Thursday, 31 January 2013


I was a total surprise when the much vaunted and incredibly talented blogger Big Fashionista asked me to guest blog for her. Not only was I massively chuffed but was also massively nervous! A new audience, new people to critique my writing! I didn't have a clue what to write about so stuck with what I knew best. Blood and Guts! Thanks again to Kellie for inviting me onto her blog. It was an absolute pleasure. Please follow her on twitter @bigfashionista and visit we website You won't be disappointed! Promise! is my blog that appeared on her website!

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

I had been driving for the best part of 8 hours on the wrong side of the road. Not because the traffic was busy and I was on blue lights, but because I was driving back home from Europe after an impromptu few days away. The kicker was that I had a night shift to get back to. I got home at about 4pm, quick shower, ironed uniform and off I went for my 6pm start. In all honesty the prospect of a 12 hour night shift filled me with nothing but dread, but what's a girl to do!? Things started just as expected and just as they always do. A job, straight away; quickly followed by job after job after job after job. It was a typical Friday night; all alcohol or drug related, just a thoroughly exhausting evening. For those of you who have worked night shifts you will know exactly what I mean by 'the 3am lull'. Eyes are heavy; an overwhelming sense of fatigue engulfs you and the thought of another three hours, three patients, and three lots of paperwork makes you feel physically sick. Your handwriting is getting worse and worse, your mood is becoming more and more fragile and your patience is well and truly gone! You spend 15 minutes at hospital eating sweets, drinking coffee and doing anything you can just to stay awake. It really is a horrible experience and if you can go through life managing to avoid 'the 3am lull' I highly recommend that you do! 

Well, it was 03:11, the rain was pelting against the windscreen, it was dark and cold. We pressed the button knowing full well we'd get a job straight away and headed out of the hospital. If anything will wake you up, this job will. The words 'cardiac arrest' still gives me the adrenaline rush, the pumping heart and the excitement.  Two miles to travel, that was all. I lit up the roof, turned on the bells and off we went. There was still plenty of traffic about and with the torrential rain filling the roads it was a nervy drive. Visibility was terrible, road marking and signs were invisible and all you could see was the headlights and brake lights of cars. I have never seen rain like it to this day. We pulled off of the main road into some kind of alley way. 0.1 miles to go, surely we would see something soon? We got a message to say the response car was on scene as we turned around a tight left corner. That was the moment that I can see like a freeze frame. No more than 50 feet away was a silhouette of someone doing CPR, lit only by the strobe of the blue lights. The rain was cutting across the view at a 45 degree angle and there was a constant whistle of wind pelting down the alley. We ground to a halt about 5 feet from them, grabbed some kit and ran over. 

Lying on the floor, illuminated by headlights was our patient; he was in the gutter of this tiny cobbled street, a crowd was gathering a few feet away and to be perfectly honest, what they could see wasn't a pretty sight. Because of the background noise, there was a lot of shouting to let each other know what we were doing. All we knew was he had fallen, where from we didn't know. Apparently he had been breathing for a few minutes before, but had now stopped. There was blood everywhere; the guy had landed face first and had massive cranial destruction. It took two of us to vaguely secure his airway but no sooner as we had suctioned blood out of his throat more appeared. HEMS arrived within a couple of minutes and took the pressure off. The six of us worked on him for about half an hour, his chest was cut open, his lungs decompressed, drugs were given and I was just watching it all in a rather detached state. I was ventilating him; once the airway was secure it was a case of kneeling there, in a pool of rain and blood, just breathing for him. I remember looking and staring at his face. A young guy, good looking, an entire life time ahead of him and here he was. Lying motionless, dead in the gutter, doctors, paramedics and technicians tirelessly working to save him and I was thinking 'what a waste'. From his head, I could see every injury he had. It would need a miracle to survive the trauma his body had suffered. It was a very disturbing sight and one that still haunts me from time to time.

He was declared dead on scene. There was that moment when the decision has been made, you have all agreed to end the resus, CPR is stopped and you take away the mask. That's it. His final lifeline. Until that point there is hope. Until that moment you have the distraction of the situation. Now you are aware of the crowd again which is now 100 strong. They had watched on in the rain. Just staring, in silence. They had seen every compression, every ventilation, every incision, every needle, every shock, every drug, every effort we had made. It is most likely the single most distressing thing most of them have seen and will ever see. In many ways I felt like I'd let them down. Stopping a resus is always a bit of a tough moment, doing it in public you can feel all eyes on you as you step away from the body. And that is all it is now; a body. He was covered in the blanket and as we stepped back, all in a daze, we found out what had happened. He had fallen from the roof, the roof of this 4 storey building. A 70 foot plunge. No one knew what happened. Was it suicide? Was it an accident? Was alcohol or drugs involved? What was his name? Why did no one know him? I don't want to think what was going through his mind as he fell. I hope nothing. I hope no one has to suffer that fear of inevitability. That moment before death. A young man with endless possibilities ahead of him had lost his life and whatever the cause, it was tragic. We all piled into the ambulance for the debrief. Everyone just sat there feeling thoroughly dejected. The saturated, blood soaked uniforms a stark reminder of what this job can throw at you. One thing was for sure, I was very much wide awake now. Only an hour and a half until the end of the shift. A quick uniform change and time for one more...

Since writing this blog, I was send a newspaper article, detailing the circumstances of this tragic accident. It spoke of a talented young man who fell to his death after a night of alcohol and cocaine. What a awful waste of a life. 

Wednesday, 30 January 2013

A Generation Gap

Working for the ambulance service I get the opportunity to see all parts of society at its best and its worst. I see some truly amazing people but also some truly despicable people. Being an ageing population we are seeing more and more of the elderly and that's not going to change. What amazes me most of the time, is how vehemently independent they are, in comparison to how totally unable to cope our younger generation is. Last night I did two jobs that summed this up. Two patients who were both perfectly pleasant but showed exactly what has happened to society in just 60 years and the stark differences in character and ideals that have emerged.

"26 year old male, ? broken ankle"

We were called to a sports hall. When we arrived, the caretaker (who acted like our presence was really putting him out) showed us to the hall. Everyone in there was still playing football, but one paused to point us into the changing room. Inside, lying a the bench, moaning in agony like he had been shot was our patient. He pointed at his ankle and told us it was broken. That information was given to a backdrop of 'bruvs' 'truss' 'ya get me' and 'innit'. That is how people talk now, I didn't hold it against him for a change, the manners were not omitted. What was amusing is that it clearly wasn't broken.

It was slightly swollen but no bruising or abrasions and certainly not at a funny angle! He had full sensation and full movement (despite the tears) and the way he described the injury, it was most likely a sprain. Still, an x-ray would confirm! The charade of being shot continued and for this I blame the footballers: the play-acting wimps that throw themselves on the floor and cry at the hint of being touched. These are the role models that kids are growing up learning from. You only have to have seen 'BallBoygate' to know what I mean! There is no pain threshold, there is huge overreaction and absolutely no sense of shame in doing so. His first thought was to call an ambulance, not a relative or taxi. This is because that's what you do these days, innit!

We got him onto the bed, because when I tried to get him of hobble with my assistance he wailed! Once on the ambulance I cannulated him because the Entonox didn't agree with him. I gave him morphine, mainly to give me some peace and quiet, but also because he gave a pain score of 10/10. He stuck to this despite me asking if it was the worst pain imaginable. He said it was and even said it was worse than my suggestion of having his arm ripped off by a bear. I refuse to believe any pain score of 10/10 because we all know there is no worse pain than stubbing your toe! Anyway, once the morphine was given we got on our way. 

En route to hospital I was doing paperwork and our patient was regaling his tales of heroism to what appeared to be everyone he has ever met. And he was really hamming it up. 'Bruvs' this and 'bruvs' that. He was telling everyone he'd broken his ankle and may need an operation. He made it clear he wouldn't be allowed to work for at least 6 weeks and was basically going to be crippled. It was also the end of his footballing career! Apparently his body couldn't take it anymore. Just for the record, he was an estate agent and this 'football career' was an indoor 5-a-side kick about on Friday evenings! Soooo melodramatic! 

We got to hospital and the play acting continued. His entire family, extended family and friends were waiting for him. He thanked us for helping him with a well placed 'Safe yeah', which I understand is a gesture of appreciation and we left him to it! 

Three hours later, and back at the same hospital and there he was limping around having got zero sympathy from the nurses!

"Is it broken?"

"Nah, just a sprain, a lucky lucky escape innit."

"96 year old female, fall, head injury"

In stark contrast to our footballing hero, this patient met us at the door....ish! Well, she was lying on floor but had crawled from the stairs and been able to lift herself up enough to let us in. There she was, beaming smile, lying on the floor. The was blood in her hair and she was holding her arm. It turns out it wasn't just a fall, it was a fall down the stairs. Top to bottom with a somersault and half twist on the way down. The first thing she said to us was 'so sorry to have to bothered you'.

Under normal circumstances she would have been collared and boarded and fully immobilised. Unfortunately, we couldn't because a) should had severe spinal curvature and b) she wouldn't let us. In fact, she was quite insistent that we got her up off the floor immediately. I checked her neck before letting her get up and there wasn't any pain or obvious injury. Once up, we dressed the injury on her head and put her broken arm in a sling. My crew mate got the chair. 

"What's that for?"

"You need to go to hospital my dear!"

"Do I have to?"

"I'm afraid so, you've had a big fall and you've broken your arm."

"Ok, but I need to go to the loo and pack a bag."

With that, she shot off up the stairs despite all my attempts to stop her! She packed a bag without any difficulty despite only having one arm at her disposal. All the while, she was apologising for being an inconvenience. She spoke very eloquently, no use of 'bruvs' or 'innit'. It was the way I was raised to speak too. I simply don't understand this new language that people speak. It really does leave me in despair when I hear the ridiculous voices that the younger generation are using. And what worries me more is that they are breeding now! Where will this lead?! Will the Prime Minister in 2065 address the nation by saying 'Yes yes me rude boyz, safe'?! 

After much fussing and packing she had everything she could possibly have need. Notes were left for her cleaner, her gardener and the milkman. The lights were switched off, as was the heating and we got her to the ambulance. 

"I'm so sorry to be wasting your time."

As we arrived at hospital, the 'footballer' was getting into a car. I thought of the dying swan act he put on and then wondered how he'd have behaved if he'd fallen down the stairs and broken a bone! I dread to think. We wheeled our patient inside, smile still spread across her face, and handed her over to the nurse. We left to a chorus of thanks and appreciation. 

There really is a huge void between generations. I know the elderly generally don't feel pain as much but they are made of stronger stuff. They respect society and society respects them. They hail from the days where respect meant something and where getting help was truly appreciated. The younger generation have been spoon fed throughout childhood, spoilt rotten and taught that services in this country are their right. The first patient wasn't a bad person and in his own way, was polite to us, but the gulf in generations was painfully obvious.

Tuesday, 29 January 2013

Unhappy Trumpton.....Bless!

"Fire Brigade concerns at ambulance delays"

I woke up this morning after a long 12 hour shift, to see a BBC article about the fire brigade YET AGAIN trying their best to undermine the ambulance service about response times. Don't for one minute think, that the complaint actually has anything whatsoever to do with them waiting for us. It's part of their ongoing attempt to assume control of the ambulance service so they can play the part of 'Action Hero' and deal with fire and medical emergencies like they do in America.

Last year I wrote a blog called Fire Brigade: Hands of our Service detailing their attempts to take our work away. And they didn't want to take everything, oh no. Just the high categories of calls. The juicy traumas, the cardiac arrests and the sick children. Basically, all the stuff the public would hear about. Funny that. 

Today's tripe wasn't their own story either. It has basically been copied and pasted from an article about how the police service are having to wait a long time for ambulances, which in fairness, they do! Equally though, we often have to wait for police. What gets me though is that the fire brigade take this stance and justify it by saying that they are never delayed. I've said it in previous posts but I'll say it again! THAT'S BECAUSE THEY ARE WAITING FOR CALLS! We are not. The police are not. Both services have more calls than there are resources for and proportionally both have much smaller budgets than the fire service. Not wanting to sound like a broken record, but in London alone there are 1.8 million calls a year to the 230,000 the fire service receive. London ambulance attend 1.3 million of those. The LFB refused to attend over 110,000 of those calls (almost 50%), only 29,000 were fires and they also charge for a lot of the calls they do attend! Their budget is eight times ours! We can't compete and should not be compared!

They speak of 'desperation' when following up on the status of emergency calls! Do they think the ambulance service forgets about them?! An ambulance will arrive when there is one available, no matter how many times you ring and moan, it won't speed up the process! One thing that was also omitted from the report was the amount of fire calls the ambulance service attend unnecessarily! In my ambulance career I have been to in excess of 30 'House Fire, persons reported' jobs, and only once have we had a patient. The rest we have been there just in case. What a waste of a resources. Only last week, I went to a cardiac arrest and there were no other units to assist me and my crew mate. We were on our own for 40 minutes. 800 yards away was a 'house fire' with an ambulance and an FRU standing by because the fire brigade had requested them. There was no patients at all. Looking for causes of delays?! There's one!

Yes, there is a problem with responding to all the calls the ambulance services up and down the country receive. There are not enough ambulances and not enough staff, but that is no reason to jump on the band wagon, for personal gain, with no real point other than undermining the work we are doing. Air your complaints at the government, not the ambulance service. You'll notice that in the article, all the speculation they made, not one incident was reported where the delays in getting an ambulance caused anyone to die or suffer in the long term because of it. No where did it say that the private ambulance that was dispatched, with 'untrained' staff, to an RTC didn't in fact deal with the patient they had. The article, like most others that the fire brigade release as part of their propaganda campaign, is baseless. 

Perhaps as a solution they could offer up some of their exorbitant budget to us! Apparently us paramedics agree with the fire service but are afraid to speak out! Funnily enough, they had no anonymous quotes! I certainly don't agree, and I know most of my colleagues will feel the same way.

Stop this nonsense, concentrate on ducks in ponds, dogs down badger dens, cats in trees, cows in ditches and the odd fire and if given the infinite resources you have, we'll match your response times and come and wait on standby at your fire calls even quicker than we do already. It's worth remembering that whilst the fire service deals with fires, pet rescues and major RTCs, we also deal with the fire's and the RTCs too. On top of that we deal with the millions of emergency medical calls, we are an OOH social service for GPs, mental health teams & patient transport services. We are addiction councillors and a taxi service to the nations drunk people. I'm really looking forward to writing a post about the paralytic fireman I picked up from a bus stop last week!

So, yet again my dear fireman, get your own house in order before you try and take ours! Hands off our service!

2013 MAD Blog Awards

This year is the fourth annual MAD awards for parent bloggers. It is also the first year I know of being nominated! I had a few messages from some of my wonderful readers saying they had nominated me. As per usual, winning anything is highly unlikely but always nice to be mentioned and you've got to be in it to win it! Obviously mine isn't solely a parenting blog but I am a working parent and have my Parenting 101 feature so why not?! You can nominate me for  two categories:

  • MAD Blog of the Year 
  • Best Blog Writer

To do so, go to and vote at will if you think I'm worthy! You'll need to copy and paste my blog URL into the two categories, which is 

Once nominations are over, if I am shortlisted then voting will begin, but we'll cross that bridge if I get there! As always, thanks again for all your support, it means the world to me!

Now That's What I Call Music 999

"27 year old female who really does have the moves like Jagger"

In what is a change from the norm, this is a musical blog post! Recently me and my crew mate have been bringing in 'mix tapes' for our shifts! It started with a bit of Frank Sinatra because at heart we are a couple of crooners! Various conversations about music during our shifts lead us to talking about the music at school discos from the late 80's and early 90's so another 'mix tape' was made! Then there was the festival / skater scene of the late 90's / early 00's! Gradually we built up 70 odd songs which are now a mainstay of any shift! Following various tweets about Mr Boombastic I had a number of requests for my playlist so I decided to post it! If you have 'Spotify', set the following up as a playlist and I bet you will all:
  • Enjoy it
  • Sing a long
  • Move your hips
  • Realise you don't actually know all the words to Informer
  • Start suffering with Jungle Mania all over again
So, have a listen, have a wiggle, add your own! If there are any classics that I have missed, please let me know! This playlist is ever expanding and never exhaustive!

Now That's What I Call Music 999
  1. All My Best Friends Are MetalHeads - Less Than Jake 
  2. All The Small Things - Blink 182
  3. All Shook Up - Elvis Presley
  4. Always Look On The Bright Side Of Life - Monty Python
  5. American Idiot - Greenday
  6. Are You Gonna Be My Girl - Jet
  7. The Bad Touch - The Bloodhound Gang
  8. Barbie Girl - Aqua
  9. Because I Got High - Afroman
  10. Black or White - Michael Jackson
  11. Bohemian Like You - The Dandy Warhols
  12. Boom Boom Boom - The Outhere Brothers
  13. Boom Shack-A-Lak - Apache Indian
  14. Boombastic - Shaggy
  15. Californication - Red Hot Chilli Peppers
  16. Come Back Around - Feeder
  17. Changes - 2Pac
  18. Closer - Nine Inch Nails
  19. Dance The Night Away - The Mavericks
  20. Don't Back Down - The Beach Boys
  21. Don't Slow Down - UB40
  22. Don't Stop Believing - Journey
  23. Dude (Looks Like A Lady) - Aerosmith
  24. Eye Of The Tiger - Survivor
  25. Fat Bottomed Girls - Queen
  26. Fat Lip - Sum 41
  27. F**k Her Gently - Tenacious D
  28. The Fresh Prince of Bel Air - Will Smith
  29. Gangnam Style - PSY
  30. Ghostbusters - Ray Jr. Parker
  31. Good Riddance (Time of Your Life) - Greenday
  32. Here Comes The Hotstepper - Ini Kamoze
  33. Hound Dog - Elvis Presley
  34. I Believe In A Thing Called Love - The Darkness
  35. I Like To Move It - Reel 2 Real
  36. I'm Gonna Be (500 Miles) - The Proclaimers
  37. I Predict a Riot - Kaiser Chiefs 
  38. In Too Deep - Sum 41
  39. Ice Ice Baby - Vanilla Ice
  40. Informer - Snow
  41. It Wasn't Me - Shaggy
  42. Jizz In My Pants - The Lonely Island
  43. Keep On Running - Spencer Davis Group
  44. King Creole - Elvis Presley
  45. Mack The Knife - Frank Sinatra
  46. Mambo No 5 - Lou Bega
  47. Many Of Horror - Biffy Clyro
  48. Minnie The Moocher - The Blues Brothers
  49. Monkey Wrench - Foo Fighters
  50. Moves Like Jagger - Maroon 5 / Christina Aguilera
  51. Mysterious Girl - Peter Andre
  52. One Night - Elvis Presley
  53. Outside - Staind
  54. Pace Your Hands - Reef
  55. Reet Petite - Jackie Wilson
  56. The Rockafeller Skank - Fatboy Slim
  57. Rockstar - Nickelback 
  58. Ruby Soho - Rancid
  59. Smells Like Teen Spirit - Nirvana
  60. Sex On Fire - Kings of Leon
  61. Staring At The Sun - The Offspring
  62. Surfin' USA - The Beach Boys
  63. Sweat (A la la la la Long) - Inner Circle
  64. That's Life - Frank Sinatra
  65. Thriller - Michael Jackson
  66. Tribute - Tenacious D
  67. Trouble - Shampoo
  68. Tubthumbing - Chumbawamba
  69. U Can't Touch This - MC Hammer
  70. Wake Me Up Before You Go Go - Wham
  71. Wonderwall - Oasis
  72. We Didn't Start The Fire - Billy Joel
  73. We No Speak Americano - Yolanda Be Cool
  74. What A Beautiful Day - The Levellers
  75. You're The First, The Last, My Everything - Barry White

Monday, 28 January 2013

Back to Basics

“23 year old male, hand injury”

Right, the time has come to get back to basics. This blog is aimed at anyone who isn’t in the know or is confused about what’s what when it comes to getting treated by the NHS. So, first things first.

Hospital: A hospital is a health care institution providing patient treatment by specialised staff and equipment.

Accident and Emergency: Accident and Emergency is a department within a hospital and is a facility specialising in acute care of patients who present without prior appointment, either by their own means or an ambulance. Due to the unplanned nature of patient attendance, the department must provide initial treatment for a broad spectrum  of illnesses and injuries, some of which may be life threatening and require immediate attention. All A & E departments in the UK are financed and managed publicly by the NHS. As with most other NHS services, emergency care is provided to all, free at the point of need and regardless of an ability to pay.

Ambulance: An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury. The word is most commonly associated with road-going emergency ambulances which form part of an emergency medical service, administering emergency care to those with acute medical problems.

Triage: Triage is the process of determining the priority of patients’ treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately. The term comes from the French verb trier, meaning to separate, sift or select. In a hospital setting patients are divided into three main categories based loosely around the old wartime triage process:
  • Those who are likely to live, regardless of what care they receive;
  • Those who are likely to die, regardless of what care they receive;
  • Those for whom immediate care might make a positive difference in outcome.

Ill people go to hospital. Really ill people go initially to accident and emergency. If they can’t get there due to their illness or injury they get an emergency ambulance. Once at hospital they are triaged. That triage will determine the speed of their treatment. Those rules apply to everyone.

So, we were called to a young guy with a hand injury. Not a bad hand injury but a painful one all the same. He had managed to close his finger in a door. It was swollen. It was bruised. He couldn’t fully bend it. He was in pain. He didn’t take any pain killers. He called 999 and asked for an EMERGENCY ambulance. This was deemed to be one of the acute medical problems that we are there for. He lived half a mile away from the hospital. His girlfriend was there. She had a driving licence. She owned a car. Her car was parked outside. His brother was there. He had a driving licence. He owned a car. His car was parked outside. His mum was there. She had a driving licence. She owned a car. Her car was parked outside. His dad was there. He had a driving licence. He owned a car. His car was parked outside. On the notice board in the kitchen was a business card for a local taxi service. They did not use it. 30 yards from the front door was bus stop. The bus which stops at said bus stop also stops outside the hospital. The patient had legs. They were not injured. He could have walked to the hospital. He chose not to. 

After a brief assessment in the £750-a-call-emergency-ambulance we drove him the half a mile to hospital. His girlfriend and mum came with us. The brother and dad followed in the car and parked in the pay & display car park. We walked the patient into the accident and EMERGENCY department. We spoke to the triage nurse and gave her a detailed history of what happened, what we have found and how he has been with us. She then triaged him based on what we told her and what her cursory look at his finger told her.

  • Those who are likely to live, regardless of what care they receive;
  • Those who are likely to die, regardless of what care they receive;
  • Those for whom immediate care might make a positive difference in outcome.

“Waiting room please”

The girlfriend with a driving license and car stepped forward.

“The waiting room? He’s in pain, you haven’t even treated him yet”

“He has a hurt finger. I have 46 patients in the department now, all of which are a higher priority. There is a baby in there who may die. There are 2 patients in there who also may die. There are 16 patients in here who NEED a bed and require treatment because they are THAT ill. There is 1 doctor on duty, 4 nurses and 2 health care assistants. There are no beds free at all. The fact you called an ambulance for a finger injury is a gross abuse of the NHS. The fact I am sending you all to the waiting room should tell you that his hurt finger never has and never will be an EMERGENCY, now go and wait for your name to be called like everyone else.”

With that, she walked off. I was in awe! She summed up in 30 seconds what I have wanted to say to every single patient who has called an ambulance for nothing and who has been sent to the waiting room.

Why do people think there are long waits in hospitals? 

Erm...because there are people who could wait to see a GP who are sapping resources.

Why are people surprised they sometimes have to wait a long time for an ambulance? 

Erm...because so many people are calling an ambulance for the most puerile of complaints.

Why are people surprised that they are send to the waiting room? 

Erm...because they don’t need to be there.

Why do people seem to want to spend night after night sat in a hospital? 

I have no answer to that. Maybe a hospital lover can enlighten me!

When I am ill I want nothing more than to lie in bed and feel sorry for myself. I will ONLY go to hospital if I absolutely have to. I would never called an ambulance unless it was a life or death emergency or if I was too injured to get myself into a taxi or a car. People seriously need to get a grip and stop expecting miracles from our free health care service. The NHS is being killed by its misuse. Accident and Emergency. THE CLUE IS IN THE NAME. Emergency Ambulance. THE CLUE IS IN THE NAME. When someone picks up a phone and dials 999 they are greeted with a question. ‘What’s your EMERGENCY?’. How anyone can hear themselves say ‘I need an ambulance because I have hurt my finger’ or ‘I have a headache’ or ‘I can’t sleep’ is beyond me! In London alone the call rate has doubled to around 1.7 million calls per year in less than 10 years. Of that, 1.2 million people get an ambulance. This jump is not down to an increase in population, nor is it down to a population that is more ill or more accident prone. It is because people are not using the services as they are intended to be used. They have become lazy and reliant on a free service and are abusing it.

Please please please people! Stop killing our NHS. Once it’s gone, it will not come back.

Have Yourself a Mental Little Christmas

After a recent spike in mental health calls I thought it would be good to do a blog on the police and ambulance service working hand in hand to get the best outcome for a patient. Mental health doesn't have to mean someone who looks like Freud, making chicken noises while head-butting a tile wall. (I'll post that shortly.) It encompasses a wide range of people & conditions, some permanent, some temporary. Some require intervention, some don't. The police service and the ambulance service generally work together trying to try and get the best, less restrictive and most appropriate outcome for the patient. I asked my friend and fellow blogger Mental Health Cop (@MentalHealthCop) if he had any suitable blog fodder for me! He sent me a tale of a job he had done at Christmas and said I could make something up to suit my needs! Having read it though, I thought it would be much better coming from the horses mouth, so asked him to guest blog for me. A few hours later it arrived in my inbox accompanied by the following:
"You can blah on your intro about what an honour it now is to have an award winner from the best emergency service!"
He would want you to see his badges ;-)
I can't really argue. He has won awards. And deservedly too! It didn't surprise me he has tried to use the titles to try and add weight to his ever failing argument that the Police are better than the ambulance service. Bless him! 

So. without any further ado and with as much pomp and circumstance as I can muster; to the sound of fanfare and drum rolls and a dose of pained sarcasm,  I welcome the one,  and the only, Inspector Michael 'The Guvnor' Brown, author of the award winning blog Mental Health Cop, winner of the Mind 'Media Award 2012' (presented by Stephen Fry) and holder of This Week in Mentalists 'Best Mental Health Not Otherwise Specified Blog' award. I wish that one day I can be as cool as he is! It really is an honour to have such a well respected member of the second-best emergency service come to my blog! 

*cue the cheerleaders*

Enjoy ;-) x

*          *          *          *          *          *

"Male, u/k age, lying in road, ? intoxicated"

My last guest post for Ella was "Policing Violent Healthcare" - and against that backdrop I'd like to tell you a Christmas Story ...

I got to work the Christmas Eve night shift last year, finishing at 7am on Christmas Day. It was the busiest shift I've had for a very long while. By about 3am, all I wanted was some hot coffee and hot food and an easy descent to 7am so I could get home to watch Master MentalHealthCop ripping into presents with yet more coffee for me. Instead, I got to work hand in glove with some awesome paramedics at a difficult job.

Just prior to 3am, two uniformed officers in a plain car were driving down a street when they came across a man lying in the gutter. Initially presuming they'd found a Christmas Eve drunk, they got stopped and got out to check him. He was pretty motionless lying over the kerb, legs in the road. Upon closer inspection, they saw a massive, gaping wound to his neck. The split flesh was inches apart, underlying muscle exposed and bleeding profusely. The guy was in and out of consciousness and it was obvious he was under the influence of something, but no smell of alcohol.

There were members of the public nearby. The officers didn't know whether they were witnesses, suspects or just people watching the police. They shouted up for more resources and an ambulance, but there was a tone of anxiety in their voice on the radio. I got down there ASAP, the next police car to arrive - it always pleases me when I get there before the sergeants! By this time, one officer was focusing on the victim, the other on the other people present and the scene management. I confirmed to control that we needed at least four more officers (and the sergeants!) to manage everything. There wasn't a clear picture about what had occurred, but he'd obviously been slashed or stabbed in the neck by someone.

West Midlands Ambulance Service - officially the best in the country (sorry Ella!)  - were there quickly after we'd called them. Two paramedics were out of the truck and assessing this guy very quickly. They didn't do much before saying, "We've got to get him to hospital." A pressure bandage was applied to his neck area and officers and the other paramedic tried to help him to his feet. I asked an officer to accompany the man to hospital with standard instructions: seize clothing, pre-transfusion blood sample request; early updates on condition to indicate life-threatening or not; any account that the victim provides to medical staff and if / when authorised ask him what happened.

They then disappeared into the truck and I focused on getting the scene sorted and getting the people present properly questioned. The sergeants took charge of it once I'd briefed them and we started to really notice how cold it was - once of my officers told me off for not wearing a jacket, but I pointed out, as a Geordie, that until the temperature hit minus four, I wasn't allowed. Suddenly, the back doors of the ambulance flew open and out leapt the patient in some considerable stated of excitement. He was, by now attached to an IV line with dressing half applied and this was trailing in the wind as he attempted to speed away and the paramedics were out of the back just after the officer who was half-holding on to his trailing arm.

I really worried about this guy. He was still bleeding profusely, he was quite obviously under the influence of something and his communication indicated that he was struggling to process information. Yet he was a victim of crime, not a suspect. Were we going to let him run off from medical treatment into the Christmas night, or not? No - it took me about two seconds to decide that if we have to sit on him and handcuff him to ensure the paramedics can work and take him by force to hospital for proper assessment, that's what we were going to do.

Where is the law that supports this? The Mental Capacity Act 2005. I have written about this on my blog and in this case it was clear cut, although I had to explain it to the officer who restrained him with me. "Yes, you can handcuff him - get the cuffs on!" I understand why officers who are not obsessed by the Criminal Justice / Mental Health interface are nervous. There's is no obvious legal authority to restrain victims and no training on the Mental Capacity Act for the police. Yet legally, it's clear and it applies to paramedics too, if they had to take action when the police are not there.
  • We can safely say this man lacked capacity: he appeared to be suffering a disturbance of the mind (temporary) because of suspected drugs.
  • He was struggling to communicate, understand, retain or employ information.
  • This is a quick capacity test made known to me by a paramedic: "ID a CURE" 
And so he was restrained all the way to hospital. In A&E, the urgency of the need to treat him was reflected in the fact that he was quickly sedated and taken for emergency surgery. Had he not been taken, he would have died in the opinion of the doctors.

This shows how the Mental Capacity Act can be used. When we debriefed it, the officers there 'knew' the (morally) right thing to do, was restrain him and force him to A&E. They worried about the legalities, as do some paramedics, but it was perfectly legal and totally proportionate to the (life-alterting / life-threatening) risks involved of not acting.

Incidentally, Mrs MentalHealthCop bought me a funky new coffee machine for Christmas - she's a good girl and knows what flicks my switch after a night shift! ;-)

Saturday, 26 January 2013

Budgies Fly

“35 year old female hanging out of window, police on scene”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

Weird, right?! This is what we heard being shouted as we approached the building we called to. There was a couple of coppers standing on the pavement looking upwards and as we rounded the building's porch we could see why! With her head and torso protruding the from the window our patient was shouting over and over again:

“If you love something, let it go. If it comes back, it’s yours”

This alone made it a bizarre job, now add her throwing all of her possessions out of the window at random intervals. The pile of things on the floor was large and varied and ever growing. Every attempt to talk to her was greeted with the same response.

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

According to the police she had barricaded the door and they were now waiting for an enforced with the universal big red key. There was also a worry that whilst trying to kick the door in she would jump out of the window. This would not be ideal. We were already going to be late off, a trauma job would be most unwelcome!

“If you love something, let it go. If it comes back, it’s yours”

It was relentless, as was the constant stream of belongings. Clothes, furniture, paintings, photos, kitchen stuff, bathroom stuff, the list was endless. Then, a cage came into view. 

“That’s not got a bird in it has it?!” Said one of the coppers.


Before I could answer, the cage, complete with Budgie came flying out with a crash and a squawk. 

“I think it has!”

The cage was retrieved and the bird seemed none the worse for it. I think it was the furthest it had ever flown!

“If you love something, let it go. If it comes back, it’s yours”

One thing was for sure, the Budgie will not be coming back up! The pile below the window was gradually rising. The bedding was next, pillow after pillow, duvet after duvet, sheet after sheet. Then came the hamster cage! A cloud of saw dust filled the air. It was certainly a rude awakening for the poor little thing inside but again, didn’t seem injured! Laundry baskets followed, then CD after CD, one at a time.

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

As time went by, her voice was becoming more and more frantic. There was a white foam clearly visible in the corner of her mouth from talking for so long without a break. She looked possessed! As amusing and bizarre the whole situation was, at the end of the day this was a person having a very public, mental health breakdown. She wasn’t known to police, her neighbours said she was perfectly normal and a phone call to the local mental health unit didn’t reap any information. Shortly after the lava lamp came flying out of the window the enforcer arrived. Before they tried the door, we had a discussion about what to do. Section 136 was useless as she was at home, section 135 was useless as there was no magistrate order so all we were left with was us deeming her not to have capacity and take her to a place of safety. Ideally, that place of safety would have been the mental health unit but as per usual, they refused to accept until she had been to A & E. *rolls eyes* The problem with A & E is their powers to hold her are limited as they claim not to have the security and staff to restrain her. The police will only stay a short while because she would not be under section and it isn’t then a police matter. Anyway, we decided all those bridges could be crossed on arrived. For now, the door………

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it com………”

She vanished from the window. The screams and shouting meant they were in! A few moments later, she appeared in handcuffs. She was restrained due to her violence on entry, and her determination to get away meant the back of the police van was the safest option.

“If you love something, let it go. If it comes back, it’s yours”

And so it continued. I sat in the police van on route to hospital just listening to it over and over again.

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

As the doors opened at A & E, it continued. All the way down the corridor, all the way through to majors where we waited to hand over. The noise she was making meant it didn’t take long for us to be seen.

“Is she under section?”


The nurse rolled her eyes.

“Well we can’t hold her, are the police staying?”

The copper came over, “We can stay for a little while but will have to leave when the skipper calls.”

“She should be under section”

“She was in her own home. We are only here in the capacity to assist the ambulance.”

Nurses think every mental health patient should be under section, they know what powers police do and don’t have, yet they expect the police to be involved time and time again when in actual fact, it’s a health care issue, not a criminal one. 

“Well when you leave, if she decides to walk out we won’t be able to stop her and we will be calling you back”

“If that’s what you have to do then that’s what you have to do”

We took the patient into the quiet room and left her there with the two coppers. As we walked off down the corridor all we could hear was:

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

“If you love something, let it go. If it comes back, it’s yours”

Well, that was another day, another dollar and only two hours late off. I know it’s said a lot by ambulance staff but every day really is different. As for mental health, I really have no answers! I was happy that we got her to a place of safety but was it a suitable place of safety?! I just don't understand why no part of the health service will take responsibility for mental health. The mental health unit won't accept her, the A & E will make no real attempt to keep her in despite the powers the Doctors have to section. Everyone would much rather let her leave so it becomes a police problem. What do the police do with a mental health patient in need of help? Call an ambulance! What do we do?! Take them to A & E. This woman is ill and needs help. She is not a criminal. It is NOT a police issue and the NHS as a whole should stop relying on the police so heavily to help with mental health. The services, the staff, and the facilities are there. USE THEM!

Thursday, 24 January 2013

Allergies & Vomiting

“2 year old male, vomiting, ? allergic reaction”

I have my very own 5 year old. In that 5 years he has vomited. In fact, he has vomited on numerous occasions, sometimes on me! Sometimes he has vomited more than once in a day. When he was a baby he would vomit milk all the time. He goes to school, he picks up bugs. He gets coughs and cold and sometimes even an upset stomach. He deals with it all. We deal with it all. Humans get ill from time to time. It’s a fact of life. We certainly never called an ambulance because he had been sick. Just sayin’!

Anyway, it was about 10pm on a bog standard weekday night shift. Me and my crewmate were parked up listening to Frank Sinatra watching the world go by when we were given a job about 100 yards away. We had pulled up, got out, grabbed our bags and rung the door bell before the 999 call had finished! We made our way up to the 3rd floor and knocked on the flat do. 

“In here, come quickly” said a frantic voice.”

We passed two teenage girls in the corridor who pointed us into the bedroom. Sitting on the bed was our patient sitting on his mothers lap. Her knee was bouncing up and down, as was the little kid! Probably not ideal for a vomiting child! I asked what had been going on and despite all the drama that was put into the story the crux of the matter was that the kid had vomited once and was now sleepy. Call me a cynic but is vomiting once a medical emergency and is it any surprise he is sleepy when it’s 3 hours past his bed time?! Despite my best efforts to calm her down, the mother was having none of it. She thought her kid was gravely ill and wanted to go to hospital. This vomiting was an apparent allergic reaction to banana. Trust me, I’ve seen allergic reaction, this wasn’t one. Even her teenage daughters found the whole thing a tad bizarre and chipped in trying to convince her to calm down. No joy!

She was convinced he was riddled with allergies and that was what had made him sick. Asking about allergies is a pretty standard question when determining someones medical history. A lot of what people are convinced they have a penicillin allergy, most don’t. They either had a side effect from taking it or simply don’t like it. The same applies to food people don’t like and in panicking parents, these make believe allergies are passed onto their children. 

“What is he allergic to?”

“Ha, what isn’t he allergic to?!”

“............” I didn’t feel that ridiculous statement warranted a response so just waited.

“Penicillin, wheat intolerant, lactose intolerant, most washing powders and nuts”

“What happens when he takes penicillin?”

“I don’t know, I won’t let him take it?”

“Why not?”

“Because I’m allergic to it.”

“In what way?”

“I feel constantly sick and ache”

“That’s a side effect. I doesn’t mean your son will be allergic.”

“I’m not risking it.”

“Has he been hospitalised or had any severe allergic reactions to anything?”


Excellent! No known drug allergies is what I wrote down on the paperwork! This conversation reminded me of an article I read in The Daily Mash that sums up my feeling on the issue!
Your Baby Is Not As Pathetic As You, Say Experts 
WORRIED parents are being urged not to automatically assume that their baby is as pathetic and ill-informed as they are. 
Research has revealed that many parents have already decided their child will suffer from the same made-up food allergies they do.
And a recent study showed 65% of GP visits were the result of parents believing their baby is developing a Coco Pops intolerance because they have a great aunt who is hypoglycaemic.
But now scientists say there are other factors that cause babies to become feverish, develop a rash or shit themselves up to 18 times a day.
Dr Tom Logan, of the Institute for Studies, said: “It’s because they’re babies.”
He added: “If your baby is developing in a perfectly normal way, try to not jump to the conclusion that it must be suffering from that corned beef allergy you read about in Take a Break. 
“Also, if you think that you may have an intolerance to cheese, black pudding and Greggs pasties, don’t assume that your baby is going to be a delusional, self-absorbed halfwit.
“The best thing to do is wait until you have finished breast feeding and then either give the baby to Barnardos or leave it outside a big, posh house.”
We use humor quite a lot to diffuse a variety of situations and as much as i’d like to have read out the above, I used some restraint! Sometimes humor works, sometimes it doesn’t. I consider my crewmate to be very funny! He has good timing and often lightens the mood at the right times. The mother was rushing around like a headless chicken trying to put her entire life in a bag. I tried to tell her that if we are not rushing around there is nothing to worry about! That didn’t help. Maybe a bit of humor to lighten the mood?! The mother had the strongest of Liverpudlian accents. My crewmate went with.....

“That’s an interesting accent, what part of London are you from?!”

The daughters laughed, I chuckled, the mother glared.

“Is that supposed to be funny? Do you really this jokes are appropriate when my child is seriously ill?” 

SHOT DOWN! He sheepishly apologised! Seriously though, lighten up! The joke however, made the whole experience very awkward. Both of us were treated to glares for apparently not taking this life and death emergency seriously enough. What annoys me is that these people call an ambulance and then don’t respect the staff on them. I can only assume she called because she was worried and wanted some medical professionals to help. We arrived, looked, assessed, took a full history and came up with an impression of what we thought was going on, a diagnosis and a list for a differential diagnosis'. We see up to 12 patients a shift, 3-5 shifts a week, 52 weeks of the year. That equates to about 2000 patients a year. We know when a patient is ill, we know when a patient is on death's door and we know when a patient has vomited and wants to go to sleep. Why not call a taxi if you are going to ignore the ambulance crew? They will be able to do exactly what we are doing and probably won’t make any jokes.

People really need to take life less seriously and lighten up. I know that something trivial for one person can be an emergency to someone else but some people really need a reality check! If you call 999 and a paramedic tells you that everything is okay and a 2 year old vomiting once isn’t anything to worry about DON’T tell them they are wrong. Life is too short to be so bloody uptight! Chill your frickin’ beans!

Wednesday, 23 January 2013

What happens if.....?

“38 year old male, throwing around his job title”

What happens if you park on a double yellow line?

You get a parking fine

What happens if you park in a car park and don’t buy a ticket?

You get a parking fine

What happens if you over-stay in a car park?

You get a parking fine

What happens if you park on or near a crossing?

You get a parking fine

What happens if you park anywhere where it says ‘No Parking’?

You get a parking fine

What happens if you park in an ‘Ambulance only’ bay?

You get a parking fine

Social status or job title does not exclude anyone from having to pay for parking illegally. Typically, at most hositals there are 4-6 ambulance bays outside a hospital marked in yellow or red lines with huge signs on the walls and the ground saying ‘Ambulances only’. It is perfectly clear and there for a ambulances with ill patients can park outside the A & E and get them into the hospital quickly and easily. Hospital staff, patients, relatives and members of the public have to use the ‘car park’. The clue is in the name! Patients or relatives or members of the public being dropped off or picked up can use the ‘drop off zone’. Again, the clue is in the name. It is very common for all the ambulance bays to be full of ambulances and throughout the day there is always a constant stream of ambulances coming and going. 

This particular day we were sat at our local hospital in one of the 4 ambulance bays. There were 3 ambulances including us, the only one free was the one directly outside of the doors which we typically leave clear if possible, incase a ‘blue call’ (critically ill patient) arrives. We were scoffing down our venting machine food and watery Maxwell House coffees when a brand spanking new, black, Mercedes SLK convertible pulled in and parked in the ambulance bay. A middle aged man in a suit got out, locked it and walked off.

“Excuse me, you can’t park there.”

“Yes I can.”

“No you can’t, it’s an ambulance bay.”

“I’m a consultant, I can park where I like.”

“No you can’t, it’s for ambulances, there is one on route here now.” (massive lie)

“I haven’t got time to talk to you, I have work to do”

With that, the pompous, arrogant, prat, walking into the A & E. Being rather hot headed, I couldn’t let this lie. I stormed into the A & E after him but he’d vanished. So, I took down his registration number and went to the reception.....

*over the tannoy*

“Would the owner of a black Mercedes, registration number LK60 BFU, parked in the ambulance bay please remove it immediately.”

After a few minutes, he had not appeared.

“Would the owner of a black Mercedes, registration number LK60 BFU, parked in the ambulance bay please remove it immediately.”

Still no sign.

With that, the receptionist  picked up the phone and called security. The security at this particular hospital also monitor the car park. He came outside, wrote out a ticket and slapped it on the windscreen. As her did, the alarm started sounding. Within about 30 seconds the self proclaimed consultant appeared. I was sat back in the ambulance by now and watched the argument unfold. He talked to the security guard like he was dirt on his shoe using such phrases as ‘do you know who I am’ and ‘I’ll have your job for this’. In an indignant last ditched attempt to throw his muscle power around he stormed to the front of my ambulance and started writing down the registration number. 

“This won’t be the last you hear about this.”

I wound my window down.

“There is a pay & display car park just over there, that you are welcome to use.”

“You’ve made a huge mistake.”

“Actually it’s you who is parked illegally, I did tell you when you parked it.”

“I’m a consultant here.”

“The sign doesn’t say Ambulance and Consultants only, don’t blame me”

With that, he got in and sped off, revving his engine as he went. What a tool! Funnily enough I never heard any more about it! I truly hate people like that, people who think they are better than others. People who treat people ‘below’ them without respect and with contempt. He may have spent years moving up the ladder and he may be a respected consultant. Unfortunately, that doesn’t give him the right to do what he likes when he likes. I don’t buy into giving respect when it has not been earned. I don’t care what his job title is, I don’t care who he is or how well respected he is professionally, he is still working for the NHS, he is still a colleague and he still has to abide by the same rules as everyone else.  A job title does not give anyone the right to talk down to or dismiss another person. Unfortunately for him, he chose the wrong girl to throw a job title at and despite his best efforts, I was the one who got to sit and watch him huff, puff and speed off in his rear wheel drive penis extension.

What happens if a consultant parks in an ‘Ambulance only’ bay?

He gets a parking fine

*smug face*