,992 Speaker 2: and then rerouting to an appropriate dental physician or dental 267 00:13:15,992 --> 00:13:19,713 Speaker 2: surgeon according the term non life threatening an indicator as 268 00:13:19,713 --> 00:13:22,312 Speaker 2: in like, yes, it hurts, but I know I will 269 00:13:22,312 --> 00:13:24,393 Speaker 2: live to see another day, you know. Yes, I think 270 00:13:24,393 --> 00:13:27,663 Speaker 2: that's a good term to describe a category of cases, 271 00:13:27,672 --> 00:13:29,872 Speaker 2: but it's difficult to convey that over the 272 00:13:29,926 --> 00:13:32,434 Speaker 2: Phone to the caller, which is why the nurses are 273 00:13:32,434 --> 00:13:34,966 Speaker 2: trained to ask certain questions. First of all, to make 274 00:13:34,966 --> 00:13:38,596 Speaker 2: sure that this isn't a life-threatening emergency. So for your 275 00:13:38,596 --> 00:13:40,795 Speaker 2: example of someone who calls him with a headache, if 276 00:13:40,796 --> 00:13:43,195 Speaker 2: this was the person's like the worst headache of their lives, 277 00:13:43,276 --> 00:13:45,986 Speaker 2: if this is associated with fever and a scary rash, 278 00:13:45,995 --> 00:13:49,356 Speaker 2: you know, then we're thinking about big emergencies, then that 279 00:13:49,356 --> 00:13:52,555 Speaker 2: caller would be led to call 995 or go to 280 00:13:52,556 --> 00:13:53,395 Speaker 2: the emergency room. 281 00:13:53,750 --> 00:13:55,929 Speaker 2: Um, but if it turns out that this was an 282 00:13:55,929 --> 00:13:58,880 Speaker 2: infrequent headache, this was a typical headache for this patient, 283 00:13:59,450 --> 00:14:01,968 Speaker 2: usually results with some medication, and down the line it's 284 00:14:01,969 --> 00:14:04,689 Speaker 2: sort of discovered that this is not something that requires 285 00:14:04,690 --> 00:14:08,409 Speaker 2: a 995 ambulance to bring them to an emergency department, 286 00:14:08,489 --> 00:14:10,569 Speaker 2: then they might say, do you know what, maybe you 287 00:14:10,570 --> 00:14:13,109 Speaker 2: can wait till morning and go to the GP. I 288 00:14:13,109 --> 00:14:14,000 Speaker 2: also want to ask you 289 00:14:14,049 --> 00:14:16,439 Speaker 2: Some time back I I learned about urgent care centers. 290 00:14:16,580 --> 00:14:18,119 Speaker 2: You mentioned that briefly, but I think a lot of 291 00:14:18,119 --> 00:14:21,469 Speaker 2: people are not aware that there's an option to visit 292 00:14:21,469 --> 00:14:24,520 Speaker 2: an urgent care center which provides almost the same facilities 293 00:14:24,520 --> 00:14:28,190 Speaker 2: as A&E for so-called non life threatening. So you break 294 00:14:28,190 --> 00:14:30,840 Speaker 2: your leg, you have a bitten into a chili crab 295 00:14:30,840 --> 00:14:33,119 Speaker 2: and it's stabbing you, you can go to an urgent 296 00:14:33,119 --> 00:14:34,349 Speaker 2: care center for those, right? 297 00:14:34,659 --> 00:14:38,159 Speaker 2: So why has that sort of not really taken off? 298 00:14:38,200 --> 00:14:40,960 Speaker 2: I mean, and is that something that we are still addressing? 299 00:14:41,070 --> 00:14:42,799 Speaker 2: Should people still be looking at that as an option 300 00:14:42,799 --> 00:14:46,280 Speaker 2: as well? If one were to call up nurse first, 301 00:14:46,330 --> 00:14:49,080 Speaker 2: then our nurses would be trained to guide you towards 302 00:14:49,080 --> 00:14:51,000 Speaker 2: either going to the urgent care center or a GP 303 00:14:51,000 --> 00:14:54,039 Speaker 2: or staying home. So this is because different centers like 304 00:14:54,039 --> 00:14:57,320 Speaker 2: the emergency department, urgent care center, GP obviously your own home. 305 00:14:57,409 --> 00:15:00,570 Speaker 2: You're differently equipped, you know, and so um you're scoped 306 00:15:00,570 --> 00:15:03,559 Speaker 2: out to deal with different kinds of conditions. So I 307 00:15:03,559 --> 00:15:06,080 Speaker 2: mean back to the whole aging population, right? I would 308 00:15:06,080 --> 00:15:10,200 Speaker 2: imagine the the workload would also increase right with the calls. 309 00:15:10,320 --> 00:15:12,469 Speaker 2: Do you think there's certain other areas that also need 310 00:15:12,469 --> 00:15:14,909 Speaker 2: to shift? I don't know like polyclinics, I don't know, 311 00:15:14,919 --> 00:15:17,349 Speaker 2: opening a bit later or more or like, you know, 312 00:15:17,640 --> 00:15:20,119 Speaker 2: certain areas that perhaps would be looked into? 313 00:15:20,359 --> 00:15:23,950 Speaker 2: Yeah, well, nationally, there's many, many different initiatives that are 314 00:15:23,950 --> 00:15:27,229 Speaker 2: looking at this piece which we call alternate care pathways. 315 00:15:27,349 --> 00:15:30,469 Speaker 2: Nurse First is one part of that solution. We're working 316 00:15:30,469 --> 00:15:33,270 Speaker 2: together with a lot of the polyclinics, with a lot 317 00:15:33,270 --> 00:15:36,270 Speaker 2: of the different aging centers and things like that to 318 00:15:36,270 --> 00:15:38,710 Speaker 2: see what we can do to help to bridge different 319 00:15:38,710 --> 00:15:41,580 Speaker 2: gaps for different populations and like you rightly pointed out, 320 00:15:41,590 --> 00:15:43,469 Speaker 2: the aging population is one of concern. 321 00:15:43,780 --> 00:15:45,789 Speaker 2: So we do need to, uh, we're working on that 322 00:15:45,789 --> 00:15:47,869 Speaker 2: piece and how to better site care for them, particularly 323 00:15:47,869 --> 00:15:51,130 Speaker 2: in the community, because community care of the elderly is 324 00:15:51,130 --> 00:15:53,469 Speaker 2: well known to have better outcomes than actually care in 325 00:15:53,469 --> 00:15:55,630 Speaker 2: the hospital. So this is a piece that we hope 326 00:15:55,630 --> 00:16:00,340 Speaker 2: to explore in the upcoming few years. Yeah, just to 327 00:16:00,340 --> 00:16:02,979 Speaker 2: educate the public on because you know. 328 00:16:03,215 --> 00:16:06,645 Speaker 2: I feel like there's so many things that Singaporeans can 329 00:16:06,645 --> 00:16:10,405 Speaker 2: do to help themselves, to help as caregivers, but maybe 330 00:16:10,405 --> 00:16:12,244 Speaker 2: they just don't know how to do that. I'm just 331 00:16:12,244 --> 00:16:14,405 Speaker 2: also curious to know which are some of the countries 332 00:16:14,405 --> 00:16:18,284 Speaker 2: whose EMS services are excellent and that it would be, 333 00:16:18,364 --> 00:16:20,405 Speaker 2: we can copy bits of it that would be ideal 334 00:16:20,405 --> 00:16:22,565 Speaker 2: for Singapore's population and all that. 335 00:16:23,179 --> 00:16:25,900 Speaker 2: Well, we do actually engage with a lot of other 336 00:16:25,900 --> 00:16:28,659 Speaker 2: countries to learn lessons from them, but in particular, this 337 00:16:28,659 --> 00:16:31,409 Speaker 2: nurse first type solution is one that's been rolled out, 338 00:16:31,419 --> 00:16:35,369 Speaker 2: I think in UK, Denmark, Japan, Finland, quite a number 339 00:16:35,369 --> 00:16:38,979 Speaker 2: of countries with very mature EMS systems and we are 340 00:16:38,979 --> 00:16:41,469 Speaker 2: trying to adopt best practices from all these countries and 341 00:16:41,520 --> 00:16:44,390 Speaker 2: Yeah, further exploring other parts of other solutions from other 342 00:16:44,390 --> 00:16:49,609 Speaker 2: countries as well. So in a nutshell, life-threatening emergency call 995, 343 00:16:49,669 --> 00:16:52,989 Speaker 2: but do know that there is a nurse first option 344 00:16:52,989 --> 00:16:58,549 Speaker 2: for non-emergency cases which is 626-26262. So those are the 345 00:16:58,549 --> 00:17:01,030 Speaker 2: two numbers we now need to know. Yeah, if you 346 00:17:01,030 --> 00:17:06,760 Speaker 2: feel an emergency, call 995. If not, call 626-26262. 347 00:17:07,609 --> 00:17:10,729 Speaker 2: I just keep dialing 2 until the line is picked 348 00:17:10,729 --> 00:17:12,770 Speaker 2: up by someone, you know, yeah. Alright guys, this has 349 00:17:12,770 --> 00:17:14,250 Speaker 2: been an episode of Deep Dive. Thanks so much for 350 00:17:14,250 --> 00:17:16,689 Speaker 2: joining us. We hope you've learned something and you now 351 00:17:16,689 --> 00:17:19,770 Speaker 2: know who to call in light of that situation. Let's 352 00:17:19,770 --> 00:17:22,530 Speaker 2: give a shout out to our team. We have Tiffany Ong, 353 00:17:22,609 --> 00:17:26,770 Speaker 2: Junai Johari, Joanne Chan, Saya Win, Allison Jenna, and also 354 00:17:26,770 --> 00:17:29,010 Speaker 2: video by Hanida Amin. Thank you so much and see 355 00:17:29,010 --> 00:17:29,449 Speaker 2: you now.