Saturday 30 June 2012

Happy Birthday

"999 celebrating 75 glorious years in service!"

75 years ago today London launched the first emergency phone number. After people had been unable to get through to the local fire service about a fire in Wimpole Street in which 5 people died, 999 was introduced. On 30th June, 1937 the capital's emergency number went live and with it the Evening Standard gave out instructions on how to use it. 

"Only dial 999... if the matter is urgent; if, for instance, the man in the flat next to yours is murdering his wife or you have seen a heavily masked cat burglar peering round the stack pipe of the local bank building.

"If the matter is less urgent, if you have merely lost little Towser or a lorry has come to rest in your front garden, just call up the local police."

If only the same rules applied! Back in the day a flashing red light and a klaxon alerted the controller to an emergency call being placed. Can you imagine the racket if all 38 million annual 999 calls set off the klaxon! Times change; now we have state of the art operations centers that calls are directed to. Of the 999 calls made 52% are directed to police, 40% to the ambulance service and only *cough cough* 6% to the fire service (of that 6% only 1% is for fires!). It still amazes that despite the 15 million + calls for an ambulance we are still not classed as an emergency service but that is a rant for another day!

Obviously, over time, the essence of what 999 is there for has been lost. I'm sure people do still call for the next door neighbour being murdered or a suspicious looking cat burglar loitering with intent, but the term 'emergency' has become diluted somewhat. People call for anything and everything, some of which beggars belief. The concept of what a real emergency is has most definitely become lost and as such the call volume to 999 is growing year on year. We all laugh, shake our heads and read in dismay at what people call 999 for but it is getting beyond a joke. The 'nanny' culture of sending our already stretched emergency services to many of these calls is causing massive delays to responses and stretching the ever diminishing budget. 

Despite rather flat campaigns by police, fire and ambulance as to what people should and shouldn't be calling 999 for, the list of the bizarre, stupid and out right ignorant calls are going unpunished. This is what we are all up against:
  • Sunburn
  • Broken nail
  • Broken fake nail
  • Pizza delivery taking to long
  • TV remote out of reach
  • Cat stuck in a tree
  • Toothache
  • A bad cold
  • A stubbed toe
  • McDonalds run out of nuggets
  • Locked inside a car
  • Hit funny bone
  • Bedroom window won't open
  • Bit tongue
  • Can't sleep
  • Noise in ear
  • Cat won't stop meowing
  • Dog won't stop barking
  • Turned away from a nightclub 
  • Cold feet
  • Central heating won't turn on
  • TV needs re-tuning
  • Needs dinner cooking
  • Lifted weights and now arms hurt
  • Showel gel in eye
  • Paper cut
  • Pizza has the wrong toppings
  • An ex won't give back a jumper
  • A lost hamster
  • Ladder isn't long enough to reach the gutter
  • Needs a lift to near the hospital
  • Run out of calpol
  • Got paint on clothes from a shop doorway
  • Hit with party popper
  • TV won't turn on
  • Postman hasn't been
  • Unable to vote for Strictly Come Dancing
  • Infected ear piercing 
  • Feels sick
  • My bins are overflowing and it is stressing me out
  • My sister will not let me borrow her clothes
  • Someone has walked past my house and looked at me funny
  • Smoked cannabis - feels funny
  • Hasn't left chair for 2 days - answered the door.....
  • Had splinter, now removed
  • Almost got hit by a moped"
  • Needs pillows fluffing
  • Can’t find a lost button
  • Mother concerned as son was crying because he failed his driving test
  • Diarrhoea for 1 (one) hour
  • Feels sick after eating some pizza he found in a bin
  • Patient's key snapped in his front door lock so he called an ambulance
  • Scared
  • Been burgled, police have been, now feeling stressed
  • No money to pay the phone bill, you were the only person I could ring
  • The smoke alarm won't stop beeping
  • I've been diagnosed with tonsilitis and my throat hurts
  • I've got no money for a taxi
  • It feels like I have fish swimming around in my arms and legs
  • Drank green fluid from thermos flask last night... Didn't realise until this afternoon
  • Picked spot on nose, now it's bleeding
  • My sons breathing is making a funny noise. Son was fast asleep and snoring
  • Headache, taken 1/2 paracetamol 10mins ago and it hasn't helped
There are many many more! I could sit here for hours listing the jobs I've gone to that are not an emergency, as could the police and fire. Over to you! Share ones you have been to or heard of and I'll add the best to the list! So, 75 years on, will the Evening Standard give an updated poster of what people should call 999 to?! I hope so! Anyway! Happy birthday 999!

Friday 29 June 2012


"29 year old female, burn to the face"

Before I tell you about the job, I think I should share a few stories from my life thus far. 


It is the first time that I can actually recall being in pain. I was on holiday with my family and some family friends in a villa in the south of France. There was a pool, a big garden, and I remember playing with an inflatable ball and a basketball hoop in the pool for hours on end! Despite my parents' best efforts to keep me covered in sun cream, my refusal to get out of the sun resulted in me having a very burnt back and face. OUCH!! What was this?! This was serious pain! The incredible cooling effect from the aftersun was short lived and I sobbed at every given opportunity until it had blistered, peeled and healed. 


My first proper school trip. I went on an expedition to Kenya for 10 days. The teachers were hot on sun cream and for the most part I complied. That was, until the penultimate day. No excursions, just a relaxing day with my friends in the hotel. We spent the day mucking around on the beach and in the pool. Having no teachers pestering us about sun cream meant I was rather slack with application! The result... I woke up the next morning in agony, hardly able to dress, blisters on my shoulders and neck and yet another lesson learnt!


GCSEs were over! My first holiday abroad with friends and no adults! I didn't even pack suncream! Off I went to Europe for a few weeks travelling. Any part of my body not covered got burnt and I didn't really care! I looked like a lobster the second I step out of a shadow so it was no surprise I was covered in patches of bright red. It hurt, I moaned about it, I applied aftersun, and did the same the next day. 


My honeymoon in South Africa. You should know the drill by now. A week on safari, left arm hanging out the window holding the camera and sure enough, my entire left side got burnt. It hurt. I applied aftersun, it peeled and it healed!


I climbed Mount Snowdon in Wales. It was a baking hot day and I spend the entire time with my back to the sun, clambering up rocks. I applied sun cream every time we stopped! How sensible of me! We made it up and down again, got in the car and drove home. Five hours later I tried to get out of my car and could hardly walk! I forgot to apply cream to the back of my legs. Doh! I couldn't stand up straight, I couldn't wear trousers or socks! It blistered, it peeled and it healed! 


I was a grey, overcast day; it had been raining on and off for the last 4 days. It was raining now in fact. I was sat in my ambulance watching the world go by when I got the call. A burnt face! This could be nasty! We headed round to the address and were met at the door by the patient. There were no obvious burns or scalds though her face was slightly pink; more so on her nose. 

"What's the problem today?"

"I have burnt my face"

"Oh right, how did you do that?"

"I think I was in the sun for too long yesterday?"

"Oh, so it's sunburn?!"


There was an awkward tumbleweed moment where I didn't know what to say and she didn't add anything to her admission to calling an ambulance for sunburn. What could I say?! All I could think in my head was 'where in god's name was the sun?!' because I sure as hell don't remember it! I went with:

"Is it just on your face?"

"Yeah, I think so"

"What were you hoping we would do?!"

"Can't you give me some aftersun or something to take the pain away? It feels like my face is on fire"

"No. We don't carry aftersun"

"Do you think I should go to the hospital?"


I am unable to say what I think when faced with these people; I genuinely don't understand the mindset. How does the thought 'I have a slightly sunburnt face, I must call an ambulance' enter into someone's head? I can't lecture them, I can't refuse to attend; I just have to turn up, be nice and advise alternative means to get treatment. This was the first time I have 'referred to Tesco' as a treatment plan. I often say how nothing amazes me anymore, and in the main it doesn't, this however did; had I really just been to someone because they had sunburn?!

My reason for sharing my sunburn experiences was simple. We all get burnt many a time. We burn, we blister, we peel and we heal. That is how it rolls. However, like me, WE DON'T CALL AN AMBULANCE!!!!!!!!

Thursday 28 June 2012

Kids and Alcohol

Kids and alcohol do not mix well. Underage drinking is something that has become common place and almost acceptable in our society. Week on week I go to jobs where teenagers are heavily intoxicated and are vomiting. Usually it is a case of picking them up and driving them in their vomit covered clothes to the hospital and phoning their parents. As kids get older, they see and hear about what kids in the years above them do, and being young and naive they think they can do the same. The long and the short of it is that alcohol is a drug. If it was invented today it would be illegal but there is so much money to be made from it ,and it is so engrained into our culture, that it is accepted.

Alcohol in moderation and even occasional excess is relatively harmless. We all drink, myself included, but the older we get the more able we are to control our intake. Teenagers don't have that inclination and as thus, a culture of underage binge drinking has developed. They drink in groups and the statistics of how common place it is feels somewhat of a concern. As kids get older the chance to drink alcohol grows. 10% of 12 year olds admit to drinking alcohol with friends; by 13 that figure doubles. By the age of 15 the figure is more than 50%. It is not the drinking that is the problem though; it is the amount they drink. Despite drinking less often than adults, when they do, they drink a lot more. This binge drinking comes with it potential serious health problems and even death. This culture of binge drinking spills over into the late teens and the consequences are there for all to see. Just read 'A life lost, A finger pointed' to see what I mean.

Alcohol use by young people is often made possible by adults. After all, teens can’t legally get alcohol on their own, and although I am not against the idea of giving my son a beer when he is underage, I certainly will be doing everything in my power to prevent this from happening:

"13 year old male, unconscious, vomiting, ? intoxicated"

It was the bank holiday weekend; the country was celebrating the Queen's jubilee and there was a patriotic, jovial atmosphere everywhere we went. This type of call is not at all uncommon and like I say, is usually a case of scoop up and transport. The address given was a park, again very common as it's the only place that kids can go and drink without the risk of getting caught. The problem with parks is access. Most of the time gates are locked and at 11pm the chance of a groundsman letting you in is zero. Luckily, one of the more sober ones of the group, a girl, was waiting at the entrance for us. We grabbed our bags and headed into the dark. In the distance we could just about see the silhouettes of about 9 or 10 of them, the glow from cigarettes clearly visible. 

Half of the group seemed very panicked, the other half were too drunk to care. The boy was lying on the floor, covered in vomit and was indeed unconscious. Within a few seconds it was clear he wasn't breathing properly. His airway was full of vomit so we turned him onto his side to clear it. As it seeped out onto the floor he took in a gargled intake of air.  We tried our best to rouse him but to no effect. We loaded him onto the bed and rushed off to the ambulance. His friends (or most of them) followed. In a teacheresque tone I demanded the phone number for his parents. I think they realised the seriousness of the situation and within a few seconds I was handed a ringing phone. The boy's mum answered and I gave her the low down in brief and told her where we were going. To be honest, she didn't really seem that bothered.

On the ambulance we started using suction to keep his airway clear. No sooner as we had cleared it more would appear. He was hypothermic and his blood pressure was in his boots. It transpired he had drunk an entire bottle of vodka and 3 litres of cider. That is enough to cause the most hardened of adults to be unconscious, no wonder he was in such a state. We blued him into hospital where we went into the resuscitation room. The doctors and nurses flocked around him and within a few minutes fluids were up and he was 'safe'. 

On this occasion he was just another statistic of a hospitalised underage drinker. On this occasion he wasn't one of the statistics of underage deaths due to alcohol. He was so intoxicated he was unable to look after his airway. He had aspirated on vomit and realistically been only a few minutes away from death. Just imagine receiving that phone call. It's no longer a case of 'pah... kids!' The consequences of binge drinking are very real and if not controlled can lead to a life of alcohol dependency and minimal job prospects. 

I don't want to be holier than thou. I spend many a night from the age of 14 in my local park drinking White Lightening, Hooch and 20/20 or Aftershock. I remember vomiting; I remember waking up on the grass and not knowing where I was. I look back now and yes, in our culture it is part of growing up, but I also know I didn't know the dangers of it. I have no memory of being educated about the dangers of alcohol nor do I remember lengthy lectures from my parents about it. That is probably because my generation was the first where binge drinking became 'the thing'. Now everyone knows about it, and knows about its dangers, it is our responsibility to ensure kids are made fully aware of the consequences of their actions. I have never taken Ecstasy in my life. Why? Because I vividly remember the campaign following the death of Leah Betts. The media was all over it and that scare mongering did its job. Maybe the tragic death of Daniel Cripps could have the same effect on our kids' ideals of what drinking is all about?

Tonight at 8pm on Twitter the will be a discussion about Kids and Alcohol run by Tots100 (@tots100) and in conjunction with Drink Aware (@drinkaware). Read here for more details and come and join in under the hashtag #kidsandalcohol 

For more information on the problems of drinking and the resources available for parents and professions see the Drink Aware website.

Monday 25 June 2012

Stars in their Eyes

"31 year old male, ? Stroke, numbness in left arm, stars in eyes"

I have to admit reading that on the screen made a fine spray of vanilla latte spray onto my paperwork. In fact, so much so that I had to start a fresh PRF! Stars in eyes made me think of Matthew Kelly introducing a badly ageing man doing his best to look like Tom Jones and singing "Sex Bomb" as he comes out of a cloud of stage smoke! Not a good mental image! We headed round to the address not expecting much from the job. I doubted very much that a 31 year old was having a stroke, but as always I kept a semi-open mind until I arrived! Because it was early in the morning on a Sunday, and as we were less than a mile away, we were on scene within 2 minutes of him dialling 999. In fact, he was still on the phone when we arrived. 

We got past the usual pleasantries of 'I can't believe how quick you came' (*snigger* "you wish") & 'wow, that was fast', and by that exchange I was happy that a) he wasn't having a stroke b) he wasn't remotely ill. I'm no doctor but it didn't take much to work out what was wrong!

"So what's been going on today?"

"Firstly my arm was numb, like completely numb, with tingling all over my hand and fingers"

"What were you doing when this started"


"Where were you?"

"In bed"

"Had you been sleeping?"


"What side do you sleep on?"

"Of the bed?"

"No, do you sleep on you left side, right side or back?"

"My left side"

"So you woke up lying on your left side, your arm was numb and you had pins and needles in your hand?"


"How is it now?"

"It's gone now"

"Did you have any other symptoms?"

"Yes..." (he didn't expand without a prompt)

"What were they?"

"I saw stars in my eyes"

"When did that happen?"

"As soon as I stood up from bed I felt dizzy and there were stars in my eyes"

"And are they gone now?"


"So what did you want us to do?"

"I'm not sure, I had a numb arm and stars in my eyes so thought I was having a stroke, am I?"


"What do you think caused it?"

"At a guess, you had pins and needles in your arm because you slept on it and felt dizzy because you stood up suddenly. Did you look at a light before you stood up?" 

"Actually yes, my wife turned the light on, do I need to go to hospital?"


I'm not Doctor Gregory House, Head of the Department of Diagnostic Medicine, but this was pretty cut and dry as far as I was concerned. Surely in 31 years he had experienced pins and needles!? He must have! Maybe I'm wrong, do people never feel slightly dizzy after standing suddenly? Do they not see the light burnt on their retina after looking at a light bulb?! I do! Do people really call an ambulance the second they feel a symptom of any kind?! Do they not wait even 2 minutes to see if it goes away?! Clearly not! We have all seen the stroke advert on TV, the droopy face, the paralysed arm and the slurred speech, but I'm sure it doesn't say call 999 if you have pins and needles followed by a 10 second head rush!? This is what we are up against people! This is one of the many 999 calls we attend to; people really do call for this! How do we stop them?! Answers on a postcard! Needless to say, we left him at home with all the information he needed on strokes so not to call again unnecessarily! I really do despair sometimes, a lot of people don't believe some of the things people call us for but that is because they judge things by their normal standards! You need a whole new set of standards to understand the mind-sets of some people! That is how I stay calm when faced with utter stupidity!

Saturday 23 June 2012

Being ill

"44 year old male, chest pain & DIB"

Difficulty in breathing can mean a number of things: asthma, allergic reaction, chest infection, COPD, traumatic injury, panic attack, heart failure; the list is endless. If you call NHS direct or 999 and mention chest pain or breathing problems you will get an ambulance. It's that simple. That is regardless of whether you need one. They are the buzz words, red flags which mean it is not worth the risk. Not only will you get an ambulance, you will probably get a fast response car too because that is what the high category of call dictates. I get the need for it and on the rare occasions the chest pain is a heart attack, or the DIB is life threatening asthma, it's great to have the extra hands. Nine times out of ten however the chest pain is a panic attack and the DIB is a chest infection. This job was a pretty familiar call, especially at 7am. People with respiratory problems are worse in the mornings due to prolonged lying down; rather than get up and see if it improves over a couple of minutes, they call 999. We arrive, sit them up, put them in a chair, take them to the ambulance and they say 'I feel better now'! Shocker!

This job was miles away, so with the usual grumbles about being sent out of area so soon into the shift, we headed off. By the time we arrived the FRU had been on scene for a while. Inside was our patient, sat on the bed talking normally. He had woken up with some shortness of breath, 'a wheeze', and a terrible cough. We ran through the usual questions, most of which the FRU had already asked so gave us the answers. His pulse was a little fast, his temperature was a little raised, his chest was raspy so in all likelihood he had a chest infection. It was too early for the GP, and the walk-in-centre won't take patients who have had chest pain. Bear in mind, when the following conversation occurred, the FRU had been on scene for about 20 minutes and had been discussing medical history and his current presenting complaint: 

"Do you want to grab some stuff together and we'll pop you up to the hospital?"

"I don't want to go to hospital"

"Why not? You've called us for chest pain and difficulty breathing and you are showing signs of a chest infection. I think you'd benefit from hospital and some antibiotics."

"I've already got antibiotics"

"What for? When did you get them?"

"For my chest infection, I saw my GP and he gave me this"

He handed me a carrier bag. Inside was a box of Co-Amoxiclav, a box of Prednisolone, a box of Paracetomol and a Salbutomol inhaler. 

"When did you start taking them?"


"How many have you taken?"

"I took one last night but I still feel ill this morning?"

"You need to take them 3 times a day for the entire course, you won't get better overnight. Why did you call us then not tell us you have already been treated?! What do you want from us today if you don't want to go to hospital?"

"I just wanted you to check me over because I still feel ill so I thought the tablets weren't working"

You can imagine how the conversation continued! It was like talking to a brick wall. He didn't see my point nor did he think there was anything wrong with wanting an ambulance for a check-up. I didn't lecture him because a) there is no point and b) that isn't my job. There needs to be much more education about when we should and when we shouldn't be used, but I am not the one to deliver it. We checked him over, filled out our paperwork, got him to sign it and left. 

I just do not understand some people's mentality. It is as if people don't expect to feel ill when they are ill! They think we carry a magic cure for 'feeling rough'! Well, newsflash, we don't! There is nothing we can do if you have already been given medication other than drive you to hospital. That is what ambulances do. I am just so fed up with going to people who have called 999, for an ambulance, and then don't want to go in one! I teach my son that if there is an emergency you phone 999 and ask for whatever service you need. The key word is emergency. That is what 999 is for. Having a cough from a chest infection that you have already seen the GP about, already been given medication for, and already started taking said medication, is not an emergency. It is called 'being ill'. Just deal with it! Get a Lemsip, take your medicine, make a hot water bottle, feel sorry for yourself, eat comfort food, watch Jeremy Kyle, do whatever you need to do, but as my mum always used to say to me:
"I know you are ill but can you do it quietly over there. Thank you"

Thursday 21 June 2012

The Pen

"26 year old female, moaning about a pen"

OK, bear with me! This is a rant, not a big one, not a long one, but one I want to get off my chest! One thing you'll notice if you are ever on an ambulance is how much paperwork we are doing. Throughout a 12 hour shift we could do maybe 10 jobs. That is 10 patient report forms. If it is a difficult job there may be continuation sheets. Depending on the job there may also be capacity forms, vulnerable adult forms, vulnerable child forms, recognition of life extinct forms and parental agreement to investigation forms. If your vehicle breaks down there is a vehicle defect book to be completed and if you crash there is an accident report form to wade through. If you are assaulted or injured, or if someone gets injured in your presence, there is the accident report form, and if you receive abuse there are forms to flag addresses. Every shift there is a vehicle summary form for all the mileage you have done. You have to sign in and out, sign out and in drugs, you have to do a vehicle cleanliness audit and keep a log of all the skills you use during your shift. Are you getting my gist?! There is a LOT of writing to do and therefore we get through pens at an alarming rate!

I'm not just talking about the amount of ink we use either. Pens get lost, pens get nicked and pens get covered in bodily fluids! The result each time is the same, you need a new pen. There is no point in having a nice pen as it won't last and the cheap biros don't work! OK, they do work most of the time, but sometimes, if we are not taking a patient to hospital we have to write on the back of our PRF and get the patient to sign. As it is carbon copy paper, the back has an oily film over it which most cheap biros don't work on. I can't believe I am talking about the ins and outs of what pens to use, but I have started so I will finish. The Paper Mate biro works a treat but it costs more than the cheapo ones! That said, you need to be able to write on both sides.

My issue with all of this is that I have to buy my pens myself. We all do. There are no pens provided whatsoever. And why not?! I know it doesn't cost much but over the years it adds up! Why should we have to pay for it when we have to write so much for our job?! We are told we have to fill out all the extra forms, so surely pens should be provided?! It is no different from employing a typist and telling them they have to provide their own computer! We are not alone; most NHS staff have to write loads and loads of paperwork and most have to provide their own pens! It is just something that annoys me every now and again. I'm annoyed today because last night I lost my pen. My crew mate had no pen and I had no spares! I had to go and buy another with the £2 I had on me. That meant I had to go without a Costa! Why the hell should I have to pay?! I don't want to write everything! I can treat a patient and take them to hospital without the need to write. I write because I have to, because it's part of my job! If you want me to write, GIVE ME A BLOODY PEN!

Rant over! 

3 am

This is an ambulance blog right?! So, you can imagine my surprise when I was asked to guest post for Big Fashionista! She is a powerhouse in the blogging world so it was a real honour to be asked to write for her ,but what about?! Fashion, beauty, lifestyle, her much vaunted Nom or Vom?! Luckily for me, and probably you too, it was none of the above! She just wanted a blog, about a job I've done, that I wanted to share with her many readers!

"18 year old male, fall from height, cardiac arrest"

3 am is a cold, dark, wet, blood soaked account of one of those nightmare jobs that stay with you. Go have a read on Big Fashionista's website and while you are there enjoy some of her fabulous posts!

A big thank you again to Big Fashionista for inviting me on to her blog. I am not ashamed to admit that I did a happy dance when no one was looking!

Wednesday 20 June 2012

The Circle of Life

Life is a funny old thing and if this job has shown me anything it is that. The general public of this fine country never fail to disappoint. I see incredible strength and incredible weakness, absolute joy and crushing sadness. Stupidity is rife, common sense is sparse and everyone loves a good drama. I get to see a snap-shot into people's lives, I get to see inside their homes, inside their bedrooms; see their photos, their prime and their squalor. The difference in people is truly amazing but the basics are the same. You are born; you are helpless and rely on everyone for everything. You grow up; work, live a life and occasionally get so drunk that you regress to the behaviour of an infant. You then grow out of it; retire, get old and eventually you are back to square one. You are helpless and rely on everyone for everything again. It is the circle of life. It is only ever going to start and finish in exactly the same way. It's how you act in the middle that defines you.

This night shift was no different to any other in terms of the length of shift, the crew mate and the type of jobs we did, but there were three jobs that stuck out, that got me thinking:

"1 month old male, crying, DIB"

Not the most exciting of headlines really! We headed round to the address expecting the usual 'walk on, walk off' type of job. They are our bread and butter jobs; no lifting required, from start to finish it would take an hour, the patient probably not that ill but a trip to hospital regardless. We arrived and headed inside. The doting parents were stressing, the baby was indeed crying. He way lying on his back, massively distressed about something. What? No one knows; they can't communicate and it's a case of 'best guess wins'. Try cuddles, try music, try food, try toys, try Calpol. Clearly in this case it was then 'try ambulance'. Unlike most other mammals, human babies are helpless. For years they can't really do anything for themselves. They need their nappies changed, they need to be fed, they can't explain what they are thinking; their frustration must be immense. This is how it all begins. Ahead are years of learning, years of making mistakes and years of paying obscene taxes, working for the best part of 50 years and if they are lucky having a reasonable retirement. We checked him over, walked to the ambulance and off we went to hospital. I love the innocence of them. Yes it's annoying that this is a complete waste of time, an arse covering exercise if you will, but babies go to hospital. I'm not risking it! I also remember how I felt the first night I came home with my son. I just stared. 'Has he stopped breathing?', 'Is he ok?', 'Why is he crying?' The fact is I was still learning and so are they! Handover complete, I ran to the shop to buy my nutritious dinner of a BLT and a coffee; a pretty standard diet. Next!

"26 year male, lying on pavement,  intoxicated"

This is the regression I mentioned. Having had 2 bites out of my pre-packed BLT sandwich and a few slurps of coffee, we arrived on scene outside a pub in the heart of the city. Lying on the floor in what appeared to be a very expensive suit was our patient. He was conscious but plastered. Apparently he had been drinking all night with friends and something went array after the last Jaeger-train & Sambuca chaser. Binge drinking seems to be the hobby of choice for most 16 - 30 year olds. They can never handle it; loose all sense of decency and end up lying in a pool of  their own vomit in front of the group of girls they had been trying to impress with their power-drinking prowess. Oh how the mighty have fallen. We got him on to the bed and onto the ambulance. His friends were very well spoken. Apparently he was a hedge-fund manager, whatever that is. Rich people investing in hedges? I genuinely have no idea. I can barely afford a tea fund. Job title regardless, he was now back to being helpless, just like he was 25 years ago. He needed positioning so he didn't suffocate, his face needed wiping and at hospital he would need undressing and dressing again. I have no doubt that once fixed he'll be mortified and full of regret. En route to hospital the regression was more than evident. Remember boys when they are born? Remember the nappy change horror? The arch of pee?! Yes... Half way to hospital this guy whacked out his crown jewels and did his best impression of being back on the changing table. It's amazing what 25 years, a degree and a bottle of Jaegermeister does to one's sense of decency. True to form, my solution was simple; chuck patient's Hugo Boss suit jacket over his crotch and swiftly avoid the golden river heading towards me. We dropped him off, cleaned out the vehicle and I got back to my BLT. Next!

"93 year old female, fall, can't get up"

The address was a care home. The word 'care' is meant to be ironic or sarcastic I think because, despite an army of 8 carers on scene, they left her without blankets until we arrived.  Obviously, for health and safety reasons they cannot help their patient, a patient in their care, off of the floor. Silly me. Unless there is an injury we are not supposed to be called, but in all fairness due to her advanced dementia she was unable to tell them. This is where life reaches full circle. Ok, so I don't imagine that in 1944 she was binge drinking her 20's away, things were different then, but I'm sure in her own way she had a raunchy dinner and dance or two. She has lived her life, a good life if her photos were anything to go by, and was now back at square one. Lying on the floor unable to do anything then herself; she needs her nappy changed, she needs to be fed, and can't explain what she is thinking or feeling. The frustration must be immense. This is how it all ends. Depressing?! Kind of. I don't want to end up like that, I want better care and more dignity but we cannot change the inevitable. We will end how we started. We checked her over and put her back to bed. There were no injuries or anything untoward going on. It was another bread and butter job, a pick up and put back to bed. I knelt down beside her. I felt something strange. A weird sensation; one I have felt before but one I promised myself I wouldn't feel again. It was the all too familiar feeling of urine seeping through my trousers and onto my knees. Joy! Next!

Tuesday 19 June 2012

Stop, Look & Listen

This week marks Child Safety Week so to that end this is the first post of three to highlight areas of concern that I have come across in recent months. The theme this year is Small steps to safety to show that by changing only a few small things, a child's safety can be greatly improved. For example: putting hot drinks safely out of reach, teaching children how to cross the road carefully, strapping your child into their car seat each time, or fitting (and regularly checking) smoke alarms; these little things can make a huge difference. We all have our moments, sometimes careless, sometimes forgetful and sometimes doing things on autopilot; Child Safety Week aims to just raise awareness of the accidents that injure and kill children and how to prevent them. Writing those few words was chilling, but it does happen. I have seen it. You only have to read 'A Tragedy Laid Bare' to see how quickly lives can change.

This post is about road safety. It is simply a look at the basics. Stop, Look & Listen! Three words which all children are taught. The thing is, do we always set the right examples? Do we always cross at crossings? Do we always stop? Do we always look left, look right, look left again? Do we always listen to what is all around us? I have to admit I may be guilty of failing on occasions. I probably cross local roads with my son without going through the routine every time. I'm writing this post because I have been to the same type of job twice now and to me, twice is two too many. 

"RTC Car vs Pedestrian. 2 patients. Age unknown. Report for HEMS"

When someone is hit by a car it attracts attention. Normally it happens in a busy area with a large footfall and as such crowds gather. What you get with a crowd is a lot of mobile phones and a lot of 999 calls. This inevitably leads to confusion over what you are going to so I tend to just wait and see. The words Car vs Pedestrian can mean pretty much anything is possible. It could be bumps and bruises, broken bones, crushing injuries and at worst, a very public, traumatic cardiac arrest. We pulled into the high street and could see about 100 meters away the hordes of arms waving at us. The sheer number of them was daunting to say the least but the frantic nature of them was a concern. I may have said in the past I love a crowd, today I didn't. Why? Kids.

Lying on the floor, surrounded by people were our patients. A mother and her daughter. They had been hit by a car whilst crossing at traffic lights. The driver hadn't seen the lights change, nor seen them start crossing. He had probably been on his phone or something similar and was understandably shaken up. Our priority however was lying on the floor. Initially heads had to be immobilised so we used members of the public. We each assessed a patient. I had mum, my crew mate had the little girl. The mum was in huge amounts of pain and rapidly becoming more and more groggy but naturally her only concern was for her daughter. Until she knew her daughter was OK I was going to get nowhere so I promised to go and see. On this occasion mum had taken the impact. A basic assessment showed the girl had been knocked to the floor by mum, no direct impact with the car and no injuries other than bruising and grazed hands.

Mum wasn't so lucky. She had instinctively turned to face the car and protect her daughter from it. The impact had broken both of her legs. She also had a broken pelvis and a broken arm. She had possible spinal injuries and neck pain. She had a head injury. A bad one. Talking loudly across the gap between where they were lying, me and my crew mate had a very public, frank discussion and decided to leave the girl where she was, the police who were just arriving would deal with her. There was no other ambulance or resources available yet. The mum was a priority; her injuries were serious enough for us to request HEMS. The next 12 minutes flew by; by the time the helicopter was circling above we had 2 ambulances and a car on scene. It was a hive of activity, everyone was doing something; the bed appeared, IV access was being gained, dressings and splints applied and spinal board and straps in position. It was organised chaos. Once the orange jumpsuits were on scene they took over. She was whisked off in the helicopter and we took the girl. 

"Is my mummy OK?"

To be continued...

"RTC Car vs Pedestrian. 2 patients. 6 year old female unconscious. 35 year old female injuries unknown. HEMS on way"

Gulp. We go to 9-10 jobs a day, 4-5 days a week, 52 weeks a year. That's roughly 2500 jobs in a 12 month period. 99% of those jobs we don't bat an eyelid to. 1% of them terrify all of us. The anxiety is palpable en route to jobs like this. Read '7.9 miles' to see exactly what is going through our mind. The only difference between that job and this job is today we pressed 'on scene'. There is something very surreal about seeing a child lie on the floor. Maybe it's their size, maybe it's just the fact they are a child, maybe it's because I see my boy lying there instead. It's horrible. She was motionless; the mother was on her knees beside her crying. We ran over. There was no pomp and circumstance, nor was there any thought spared for the mums injuries. Today, the little girl took the impact. Take a moment to think of a child standing next to their mother. Think about where the bonnet of a car is on each of them. You can probably see why the mum in the last job had leg injuries. You can also now see why this girl was unconscious. 

The girl was alive, her airway was clear, she was breathing, her pulse way strong. Primary survey clear.  Due to the fact she was unconscious and so small we decided to get her on the ambulance as soon as possible out of the public glare. We fitted a collar and as soon as the second crew arrive we got her on a board and out of the public view. The mum came with us and was incredible. She let us do our thing. She sat in the front of the ambulance watching through. She didn't ask questions, she didn't distract us, and that is such a huge help. As a parent I can only imagine what  was going through her mind. Someone asked for an update on HEMS. Before the answer was given the back door swung open. Thank god! The sea of orange got on board. No helicopter this time, they had come in the car and would travel with us to hospital. We stood back and they did their thing. Once stabilised we left. It was a 20 minute drive to the trauma centre. Eyes fixated on the road I made my way through the traffic, all the time aware there were 4 people standing up in the back. Mum stared. She didn't say a thing. Just watched and cried. As we pulled in to the hospital she said:

"Is my baby going to be OK?"

To be continued...

Stop, Look & Listen. Both of these accidents happened at pedestrian crossings; the lights had changed to red, the green man had appeared, and they had crossed. The traffic had not stopped. Autopilot had kicked in. You see a car stop, the green man appears, the beeping begins and you cross. Unfortunately, where there was no car waiting on the far side there now is one; seconds later and there is nowhere to go and nowhere to move to. The impact is inevitable. All that remains is who will take the brunt? Both of these could have been avoided. The small step to safety is just to double check. Have the cars in both directions and both lanes stopped? Is it safe to cross? Drum this into your little ones. Set the example. Stop, Look & Listen.


How do you say "Probably not" to anyone?

On The Buses

"45 year old male, unconscious, breathing unknown, life status unknown"

Public transport. We all use it at some point. Personally, I avoid it where I can. The price does not match the experience. If it's a train you have to pay an obscene amount of money to go minimal distances. For that money you get to stand up in a hot sardine tin, armpits in your face, rubbish on the floor, chewing gum on the seat, shoehorned in like battery hens and you are taken from A to B where you may or may not get pick pocketed. It's all part of the fun. Then you have the bus. It's still at least £2 just to go 1 stop up the road; again you have to stand, chavs aplenty line the aisle having conversations across the bus: 'yes bruvs', 'no bruvs', 'trust me bruvs', almost in three part harmony. The baby at the front is crying, the diva behind you is on her mobile phone and you sit there tediously moving through the traffic slower than walking pace. Then you have 33 sweaty school boys bundle on, block the exit and spend their entire journey throwing balled up paper at each other. On top of all of that you have the drivers. They have a warped sense of power and never smile. They think they own the road and I'm pretty sure they get their driving licence free with a Fisher Price 'My First Car' kit. And yes, we have to pay for these experiences. 

My feelings about public transport aside, it is my dealing with bus drivers at work which sends me into a blind rage. It's not the fact that they pull out on me without indicating, block the road when my sirens are blaring so they can continue their drop off and picks, or even flip me the bird because I cause them to have to move out the way for me. It's none of that. It's there bone idle, lazy abuse of the ambulance service every single day. 

6am starts are wrong; when you leave the house it is too early for breakfast and I generally ignore the alarm for so long that coffee isn't even an option. We checked over our vehicle, made a coffee and I put my toast in the toaster. JOB! Typical. About half a mile away the update came through:

"Patient on 84 bus in bus station"

I looked frantically around for something to throw in frustration. There was nothing. I suddenly developed fluent 'French' and filled the cab with all sorts of expletives. God knows what my blood pressure raised to but apparently my face was bright red. Admittedly I was pre-judging the job, but having done the same thing countless times I was fully prepared for what was about to happen. 

We pulled into the bus station and headed for the bus with its hazard lights on. In the cab was the driver, feet up on the dashboard, newspaper in hand and a COFFEE on the dashboard. As I approached, the door was opened for me. The moron behind the glass pointed upstairs and said:

"He's upstairs at the back"

"Can you take us too him then? Who's up there with our unconscious patient?"

The driver looked extremely put out but I didn't move an inch until he got out of his cab. I gestured for him to go ahead of us. As he started to go up the stairs the (not so fast) response car arrived. A patient unconscious and possibly not breathing gets a full works and highest category of call. The two vehicles have just cost the tax payer £1500. We followed the driver up and sure enough, at the back of the bus in the corner, was our patient, asleep.....

"When you called you said the patient was unconscious, he isn't"

"I thought he was"

"He's asleep"

The driver just shrugged his shoulders.

"HELLO, wakey wakey, rise and shine!!" I shouted whilst shaking his leg.

His eyes burst open with shock. What a rude awakening! He didn't have a clue what was going on! He had simply fallen asleep on the bus. He had been up all night and had waited for the first bus and had nodded off. Now he needed to go back in the other direction. He hadn't even been drinking! He was very apologetic for 'wasting our time' and headed off on his merry way.

"Don't worry fella, we all get tired, and it wasn't you who called us, apparently it takes an ambulance to say 'wakey wakey'!"

He laughed, I felt smug, my crew mate cringed and the bus driver frowned.

"It's not my job to wake people up, it's not my problem if they fall asleep"

"But it is the ambulances job to get your passenger off your bus?! Such a waste of resources"

"We are not allowed to, for health and safety"

"What?! You're not allowed to talk to people, say 'Hello' or 'Wake up'?!"

"No, they might be violent"

"True, best get a couple of girls to come and do it. Do me a favour; don't say unconscious and not breathing unless they are both of them. If they are unconscious and not breathing you should be looking after them, not reading your paper. Unbelievable"

With that, I grabbed my bag and stomped off.

Every single day these people are wasting time and money through sheer laziness and blatant lying. They don't even try. They look in their mirror and see someone still on the bus and call us. What if someone was actually dying? What if they were having a stroke, a hypo or worse, had gone into cardiac arrest and needed CPR?! Does health and safety mean they cannot help a member of the public, the paying public, when in need? This is not what an 'Emergency Ambulance' is for, this is not how the taxpayer's money should be spent, and most importantly, this is not a reason for me to miss breakfast and go without coffee. Now where in God's name is the nearest Costa?!!!

Monday 18 June 2012


What do you want for your kids? Success, happiness, good health etc, are all things that are top of the list. The dads may wish their son becomes a footballer or a golfer. The mums amongst us may wish their daughter becomes a dancer or a doctor (The chavs amongst us want them to be a WAG!). These aspirations are generally a flitting fantasy based on our own childhood wishes and realistically we just want the basics. We put a strong onus on them being good people with a good work ethic and to have a good character with good moral fibre and good manners. We just want them to be good! We are there to nurture their interests, guide them through the good and bad times and hope they leave with enough social nous to make their way in the big wide world. There will be slip-ups along the way, that is a given, parenting being the prime example. I have certainly made my fair share of faux-pas during my almost 5 years as the owner of a boy!

"5 year old female, fallen, bleeding from face"

It was a gorgeous summer evening, the kind of evening where all you can think about is being sat in the garden, a BBQ, a jug of Pimms, some music and the company of friends. There was the smell of burning charcoal in the air and the thought of sizzling meat and a token potato salad was frustrating and making me drool. Why? Because I was 4 hours into a 12 hour shift in an ambulance with no air-con and my lunch bag only housed a soggy tuna sandwich and a warm bottle of water. Yes, before you ask, I AM living the dream. The 'bleeding from face' appeared on our MDT and was met with all the enthusiasm you could expect. We now had a choice; drive 4 miles with windows open and risk losing our sense of hearing or drive 4 miles with the windows closed and risk melting to death. We opted for the former! Needless to say, 4 miles later we wandered towards the front door of our patient's house with a severe ringing in our ears.

As we approached the door we could hear the crying. All kids have their very own set of cries. There is the hunger cry, the pain cry, the tantrum cry, the ill cry, the fake cry, the overtired cry and the 'give me what I bloody want' cry. We all know them and deal with them in different ways. I could tell, as we were walking up the path, this was a pain cry. When our kids are in pain, what do we do? Comfort them, reassure them, play down what has happened: 'it's not that bad', 'shall I kiss it better?', 'you're being so brave' etc. It is natural; we will do anything and tell them any lie we can, just to make them feel better. It's called parenting. 

"Hello there, what's happened today?"

"She slipped on da wet floor gettin' out of da barf and smashed her face on the floor, oh my god, there is blood EVERYWHERE"

She ushered me into the little girl's bedroom but before I could say anything she had time to quickly berate her for mucking around at bath time. 

"It's OK, it doesn't matter, have you hurt yourself?" I asked the girl as I knelt down.

Before she could answer through the tears, mum interjected:

"Oh my god, it's really deep, it won't stop bleeding, oh my god, she's gonna need stitches and EVERYFING. It looks awful"

No wonder she was crying, poor little thing. I tried my best to assure her that it was OK and I was just going to have a look. The mum butted in again:

"Oh my days, her face is gonna be fucked up, she's gonna have a scar, she can't have stitches on her face, oh my days!"

Just out of interest, what exactly are you imagining here? A large cut across the forehead bleeding profusely? A fat lip and a nasty gash somewhere on the face? How about if I said it was a 3mm cut underneath the chin, not remotely visible if you were looking at her! Yes... I know. Why the drama?!

"It's not that bad at all, it's not even bleeding now, it won't need stitches and probably won't even need glue." conciliate.

"It needs glue, it has to be glued, I can't risk a scar, tell 'em it has to be glued."

"The hospital will decide but it is so small and under her chin they probably won't bother to be honest." I continue.

"Nah, I ain't 'avin that, they 'av to glue it, I want her to be a model, I can't have her havin' a scar or a fucked up face, no way, she's gonna be a model, I ain't 'avin her let me down cause of a scar."

You can imagine what was going through the little girl's head and why she had a totally rational fear of me. She was crying, waiting for an ambulance to come and take her away. Take her away because her face 'looked awful', it was bleeding everywhere, there was going to needles and stitches, she was going to have a scar and if she failed at becoming a model her mum was giving off the impression she would love her less! THIS is not parenting. This is madness & I had to tell the mother that she was scaring her child for no reason. I spent a few minutes chatting to the kid, convincing her there would be no needles or stitches and a nurse was just going to look at it and probably give her a sticker for being so brave!

"Will I be able to go to school tomorrow?"

"Of course you will! What are you doing at school tomorrow? Anything fun?"

"I'm doing a dance in assembly and then there is a cake sale." she said with a grin.

Cue mum...

"But I've told you that you can't eat cake or you'll get fat. Also we don't know the hygiene in other people's kitchens, it could be minging"

Cue despair...

I have clearly led a sheltered life up until now. Obviously you see pushy parents on TV, but weight conscious 5 year olds? Mums obsessed with living their own fantasy through their kid's short childhood? Doesn't that only happen in American pageants? I really don't know what distressed me more, her inability to make her child feel better when distressed or her unhealthy obsession with her daughter's future. I just wanted to scream 'LET HER BE A KID'! Success? Happiness? Good health? They certainly appeared so far down on the list of priorities in this household. Aspirations of grandure are never healthy and the pressure and expectations can ruin a childhood.  The 'ambulance' in me wanted to tell her off about inappropriate use of the service. Kids fall over, they get bumps, they get bruises, they get up, they cry, you kiss, you feed, they smile. Simple. The parent in me wanted to tell her to calm down, comfort, kiss and hug her daughter, stop frightening her and make everything better. The foodie in me wanted to say 'just let her eat some bloody cake'! Instead, I kept schtum, blew up a rubber glove and made it look like an elephant. 

Cue the smile...