They had been kept secret until now.

They expose how ordinary Queenslanders in need called paramedics under “extreme pressure” who could not rapidly respond due to hospital ramping and surging workloads.

The Queensland Ambulance Service “Significant Incident Review” cache details at least 20 instances where people died after ambulance delays.

This was all between January 2021 and April 2022.

Service under ‘extreme pressure’

An elderly woman living in a Burleigh Heads nursing home died while waiting for an ambulance to arrive, with “extreme pressure” on the service and hospital ramping delaying paramedics by more than two hours.

She had been struggling with chest pain and lung issues for three days, with a doctor ordering she be taken to John Flynn Hospital

“Extreme pressure” on the ambulance service, including 15 pending Code 2 cases, two-hour delays at Gold Coast University Hospital and Robina Hospital, meant an ambulance was not dispatched until 2 hours and 16 minutes after the initial call-out.

The report stated both hospitals on the Gold Coast were on “level 3 escalations with bed blocking of a mixture of Covid and medical patients”.

“The Gold Coast Local Ambulance Service Network (GCLASN) had been experiencing extreme pressure from community demand, this resulted in a pending workload at the time of this case and extensive hospital delays at both GCHHS hospitals”

‘Pending queue’ for an hour

A woman who called QAS complaining of abdominal pain with vomiting and dizziness died at home after her case was put in the “pending queue” for an hour.

At 12.59pm, the same time an ambulance was dispatched to the scene, the woman’s sister called up to say the pair had been speaking when the patient “groaned in pain” and dropped the phone.

Wrong address – 506km away

An ambulance call-taker incorrectly logged the address of a man found unresponsive on his couch by his wife as a home in Taroom, in Central Queensland.

The mistake was realised nine minutes later, with paramedics arriving at the correct address in Oxenford — 506km away — about 15 minutes after the initial call.

The man was treated at the scene but was declared dead at 5.10pm.

‘Demand for services exceeded’

An elderly woman who fell at her aged care home, potentially fracturing her leg right below her hip, lay on the floor for nearly six hours waiting for paramedics because “demand for services exceeded” QAS resources available that night

There was an average of 41 Code 2 and 9 Code 1 cases pending every 15 minutes between 7.45pm that night to 12.44am the next day.

The report showed the initial ambulance was diverted to another case where someone had fallen and was having a fit, while the second ambulance was diverted to a case where someone had self-harmed with a knife.

No suitable resources available

An elderly woman living at Regis The Gap Aged Care Facility waited more than three hours for paramedics to arrive after suffering a fall and was only taken to hospital “critically unwell” just after midnight.

She died later that day.

The review found there had been “no alternative more suitable resources available”.

Extreme demand for services

A woman suffering thoughts of suicide called for help just after noon, with “extreme demands for service” across southeast Queensland leading to an ambulance reaching the scene more than two hours later.

The woman committed suicide while waiting.

The report revealed there had been a 20.7 per cent spike in triple-0 calls to QAS that day, with ambulances ramped across Redcliffe, Prince Charles, RBWH, and Caboolture hospital — including one who waited at Redcliffe for two hours and five minutes.

“The QAS was experiencing extreme demand for service and (emergency department) pressures across SEQ, which affected paramedic availability at the time of the request, with a high number of pending Code 2A cases,” the report stated.

The QAS ended up losing 186 hours of paramedics availability on February 15 — the equivalent of nearly eight days.

A second ambulance, dispatched after the first one was diverted to another case, was made to swing around to Roma Street Ambulance Station to pick up a student paramedic “slightly further delaying” the response.

Paramedics arrived on scene at 2.55pm.

Ambulance diverted to higher priority incident

A woman who fell from her bed waited 3.5 hours for paramedics to arrive, suffering a stroke in the interim that led to vomiting, dizziness and slurred speech.

She never recovered, dying six days later.

The report revealed QAS on the Gold Coast was “experiencing high demand” that day, with delays at both hospitals in the area resulting in the woman being put on a “pending queue”.

An ambulance was not assigned to her until 12.39am, but was diverted 12 minutes later to a higher priority incident.

The next unit arrived on scene at 1.04am, deemed her to be suffering from a suspected stroke, and took her to Gold Coast University Hospital.

Flat-lined in ambulance ramped for 48 minutes

A woman suffering chest tightness and dizziness flatlined in an ambulance outside Caboolture Hospital after being ramped for 48 minutes.

The woman had gone to her GP in Morayfield on March 1, with the doctor deeming her symptoms serious enough to call QAS.

They waited just 4 minutes between the call and paramedics arriving, with the ambulance taking off from the GP clinic about 7.37pm — only to sit behind four other ramped ambulances including one that had been there for one hour and eight minutes.

While in the ambulance the woman’s heart rate dropped to 30bpm before becoming unresponsive.

Paramedics were able to revive her and she was handed over to the hospital’s resuscitation unit.

High workload, extreme pressures

A man whose family was told to take him to hospital in their car due to ambulance delays died of a heart attack a few hours later

The man’s family called QAS just after midnight, saying he was suffering from a runny nose, coughing and sweating.

The man’s son called back 25 minutes later and was told the QAS had a “high workload” with “extreme pressures” being felt since 9.45pm the previous day with the call taker then suggesting the family take the man to hospital themselves.

They headed to the renal unit of the Gold Coast University Hospital, but was directed be security to head to the emergency department.

Once he got there about 1.21am the man suffered a heart attack and was resuscitated by staff.

Unfortunately he died about 6am that day.

Response time impacted by staff vacancies

A person who had difficulty breathing was found unconscious by paramedics when they arrived 45 minutes later, but they could not be revived.

An internal review found the under pressure dispatcher should have sent the closest ambulance unit available, a critical care paramedic who was the only crew free in area, but did not.

A “high demand” for ambulance services and a “high number of unscheduled staff vacancies” also impacted response time.

Four unsuccessful attempts to dispatch crews

A 91-year-old woman later deemed “severely septic” died in the emergency department after waiting nearly three hours for paramedics.

The woman started off with abdominal pain which became progressively worse as she waited, with paramedics turning up at 1.17am to find she was “severely septic”.

According to the review “high community demand” led to “some delays” in getting patients from ambulances into hospitals, with four attempts to dispatch crews to the woman unsuccessful after being redirected to higher priority cases.

Thirty-nine paramedic shifts unfilled

An intoxicated man having a mental health episode ultimately died of a heart attack next to his bed after waiting eight hours and 42 minutes for paramedics to arrive.

There was significant ambulance ramping across southeast Queensland that day a review found, with 60 vehicles stuck across the region’s emergency departments, some for three hours.

The demand for ambulance services was also so high there were 42 Code 2 and 3 Code 1 incidents pending when the call to help the man came through, with one case pending for six hours and 28 minutes at the time.

There were also about 39 paramedic shifts that went unfilled in the Metro North, South and West Moreton region over May 4 and 5, including 15 absences for the night shift at Metro South.

“The QAS response delay to attend the patient arose due to a number of pressures affecting paramedic availability to respond to emergency cases in the community.

“This included a high demand for ambulance services across South Eastern Queensland, a high number of unscheduled staff vacancies in the Brisbane area which were unable to be backfilled … (and) delays offloading patients at Metro North and Metro South HHS”

Missed opportunities in fumbled QAS response

There were “numerous missed opportunities” in a fumbled QAS response that involved a 69-year-old woman dying after waiting 9 hours and 16 minutes for paramedics despite six triple 0 calls being made.

But there had also been “extreme hospital days” and “very high demand” across the Metro North and Metro South areas, which impacted “paramedic availability” according to an internal QAS review.

The woman, who had just been let out of hospital after 11 days for urinary retention, complained of severe abdominal pain, vomiting and weakness with the first triple 0 call logged at 2.02am.

By 8.56am, when the woman’s family had made the fourth triple 0 call, there was potential for the woman to be in sepsis and by 10.44am the QAS rejigged the case and declared it a stroke.

An ambulance was dispatched but then diverted to a higher priority case, with the next crew activated at 11.06am with a “non-divert” notification in place. Paramedics declared her dead.

“During the night of 12 June there was very high demand for service across the Metro South LASN and Metro South response areas that continued into the day with SEQ Escalation of “Extreme Hospital Delays” affecting paramedic availability”.

Extreme escalation on workload

An elderly man living in an aged care facility died after an “avoidable” 27-minute delay in dispatching an ambulance despite “multiple units” being available for response.

A review of the case found the workload placed on the clinical deployment supervisors that night “may have impacted” on their abilities to work through normal protocol, with the southeast Queensland region at “extreme escalation” on workload and resource availability.

Four crews diverted to higher priority cases

A woman who fell and hit her head waited 3.5 hours for an ambulance and ended up dying later that day, with the cascading impact of significant ramping and a lack of resources to blame.

An internal review found the Metro South ambulance service area was 12 officers down on day shift while 18 afternoon shifts were unfilled that day.

Four ambulance crews were dispatched to the woman in quick succession, but each was diverted to higher priority cases, with the situation made worse by bad ramping at hospitals across the south by midmorning.

According to the review by 10am there were 13 ambulances ramped at the five hospitals in the area — Logan Community, Redlands, Queen Elizabeth II, Princess Alexandra and Mater — one for up to 1 hour and 40 minutes.

“Delayed response resulted from impacts on paramedic availability due to Metro South HHS workload, staffing and hospital delay pressures.”

Significant issues with ramping

An elderly woman’s heart gave out after being ramped in an ambulance at Gold Coast University Hospital for an hour, with a review revealing both hospitals in the area had significant issues with ramping that night.

The woman was nearly “bypassed” to be sent to Robina Hospital in a bid to spread the workload, but paramedics decided to take her to GCUH where there were 10 ambulances ramped including one that had been there for 55 minutes when they arrived.

An hour into waiting in the ambulance, the woman went into cardiac attest and could not be resuscitated.

The QAS review found both GCUH the Robina Hospital were dealing with significant workloads, with 165 people being treated across both emergency departments and another 36 waiting to be seen.

Ambulance ramped for 3 hours, 32 minutes

A child who had taken an overdose of ADHD medication waited 1.5 hours for an ambulance to arrive, quickly becoming less responsive to touch once picked up by paramedics and going into shock due to abnormally high body temperature.

A QAS review found the service was facing a high workload, while ambulance ramping at hospitals across the Metro South region were slowing paramedics down.

It found there were 38 pending cases when the call for help came in, with eight ambulances across five hospitals waiting more than 30 minutes to offload patients.

The longest time an ambulance was ramped that night was three hours and 32 minutes at Logan Community Hospital.

Nine ramped ambulances across the region

Paramedics were delayed nearly 40 minutes getting to a man that had collapsed in his home due to “existing hospital workload” including nine ramped ambulances at hospitals in the region.

The man, who had a history of heart illness, had been lying on the floor when the critical care paramedic arrived and went into cardiac arrest about 38 minutes later and once again right before they reached the hospital.

A review found it took 18 minutes to identify a paramedic that was available to respond because of the workload at the time, with 23 calls for help pending at the time.

There were also multiple ambulance units delayed at hospitals in the Metro South region, with the longest ramped for 2 hours and 32 minutes at Logan Community Hospital and others ramped for 1 hour and 48 minutes at Princess Alexandra and 1 hour 15 minutes at the Mater.

Help ‘should have come last night’

A man was rushed to hospital unconscious early on a Thursday morning after stretched paramedics failed to turn up the night before when he lost strength in his left leg and collapsed on the floor.

A distressed relative, calling triple 0 that morning, said help “should have come last night”.

The man, who had a history of heart illness, was unable to stand on Wednesday night after three days of dealing with pins and needles culminated in losing strength in his left leg.

But ongoing “delay in dispatch due to workload” meant paramedics did not arrive, with the man somehow getting from the floor to his bed through the night as the strength in his legs dissipated further.

The review revealed there was a “delay” finding an ambulance unit due to the existing workload, with 19 cases still pending in the community when the call came through and 11 crews already at hospitals — including four which were ramped.

The longest ramping time was two hours and 37 minutes.

By 1.19am the request for an ambulance had been cancelled with plans for the man’s relative to call back once he woke up.

Early in the morning triple 0 was called again, with the relative now telling dispatchers there was a faint pulse in the man’s arm.

Paramedics arrived within 17 minutes of getting the call, transporting the man to hospital unconscious.

‘Terse’ and ‘lacking in compassion’

A grandmother who waited 1.5 hours for an ambulance was later found to have suffered a stroke, succumbing in hospital four days later.

The highly detailed investigation of her case has laid bare the intense staffing shortages and workloads faced by paramedics, with the crew that tended to the grandmother not receiving a single break or opportunity to have a meal throughout their 12-hour shift.

Cascading shortfalls ultimately led to the grandmother being treated for her symptoms of headache and unfocused vision, outside of the three-hour window advised for stroke patients.

Her grandchild, who was with her throughout, was also at one stage asked if they “should try and take grandmother to hospital” in their own car.

The service was so stretched that night there were multiple calls for help, including code 2 incidents, which were pending for one hour 52 minutes and one hour seven minutes throughout the night.

The review was also found the dispatcher on duty at the Maroochydore Operations Centre was working solo on the night, despite the site being hit with “very high” demand of 492 calls — or about 20 per hour — that day.

The dispatcher, who had been criticised for being “terse” and “lacking in compassion” when on the phone, dealt with 67 calls in one shift and was the only person available to input hospital and other communication information.

And the Sunshine Coast district had “significant staff shortages with 50 per cent of night shift crews not able to filled”, with a total of 11 officer spots unfilled despite “intensive” efforts of management which included casting the net to greater south east Queensland.

“SEQ were unable to provide resource assistance due to SEQ workload (pending queue/ nil resources available in Brisbane”, the report stated.

Total of 174 hours of paramedic time ‘lost’

A patient was found unconscious and had to be resuscitated by paramedics after waiting nearly eight hours for them to arrive.

An internal review found the delayed response from QAS was “impacted by increased workload demand and hospital ramping at the time of the call and subsequent period”.

Delays unloading patients at hospitals across Brisbane’s north and south were so critical it was found a total of 174 hours of paramedic time had been “lost” — the equivalent of having 34.8 paramedics unable to serve the community that day.

Demand for help was so high that the number of incidents that hadn’t been dealt with more than one hour after being called in hovered between 25 and 33 between 11.30pm and 4.30am.

According to the review there were only 22 ambulance officer across the Brisbane metropolitan region that night, which was “considered a significant shortfall in staffing”.

“(At the time of call) … there were 10 QAS ambulances located at Metro North HHS hospitals and of these 9 had been ‘ramped’ for over 30 minutes, with the longest being 1 hour 52 minutes at The Prince Charles Hospital,” the report stated.

Five-hour wait time in QAS priority queue

A man with cuts to his hands and arms was found by paramedics hunched over a bathtub pulseless after they arrived 1.5 hours after the call for help had been made.

A “high demand” for service across Brisbane’s north and south and “extreme hospital delays” affected paramedic availability, alongside the incorrect labelling of the case by a dispatcher an internal review found.

A second triple 0 call made 1 hour and 18 minutes after the initial call informed QAS the man was unconscious and not breathing.

Paramedics arrived at 6.31pm and located the man “kneeling on the floor hunched over a bathtub unconscious, unresponsive and pulseless” before declaring him dead 3 minutes later.

The review found between 5pm and 6.15pm that day, an average of 51 ambulances were at hospitals across Brisbane, Logan and Ipswich, with about 26 ambulances ramped at any one time — some with maximum wait times of 4 hours and 3 hours.

As a result, there were people waiting in the QAS priority queue for up to 5 hours.

Situation deemed ‘extreme’ by QAS

A person complaining of shortness of breath was found unconscious by paramedics when they arrived one hour and 19 minutes later, but the patient could not be revived.

A review found the ambulance workload and hospital delays — which equated to 108.5 hours or 4.5 days of “lost” paramedic time — was the cause of the deadly wait.

Compared to a “typical Thursday” the region had more paramedic crews on night shift than normal.

In the lead up to the incident “significant pressures” including hospital delays and ambulance ramping were rife throughout southeast Queensland, with the situation deemed “extreme” by QAS from 11.15pm on December 19 and returned to “normal” six days later on Christmas afternoon.

Between 1.15am and 3.30am on the night of the incident, the number of ambulances ramped at Ipswich Hospital was between two and six, with the longest wait time to unload a patient clocking in at 4 hours and 22 minutes.

The report stated the QAS staff involved in the case were “feeling very saddened and deflated at the outcome of the patient”.

‘No available paramedic units’

A man who collapsed on the toilet after suffering chest pains all day was found dead by an ambulance crew after a 39-minute delay, caused by heavy workloads and ramping.

A review found it took 22 minutes for an ambulance to be dispatched to the scene, with the responding crew travelling from 17 minutes away as “there were no available paramedic units to dispatch to the incident due to existing ambulance workload”.

It was revealed the workload in the southeast was deemed “extreme” by QAS due to “significant pressures”, including ramping, from 7pm on New Year’s Day and the situation did not return to “normal” until January 15.

“At the time of the call, there were 49 paramedic units at hospital, with the longest at Mater Adults at five hours and 42 minutes ramped, affecting QAS paramedic availability to respond to emergency cases in the community,” the report stated.

A total of 87.58 hours of paramedic availability — the equivalent of 4.5 days — was “lost” on January 4 due to ramping.

One of the busiest days on record for triple-0

A person who couldn’t get up after falling and potentially fracturing their knee waited six hours and 42 minutes for paramedics to arrive, with their niece lodging a complaint over the delay after the patient died in hospital the next day.

The incident, during the first Omicron wave, happened on one of the busiest days on record for triple 0, while 160 QAS staff were furloughed due to the pandemic.

The backlog of calls for help was so deep the review revealed instances that day when people had been waiting 8 hours or more for ambulance crews to arrive.

The day before the incident, paramedics lost a total of 136.66 hours — or 5.7 days — waiting to unload patients at hospitals.

Extreme hospital delays across South East Queensland

A woman with Covid-19 complaining of breathing difficulties collapsed while waiting 51 minutes for an ambulance to arrive, with paramedics unable to revive her “despite best efforts”.

There had been “extreme hospital delays” across southeast Queensland affecting paramedic availability according to an internal review.

Between 3.45am and 4.30am that day the number of ambulances ramped at hospitals across Brisbane and Ipswich steadily increased from three to eight, with one crew logging a wait time of six hours and 50 minutes.

It was confirmed the woman had discharged from hospital against advice.

‘Staring blankly and purple’

A person who was vomiting and bedridden after a recent fall deteriorated while waiting for paramedics, with the final triple-0 call stating they were “staring blankly and purple”.

Paramedics declared the person dead when they arrive more than three hours after the initial call for help.

Workload pressures, including a high number of pending calls for help, were to blame for the delay according to an internal review.

There were also compliance issues with the logging of the initial call for help that impacted response time.

Urgent help wait times blow out to 42 minutes

A 94-year-old woman sounded the alarm complaining of pain and shortness of breath after a fall, with paramedics arriving just minutes before she went into cardiac arrest.

The woman was revived and taken to hospital in a critical condition.

A review found the workload across Brisbane’s south was the cause of the delay, with people needing the most urgent help waiting an average of 42 minutes for an ambulance and some waiting more than two hours that day.

In total 98.76 hours of paramedic time was “lost” that day due to hospital ramping, equating to 10 paramedic crews throughout the day rendered sitting ducks.

“High demand for service and hospital delays at the time of the call was noted, reducing the availability of ambulances,” the report stated.

Only a solo paramedic unit available

A man suffering severe chest pains went into cardiac arrest just as paramedics arrived, with a review finding this “may have been prevented” if a single-officer crew had been sent earlier.

On the day of the incident “community demand” for first responders on the Gold Coast was “high” while hospital delays at Gold Coast University Hospital was at “extreme escalation”.

When the dispatcher put the call out for an ambulance, there was only a solo paramedic unit available and they were sent out while the dispatcher continued to look for a full crew.

An ambulance became available, the solo paramedic was diverted to another case, and the crew arrived on the scene 20 minutes later and went to work resuscitating him.

The man was revived.