Saturday 29 October 2011

Claim Pain

"RTC, Cars vs Car, 3 patients with neck pain"

Over the past decade, a culture of claim has slowly developed in Britain. Advert slogans like 'where there's  blame, there's a claim' encourage people to claim for absolutely anything. A woman made a claim for £1m because her chair 'farts', gamblers sue casinos for loosing money, McDonalds were sued because someone burnt their tongue on hot coffee. The growing litany of ludicrous litigation needs to end. We now live in a country where kids can't do a sack race, can't play with conkers, where every injury costs companies money and where even burglars can sue for injuries sustained while 'on the rob'.


The fear has gripped every council and business and the introduction of absurd rules, regulations, signs and labels have become common place but one of the biggest areas abused by the public is that of whiplash. England has become the whiplash capital of Europe. Over 1300 claims are made every single day and accounts for over 75% of all injury claims in the country. This huge amount of claims has in turn led to a huge amount of companies encouraging people to claim. Just type 'claim' in to any search engine and see just how many there are.


We were called to the above job. When we arrived there was a big black BMW, a man, a woman and a child occupied the seats. Behind them was a mini cooper. Standing next to the mini was a mother and child. They were both fine, and the reason they were fine, was the it was a 2mph impact. Not a mark on either car. The police who were on scene had requested the incident be reviewed on CCTV. It was and the following came of the radio:

"No more than 2mph. The front vehicle didn't even move"

Case closed? No. I had 3 patients. The eastern european family in the BMW all had neck pain. Even the 2 year old. (I couldn't confirm this as he didn't speak english but the parents assured me that despite the fact he was laughing, the child had neck pain)

"Ok sir, stay nice and still, we are going to arrange to have the roof cut off your car"

Like a jack-in-the-box he leapt out of the car, as did his wife and the child was removed. Amazing recovery. They made it clear they needed to be checked over and needed a copy of my paperwork. 

"I'll give my paperwork to the hospital"

They declined hospital. They wanted to go and see their own doctor. Totally fed up and frustrated I completed the necessary paperwork and off they went. And here lies the problem. They will put in a claim. The lovely lady who bumped them will be financially punished with an increased premium despite there being no damage OR INJURY! The family will probably be awarded £2500 each for whiplash injuries as they are hard to prove and the doctors who assess them don't care. Doctors are there for diagnosing and treating but they are being used to alleviate social conditions and perpetuate a compensation culture. If you’ve got a doctor who is being paid £200 for every report he stamps, there is no incentive for him to turn around and say ‘I don’t believe you’.

I don't know what is being done by the government but something has to give. These idiots got 2 police cars, an FRU, an Ambulance and no doubt 3 GP appointments. For emergency services alone you are looking at a net bill of £3000 to the tax payer. Multiply that by the 1300 claims a day and its evident that 'claim pain' is not sustainable. Stop it and that 'national deficit' may become easier to wipe off.

Speechless

"81 year old female. Cardiac Arrest"

We'd been on duty for the best part of 18 seconds when we were treated to a 'Sunday suspended'! I don't know why Sunday mornings seem a popular time to die, they just are, it's the way it is. Any way, off we went. We pulled in to the road to discover it was extremely narrow, cars parked bumper to bumper as far as the eye could see. As is customary in this situation and due to the nature of the job the truck was unceremoniously abandoned in the road. Blue light and hazard lights remained on.

We began resus and due to the unique time of day a second crew was unlikely. As some may be aware there is a daily shortage of ambulances and cars between 6:30am and 7:00am. All night crews are either finished or on their 'off job'. Most 6:00am starts are already on their first job and most other crews start at 7:00am. Therefor 6:31am is a bad time to die. Luckily for us today, we were a training crew so there was an extra pair of hands!


Anyway, resus in full swing, sweat on brows, family of patient hidden away in the kitchen, everything was going to plan when the door swings open. A builder of some description was stood in the doorway with a face like thunder.


"You're blocking the road, can you move  your ambulance?"


"Get out and NO!!"

The absolute cheek. I was speechless, to enter someone's house for starters, then to make that request when we are doing CPR on someone. I was livid. Emotions aside, we continued but unfortunately for our patient her time was up. We 'called it' and informed the family. As it was an unexpected death the police have to be called to arrange removal.

The student who was with us had never done a cardiac arrest and in their excitement, had left the keys of the ambulance in the ignition. We gathered up our kit and headed out to the truck. As I got to the front door I watched in amazement as our ambualnce with 'that builder' behind the wheel began driving away. I dropped my bags and laid chase! Not on my watch! As luck would have it, as he was driving off the police pulled into the road. With an array of frantic arm waves and the fact I was running after it the police blocked it in.

I got to the cab, swung the door open and unleashed an onslaught of fury at the obnoxious prat. The police came running over and promptly dragged him out of the cab. He was moving it so he could get his van past. He didn't see the problem. If we had been conveying our patient his selfish actions could have had much greater consequences. Luckily that wasn't the case but I had the 'red mist'. I continued to vent all my anger at him and the police. Luckily for him he was arrested and taken away from me. He was arrested / repremanded for the following:

1) Taking a vehicle without concent of the owner
2) Obstructing the emergency services
3) Tresspassing
4) Driving without valid insurance
5) Assualting a police officer

What happened to him after I dont know. The student was left red faced for leaving the keys, and I was left red faced with pure rage. Speechless.

The Bystander and Me

"25 year old female, reviling in the glory of an emergency"

Working for the ambulance service invariably involves working in areas which are very public and often, doing what we do, draws a lot of attention. The blue lights, the sirens, the hi-vis jackets, they all add to the illusion of an emergency. They all lead people to think that someone is dying or is dead! Obviously for those in the know, this is rarely the case but humanity has a morbid fascination with other peoples misfortunes.

We laugh when people fall over, we watch videos and TV programmes highlighting the misfortune of others, so its only natural that when we turn up to a busy high street on a Saturday afternoon making all the noise we do, people will stand and watch. Its a fact of life. Yes its morbid, yes its not their business and yes its an added pressure but as a race we are an inquisitive bunch.


Obviously, when there is a crowd we are on best behaviour. As a uniformed service the image we project, reflects on us, our colleagues, our employer and the NHS as a whole. I personally love a crowd! I like the drama of it all! The rows and rows of faces staring at you. I tell myself they are all in awe of me and what I'm doing. Its like being in the middle of your very own TV drama! Love it! I have a well practiced 'emergency face' which lets people watching know a) I'm serious b) I know what I'm doing c) I'm far to busy to talk to random punters. This temporary persona that I take on hides the inner 'morally casual cynic' in me and helps me keep my job!

The above scenario is fine for most jobs. Take an RTC I did a few months back as an example. Car mounts pavement on a busy high street, hits a woman, goes back into the road and goes under a lorry! Carnage! There are ambulances galore, police, fire brigade and HEMS circling above. The reason this was perfect for the crowd because it did indeed have everything! Only the woman on the pavement was injured and that was only a possible leg fracture. The key here, is minimal pressure! There were lots of grown-ups! Minimal responsibility and no life or death moments! The crowd was 6 or 7 deep, loads of cameras, hundreds of people all behind the police cordon. I loved it!

However, my tune does change and there times I want everyone out of sight and out of mind! i.e. When the shit is hitting the fan. When a life hangs in the balance I don't think its morally right for people to stand and watch. Don't get wrong, I probably would, and most of the people who watch probably don't have a clue what is happening but even my emergency face doesn't cover up my frailties when I'm out of my depth and know it!

We did a traumatic cardiac arrest, fall from extreme height. It was dark, raining, middle of the night, we were working on this young guy who was a real real mess and we had a crowd. A big crowd. About 100 piled out of the night club we were next to and watched for an hour. It was horrific, repeated requests to move back fell on death ears. We knew this guy we were working on was gone but we had protocols to follow. When all those protocols were exhausted we stopped, stepped back and there it was. 100 pairs of eyes staring at you. At this very moment, I hate the bystander.

I can't pick and chose when I have a crowd so my love / hate relationship will continue. I will use them to massage my ego during the good times and deal with them crushing my confidence during the bad, but if you must watch then please please please do the following.
  1. Stay well back
  2. Don't talk
  3. Don't film
  4. Don't heckle (see no. 2)
  5. Don't judge

Thursday 20 October 2011

Something stupid


"24 year old male, just wants to do something stupid"

Call takers can only write down what they are told, and that often leads to us reading some bizarre things on our screen. As soon as 999 is dialled, a computer automatically dispatches the nearest ambulance to either a) the address linked to the landline or b) the mobile phone coordinates from where the mobile is calling from. Yes, this is what the job was given as and it was the only information we had to go on! What do you say to that? How do you prepare? Is he suicidal? Is he just stupid? What stupid thing could he want to do? It sounds as if he is unsure and is open to suggestions. With so many possibilities we thought it would be prudent to compile a list of options / suggestions / guesses as to what he might have done / be about to do / is considering! There was a good chance that once the call had

1) Jump off a bridge

2) Get married

3) Jump off a telephone box

4) Open an unknown link on Twitter

5) Play with traffic

6) Eat yellow snow

7) Play chicken with a train

8) Scuba dive in a shallow fountain

9) Get a scooter and put a big card board box around it. On the side write Time machine.

10) Eat glass

11) Stick head in a crocodiles mouth

12) Get incarcerated in Shawshank prison

13) Go to Libya

14) Say 'bomb' on a plane 

15) Buy a BlackBerry

16) Join the ambulance service

17) Provoke a man with a gun

18) Declare a 'jihad' on a super-power

19) Listen to Justin Bieber 

20) Call an ambulance for 'wanting to do something stupid'


Needless to say, we were cancelled but it was fun to guess! I wonder what he did?!




Karma

"25 year old male, RTC, Car vs Traffic Island, Injuries unknown"

A while ago we were driving along a single carriage way on our patch. It is a bendy road and traffic invariably travels faster than necessary because of this. I find the increased danger of a road is inversely proportional to the speed at which people drive on it. On this particular day, it was first light, the road was wet and there was a slight fog descended upon us.


The road in question is about 4 miles long, no major roads join or cross it until the very end. We were trundling back to station when a £300,000 silver Porsche Carrera GT sped up behind us. He flashed his lights, I assume to show displeasure at our stance of sticking to the legal speed limit. Where he wanted or expected us to go I don't know. You can't just move a 3.5 truck out the way on a narrow road!! Anyway, we continued trundling as did he with his inane flashing of headlights and beeping of his horn. I may be guilty of dropping off the gas slightly but hey,  who wouldn't!!

The 'prat in a Porsche' made a number of attempts to overtake me. His first 4 or 5 were foiled by streams of oncoming traffic adding to his bizarre frustrations! Eventually he passed, treating us to an array of mouthed obscenities and hand signals to let 
us know exactly how much he hated us. All this did was make us laugh and laugh we did. He sped off into the distance, right arm hanging out the window, flipping us the bird! What a tool!

Like previously mentioned the road is a long one, there were still a good 3 miles to go so with spirits high and 'The Rat Pack' serenading us we continued on our journey. A few minutes later we rounded the final bend, and there it was........

Karma!

Our early morning happy camper was standing on the side of the road, mobile phone to his ear, staring at his beloved Porsche, wrapped around a traffic island. Oh, what a shame! We pulled up, I'm sure our smugness and satisfaction was perfectly visible, but nether the less, consummate professionals we are, we offered our services.


"Are you OK sir? Are you hurt, do you require an ambulance?"

"No I don't" (I decided now wasn't the time to remind him of manners)

"Are you sure? We can check you over if you like"

"I'm fine, leave me alone"

"OK sir, have a good day!"

Tuesday 18 October 2011

Musings from a waiting room

"25 year old female, Haemotemesis, Abdo pain, Nausea"


This patient struggled through her 12 hour shift, took analgesia as per packet guidelines and when symptoms worsened didn't call 999. She made her own way to A & E. She is me! Take note!

This blog was inspired by the 5 hours and 51 minutes I spent people watching in the A & E department waiting room of a busy hospital. I fear the experience has scarred me, it may take a while to recover emotionally. I was in severe pain. I checked myself in, took my seat and waited patiently with the masses. I watched. And watched. And watched.

The Teens - Every waiting room has them. Tonight it was a group of 3. 2 guys and girl, about 16 years old, one had a bandage on their hand. I gather he punched a window. Of course he did. Their conversation was mundane and juvenile. "yes bruv, no bruv, 3 bags full bruv". They had the combined vocabulary of an Otter. Luckily they were only offending my senses for 2 hours but it was a long 2 hours.

The Cougher - 35 ish year old male. With his wife / partner / pet. I couldn't tell. Anyway, god gave us hands for many reasons but right now their only real use is covering your mouth when you cough. I don't want your plague. I dont want to have to dry my face. You don't even need to be here. Go home, have a Lemsip and man up you big girl.

The Fighters - More commonly seen at the weekends but they made an appearance tonight, just to mock my existence. Donning the usual Hackett and Nickleson polo shirts, stained in blood they lorded over each, spouting macho nonsense over their plans for revenge. Pathetic. You're not hard, if you were, you wouldnt be in hospital. Get a job, stop drinking and fighting on a Monday night and piss off!

The big family outing - Sat opposite me are what I believe to be a Nigerian family. A husband, wife and their litter of 4. I'm guessing the youngest was unwell but I don't really care. What I do care about is the lack of control they have over their sprogs. This is a hospital, not a crèche, if you feel it necessary to bring them here (why one of you can't keep them at home I don't know), shut them up. Don't let them run around or throw things or shout or scream or talk. Silence. Or, at least make a vain attempt to let them know their behaviour isn't acceptable. Don't just sit there. It's getting on my tits.

The sleeper - It's a busy waiting room, people are unwell and are having to sit far too close to each other than should be legal. However, the situation is made less comfortable by a 40 year old man who believes it's his divine right to lie across 4 chairs and sleep. Selfish moron. I did not let this pass without comment.

The chatter - My phone (on silent) rang 3 times during my visit. It was the same lovely person each time (I said I'd mention them, thank you) but I went outside each time to answer it. That's the done thing. This 'businessman' was far too important for courtesy. He thought he would share. All night. And keep his phone on loud so every ring and beep grated in my ears. Self obsessed rat. The gaul of some people astounds me. I also never worked out why he was even there.

The moaner - I'm waiting, the teens, the cougher, the sleeper, the family and the chatter are waiting. Most of them, no all of them are grating on my senses but they are waiting their turn. Why are you any different? Loud, obnoxious moans, spouting off about rights and quality of service. Taking it out on the receptionist. Trying to gather followers to his cause. IT WONT MAKE A BLOODY DIFFERENCE. Wait your bloody turn. It's the NHS. That's how they roll. Don't like it, jog on and go private, but whatever you do, do it quietly and away from me. Moron!

I could carry on for hours and I may take up this subject again but I'm gonna leave it there. Waiting rooms are horrible places. I wasn't alone in my obvious displeasure at my surroundings. There were plenty of people, some unwell and some injured who kept themselves to themselves and waited their turn. Eventually my name was called and my waiting room safari was over. I had to endure some of the most intolerable people society have to offer. Maybe I'm a snob, I probably am, but having to sit with that bunch of misfits pained me. I have no doubt that David Attenborough could have happily filled a 6 part series speaking about their habits, habitats and breeding rituals but quite frankly, they don't warrant the air time.

NB: Big thank you to @Jaysmithjay for a Twitter welfare check every 20 minutes. Legend! :-)

Sunday 16 October 2011

The Great Tit

"26 year old female, tutting, rolling eyes and sighing"


In the ambulance service, different people attract different types of jobs. Some are trauma magnets, some do babies, some do strokes and some do mental health. I see myself as the 'shit shovel'! Thats not saying I don't have the occasional good job but invariably, on the average night I go to absolute tosh. So, to prove a theory, I wrote down the presenting complaint for every job in a random 12 hour night shift. The calls may not necessarily have been as given but this is what I was sent to.........


1) 24 year old female, Abdo pain, currently on her period, pain is really bad

2) 22 year old male, head injury, ? intoxicated

3) 38 year old female, feels dizzy, has been smoking cannabis

4) 27 year old female, in labour, first child, contractions every 6-7 minutes

5) 42 year old female, Noise in ear, can't sleep

6) 19 year old male, ? fractured wrist, jumped off telephone box

7) 18 year old female, lying on pavement, ? unconscious, ? intoxicated, vomiting

8) 23 year old male, unknown injuries, involved in fight, police on scene, pt. in handcuffs

9) 26 year old female, high temperature, shivering, headache, can't breathe

10) 89 year old female, fall, can't get up, carer on scene


That was my shift, that's why I moan, that was genuinely a shift, as it happened. This is what I want to say to them but I couldn't. If only.....


1) So what, it's your period. Deal with it. Tit.

2) I don't care. If you can't handle your drink, don't drink. Tit.

3) What do you expect. Tit.

4) You've had 9 months to book a taxi or arrange a lift. Why didn't you? Tit.

5) Really? I can't sleep. Go away. The noise in your ear is me saying...Tit.

6) Erm...dont jump off a telephone box. Simple as. What do you expect? Tit.

7) Class. Pure class. See job number 2. Tit.

8) Tit

9) It's a cold. Man up. My temperature is currently higher than yours. Tit.

10) Ah bless ya. You my dear can call us any time. Polite, courteous and thankful. An absolute pleasure. Almost makes the last 9 worth while. Almost.



Saturday 15 October 2011

Pizza and ambulances

We all know the problems with pizza delivery guys. They fly through traffic with out care or consideration to themselves or other road users. They weave in and out of traffic jams, swerve round patestrians crossing and are generally a menace to everyone. However, we like them.....

"RTC, Car vs Moped, 23 year old male, Papa Johns delivery driver hit from behind"

When this job springs up on the MDT there are 3 things on our mind.....
  1. Drive fast, we don't want to be cancelled for a nearer vehicle
  2. Drive fast, we must be first on scene, before the police
  3. Drive fast, there might be free pizza
Morbid and cruel yes, but a hot meal is like a blue moon in the ambulance service, so the treat of a squashed, hot, free pizza is an opportunity not to be missed. Yes, the primary concern is the patient (depending on levels of hunger!) but still, thats just the way it is.  On this particular occasion we were indeed first on scene and there was pizza on board (nothing worse than an pizza RTC post delivery!). Lots of it. 1 x Large pepperoni, 1 x Large Meat feast and 1 x Veggie supreme, 3 sides and a bottle of coke. 

With the huge amount of pizza weighing heavily on my mind, a rapid and concise patient assessment was necessary. The guy wasn't injured, a few scrapes and grazes etc. but he did want to be checked over, so we took him to our local walk-in center. We handed him over to the nurse and went back to the ambulance...

...where we feasted like royalty!!! I love this job!!!

Awkward

"Unknown sex or age, Cardiac Arrest, CPR in progress, access OK"

Well that was enough to get the blood flowing and adrenaline pumping. Blues and Twos blaring we winded our way through the traffic, we weren't far away so there was a good chance we would be first on scene. Secretly most crews have their fingers crossed that they are second but today we were indeed first.

We screeched up to the house, grabbed all the kit we need and made a brisk walk to the front door (with the exception of the occasional university student we never run!). The door was ajar so with a courtesy knock we headed in.

"Hello, ambulance service"


A panicked, distraught voice shouted back...

"In here, quickly, I'm in here"

We made our way along the hallway and into the poorly lit room at the end. As we entered the room there was a man in his 50's doing CPR. He had scraggly grey hair, week old stubble, dirty clothes and tears running down his face.

"Please help, he's died, he won't talk to me"

No amount of training can prepare you for the scene that we were witnessing. We are trained in black and white and the grey areas are often skipped over. And this was indeed a grey area. 

The man was doing CPR on his armchair. Not CPR on someone in an armchair.....actual CPR on his armchair.

The squeak of the springs were audible with every compression. Despite it being an innocuous piece of furniture the man was distraught. How do you deal with this? What do you say? What do you tell him?

We muddled our way through those questions, and discovered a 20 year history of extensive mental health problems. It transpires that since April 1993 he has had to fend for himself, minimal help, just left to cope with his delusions on his own. Margaret Thatcher's Care in the Community simply dumped these people on the streets. The communities didn't care because people fear mental health. Like us they don't know how to react, what to say, where to look. And to be honest, there isn't much we can do either, a trip up to A & E is the best we could offer and as he came voluntarily there is a good chance he will self discharge. Something has to be done about mental health in this country but what, i don't know. 

Friday 14 October 2011

Let there be light

"21 year old male, thinks he has gone blind"

It's wrong to judge on call details alone but there were only two words on my mind when this job popped up on the screen. 'Yeah' and 'Right'. I could be wrong, but I strongly doubted it. I imagine it is extremely rare for a healthy young male to just suddenly go blind! Anyway, with 7 minutes and 59 seconds to turn this job into what the government consider a success, we 'made progress' through the early morning rush hour traffic. We pulled up outside to notice that unfortunately, this job was already a failure. 8 minutes and 42 seconds had elapsed since the call began. Oh well!

We were greeted at the door by the patient, eyes shut and covered with his hands. He had a towel wrapped around his waist, and was dripping wet.


"Good morning sir, what's been happening this morning?"


"I can't see"

"Ok, so what happened?"

"I was washing my hair, and my eyes really started stinging, now I can't see anything"

"So do you think that you could have got shampoo in your eyes?"

"Maybe"

"Have you tried to open your eyes?"

"Not yet, I didn't want to do any damage"

"Ok then, shall we try to open them and I'll have a look?"

He tentatively opened his eyes, and to his and my amazement he was able to see. Shocker! It was far too early in the morning for me to sum up the energy to lecture him about the inappropriate use of an EMERGENCY service so I did the relevant paperwork and made a swift exit back to my lukewarm coffee. The stupidity and lack of common sense in the youth of today never ceases to amaze me! I certainly felt vindicated for my pre-judgement! 

Nature Vs Nurture

"25 year, spouting racist abuse and teaching her child to be a bigot"

As a country, I think we see ourselves as tolerant; we embrace and celebrate diversity and generally thrive as a multicultural society. There are however, pockets of people who are still stuck in the dark ages.

A few weeks back there were a 'giggle' of ambulance crews (I've made up 'giggle' as a collective term for crews but like it!) stood talking outside our local A & E. The riots were still a hot topic of conversation and the term 'Broken Britain' was being branded about. Like a family of meerkats all of our heads turned in unison at the voice of a women not 20 feet from us.

She was about 25 years old, donning a hideous pink velour tracksuit, stomach hanging out and obviously pregnant. Her hair was tied back tight into a council facelift, her eyebrow was pierced and she was chewing gum like Sir Alex Ferguson on derby day. She also had a toddler in tow. An asian man exited the A & E and walked passed her.

"Dirty fucking paki" she shouted

He had enough moral fibre to walk away despite the continued onslaught of racial abuse she continued to shout. We then watched in utter bewilderment as the following conversation occurred between her and her little boy:

"Say dirty fucking paki"


The boy, whose voice was filled with all the innocence that a three year old should be, repeated what he was told.

"That's my boy, now say dirty fucking nigger"

And without knowing better he did.

"Well done, mummy's so proud of you, now say filthy fucking Muslim"

This exchange continued for a number of minutes. Eventually the police arrived and removed her. I can only assume she had been at it long before we arrived. The sad thing about it is, ignoring the profound ignorance of the mother, what chance does that kid have? He is growing up with racism and hatred being the norm and sadly, those opinions probably won't change. I have no doubt that unfortunately,  ten years from now, he will be roaming around his estate with a group of friends abusing passers-by, he'll probably be violent and racist to anyone who isn't white British. It's painfully obvious which one of Nature vs Nurture is to blame.

I truly didn't think that this kind of racism was still common place, maybe I've been sheltered from it, maybe I've subconsciously chosen to ignore it but its still there. The riots put the spotlight on a broken Britain but the problem runs much deeper than some broken shop fronts and missing trainers. The estate culture in and around the city is a breeding ground for racial hatred and with communities of one particular ethnic group segregating themselves from the rest this social divide will continue to grow. These are the issues that need addressing. Sure, she can be arrested and charged & will probably be fined, but living on benefits means she'll pay her fine at £5 a week for a few years at no real cost to her. Recently there have been a number of high profile cases of racism in football from the likes of Louis Suarez and John Terry. It highlighted that racism is still in all facets of our society, from the rich to the poor and from various cultural backgrounds. I firmly believe there is no smoke without fire and as much as education education education can help our youngsters understand and embrace multiculturalism, with racist parents and racist role models absolutely nothing with change. 

Thursday 13 October 2011

Knock Knock Knocking on Heaven's Door

"50 year old male, DIB, feels hot"

Working in the ambulance service gives you a rather morbid sense of humour, gallows humour if you will. You find things funny that normal people wouldn't. Discussing dismemberment over a gourmet meal seems perfectly normal to you, death can be amusing and most situations the layman would find incredibly traumatic you laugh off without a second thought. That's life. It's a coping mechanism but one that rarely fails to disappoint!

We arrived at the care home and were taken to the patient. He was only 50, but had vascular dementia. Until 5 months previous, he had been a university lecturer in English literature at a prestigious university. Now, he was bed bound, couldn't talk, couldn't move, didn't recognise anyone and was simply waiting to die. His wife was sat by his side holding his hand. It was a very sad story but an all to familiar one. Life can deal some real hard knocks.

To cut a long story short, he was ill, ill enough to warrant a blue calll, ill enough to give us real concern. The trolley bed was brought in and we began assisting staff to put the patient into the hoist. Slowly he was lifted out of his bed. Suspended in mid-air, unaware of what was happening to him, we began turning him around so as to lower him to the waiting bed. However, during the raising and turning process his foot made contact with a 'Billy Bass'.

The fish sprung into life. The head turned 90 degrees to face us and started singing 'Knock Knock Knocking on Heaven's Door'. The irony was too much. Despite every inch of me trying to stay the consummate professional, I couldn't. I started laughing. So did my crewmate. So did the carer. So did his wife. There were tears running down our faces and the damn thing just wouldn't stop. It sang like there was no tomorrow. It's head swinging backward and forth, mouth opening and closing in no discernible rhythm at all. We couldn't stop the damn thing either, and why?... because our patient was suspended from a hoist in between us and the bloody fish. Eventually we pulled ourselves together and got him on the bed. Billy had piped down by now but as we walked off he started up again. This time it was Bobby Ferrin's 'Don't Worry, Be Happy'.  A nice sentiment drowned out by the laughter. There is a time and a place for humour in our job and now was neither the time nor the place but what's a crew to do?! 


Retreat!

"22 year old female, Having an emotional breakdown, throwing things around, states not throwing things at anyone, just around the room, also threatening suicide, does not have a weapon but is in the kitchen so could grab something, there are knives, she is now holding a knife, do not approach"

Now, as you can see, the darlings in control have taken a full history already, they know exactly what we are walking into, they know it's volatile and dangerous, they know that with this information we will wait for police and don our stab vests. The only problem, as I'm sure you are all too aware, is that computers have glitches. The particular glitch which caused the issue on this job was one of timing. The updates that the call taker was getting did not make it to our MDT until after we had entered the property. This is what we got...

"22 year old female, Having an emotional breakdown" 

With this information, we did not wait for police, we did not don our stab vests and most definitely did not expect to be greeted in the kitchen by a 12" knife.

RETREAT!!!!!!

Once is enough

"32 year old male, Fall, Head Injury, Serious bleeding, ? Intoxicated"

As i'm sure you can imagine, seeing this on the MDT produced a deep inhaled breath, followed my prolonged exhalation of dread! This had all the makings of your typical friday night drunk. A few slurps of coffee and off we went.

The location was a pub in a grim part of the city, not an area I was familiar with, nor an area I ever want to be familiar with. As we pulled up we could see a few people milling around a man on the bench outside. He was indeed bleeding from his head. He didn't look like a pleasant chap, but I was always taught not to judge a book by its cover.
"Hello Sir, i'm with the Ambulance Service, can you tell me what's happened this evening?"

With a slightly cross-eyed sway and a look up and down he eventually fixated on my face. A few seconds past where I can only assume he was focusing!

"Why don't you just fuck off?"

So, with a spring in our step, we picked up our bags and did exactly that. Once is always enough!

Are We There Yet?



I know, I know. You child is ill. The apple of your eye, the light of your life is suffering and there is only one thing to do. Throw you hands in the air, scream, panic, flap your arms, run round in circles, call your mum, call your friends, call NHS direct for advice. Once you have ignored all of them, because obviously they are all wrong, run to your GP. Or not! I know it's scary, I myself had many a sleepless night because I hadn't heard my baby cough or move for at least 8 seconds, but please, don't act like a maniac! See it from our point of view... you are an adult, a responsible adult, yet you are acting like a numpty! Breathe! Breathe some more! Now stop. Listen. Listen to what we are ALL telling you! We are the people in the know! You have asked us for an opinion because deep down, you know we will do what is right for you and your beloved! Basically, just chill your beans!

"10 week old baby, breathing difficulties, limp, GP on scene" 

18:01 and we are off! Off to a GP surgery. Probably because the GP wants to go home and doesn't want to be late off. God forbid!

We arrived and wandered through the maze of corridors, past the many shocked looking faces in the waiting room and towards one of the consultation rooms. As we got closer to the door it became apparent there was a rather unhappy baby inside. The screaming was deafening, there were certainly no 'breathing difficulties' going on here!

We entered the room; a very worried looking mother was sat on a chair, baby in arms, accompanied by the GP and two nurses. It transpired that the baby had its first vaccinations today and apparently went pale and limp about an hour ago. Despite the current lack of symptoms the GP had put the baby on full flow oxygen. She stated we were to take the baby to the nearest A & E department for a check-up. It was from this point that things took a rather frantic turn.

The child's mother was about 35 years old, well spoken and well dressed. It was her first child, so I can empathise with her for feeling worried; however she took the fear to a whole new level. As we picked up our response bags to leave she stood up headed for the exit. When I say headed, I should really say sprint, Usain Bolt would have struggled to keep up. She worked her way through the maze of corridors turning left and right like Miss Pac Man on speed. A frequent turn of the head over the shoulder to see if we were still close behind was accompanied by bizarre questions like "does your ambulance have resuscitation equipment?" and "Is there oxygen on your ambulance?"

Bear in mind, there is nothing wrong with her child, no swelling or reddening at the injection site, no temperature, the chest was clear; in fact all the observations were normal. The baby was very hungry and was telling everyone within 100 meters this was the case! Despite constant reassurance she just became more and more panicked. Once on the ambulance my crew-mate began the arduous task of trying to obtain her details. "Are we moving yet?" "When are we leaving?" were the responses to the basic "What is your address?" questions. After 45 seconds of observing this frustrating interaction I'd had enough. I went and sat behind the wheel ready to leave.

It was 1.3 mile journey to the hospital; I hadn't gone 100 yards when I heard "Are we there yet?" How on earth could we possibly be there yet? Surely she isn't that stupid. I was wrong. Every time, and I mean every time I put my foot on the brake pedal or stopped at the traffic lights I heard "Are we there yet?" I could hear the frustration in my crew mate's voice grow with every reply until eventually I heard "No, we are not, I can assure you that when we do arrive, however, the driver will stop the ambulance and let us out, until then, could you please answer my questions." A wry smile spread across my face and remained there.

After a very long 4 minutes we arrived. I opened the door and, like a springbok on the Savannah, out she jumped, baby in hand, "where do I go?" We ushered her in the direction of the door and off she went. We followed at a medium pace as she continued to take 5-6 paces, look over her shoulder and then continue. She was waiting at the nurses' station when we arrived. Anyway, a handover was given, blah blah blah and we left the poor staff to deal Mrs Frantic and her crying sprog (still very hungry)!



In itself it was an easy job, a walk on /walk off, just how we like em'. However, it was ruined by relatives yet again! And for some reason it really irked us. How dare she? She probably has a very nice home, a very nice husband, and very nice bank balance, a very nice job, a very nice supportive family and very nice friends. She probably has at least a 2:1 in a social sciences degree (she looks the type) so has had a good education but none of that has given her the ability to respect our opinions and professional advise. She spoke to us like we were dirt on her shoe, a couple of chauffeurs dressed in green that certainly have no medical training of which to base an opinion on. What do we know? If she had just taken a moment to listen to us and the GP telling her that babies do in fact cry, and that he was probably hungry, all of this could be avoided. She would be at home with her husband, baby asleep with a full stomach of milk and we would be attending another call in good moods. Instead we are hacked off and ranting. So what did we do?

Comfort eat...

Saturday 1 October 2011

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