Sunday 28 July 2013

Boredom, Terror and Celebration

Fate is a funny thing isn’t it?! I’m not a great believer in it. I’m pessimistic at the best of times so the thought that things happen for a reason is a little beyond my comprehension! I’m also as far from religious as can be, so the concept of a greater force intervening in life’s goings on isn’t something I buy into to. Personally, too much bad stuff happens in the world. There is just too much hurt and tragedy, but religion is not a debate  I'm going to get into at any point on here! Each to their own! The reason I brought it up, is that fate, by definition is the development of events outside a person's control, regarded as predetermined by a supernatural power. Obviously I don’t believe in it but sometimes, I’m left wondering. 

For the last few months, I’ve been working on the Fast Response Unit (FRU). It has been a change of pace and a new challenge but one that I've thoroughly enjoyed. Lone working and not having a crew mate to rely on and bounce ideas off has really helped me develop as paramedic. At times, it has been utterly terrifying, knowing the buck stops with you. The weight of expectation from the public, often at the greatest time of need can be daunting to say the least! But, with every tricky job that passed I found myself growing in confidence and stopped being daunted but the prospect of arriving on my own. 

On the FRU, there is a lot more downtime. 
'EMS Rule 10: EMS is extended periods of intense boredom, interrupted by occasional moments of sheer terror.'
We are only sent to the higher priority calls, so a lot of the time I’m sat on standby waiting. I have 3 or 4 places I hide out but today I fancied a change! I drove around and eventually settled upon a quiet road, off the beaten track, where I could read my book and wait. No sooner had I turned the first page, a job was sent to me! Typical! 

“18 month old female, choking” 

Well, to quote myself, “I found myself growing in confidence and stopped being daunted by the prospect of arriving on my own”. THAT was clearly a lie! I looked at the address and brought it up on the map. It was on the road that I was sitting on about 200 ft down the road. I was on scene within 30 seconds of the call coming in. I’d had no time to gather my thoughts or think about what the algorithm was for a choking toddler. Before I could blink, I was being waved at by a frantic parent, was holding all my bags including the Pediatric Advanced Life Support (PALS) kit and was heading into the unknown. Proper choking is extremely rare, normally in the 6-8 minutes it takes for us to arrive the obstruction is cleared, or partially cleared and there is nothing for us to do. I’ve seen 1 choking since I started and that was on an adult. That was cleared with back slaps! Pleeeeeease let this be the case here! 

As I rushed into the kitchen / diner the lack of crying, coughing and other noises associated with a distressed infant were worryingly missing. Her mum was frantically slapping the little girls back but to no avail. I took the child, who’s eyes were pierced with fear and started back slaps. There was no air movement at all and unless the obstruction was cleared quickly this little girl would be in a whole world of trouble. After just 3 back slaps, that ‘whole world of trouble’ was realised . She went limp in my arms. It was a feeling I'd never experienced. The life draining out of a child. My heart was racing, the mother was asking what was happening and begging me to do something. I knew the algorithm would tell me to start CPR. 

I ripped open the PALS kit and grabbed a pediatric laryngoscope. It was so small compared to the adults. I put it into her mouth and lifted it as I had done in training school a long time ago! The light on the blade lit up her mouth. I was now lying on my front desperately looking down her throat, manipulating the blade to try see something. Anything. Then I saw it. I blindly reached for the forceps with my spare hand, not wanting to move a muscle now I had the obstruction in view. How I managed to locate the forceps I'll never know but I just shouted ‘OPEN THEM’. They were taken for my hand and then returned, out of their sterile packaging. As carefully as I could I inserted them into the mouth and at the second attempt, I managed to grab the stray piece of apple. 

Amazingly, she still had a pulse so I just started ventilating her. In my head I was begging that she would start breathing. I radioed to control and quite rudely demanded an ambulance immediately! I think the tone of my voice said it all. For what seemed like an eternity I ventilated the little girl waiting for the ambulance to arrive. Then inbetween my ventilations she took a breath. Then another, and another, and another. I took the bag away and just starred.......she was breathing on her own. 

On cue the ambulance crew arrived. They looked at the bag I was holding, the open PALS kit and said ‘Ready to go?!’. They grabbed my bags, I scooped up the girl and as quickly as they arrived, we were gone! The blue call was put and we left. Mum was holding the girls hand and I was just starring still! 
Her eyes, slowly opened, she coughed and then started crying. I’ve never been so happy to see a child cry. Overwhelmed would be an understatement. We arrived at hospital and I handed over to the waiting Doctors. There was a total sense of relief as I walked away, back to the ambulance. I sat there starring at my blank paperwork and was physically shaking. All the adrenaline and emotion pouring out. It was a totally surreal experience. I sat there and didn’t write a thing for about 10 minutes. I felt validated as a Paramedic and was by far the proudest moment of my career to date. 

Will I feel calmer if I ever have to face that situation again? I very much doubt it. I could have parked absolutely anywhere in a 16 square mile area. I chose this road. I don’t know why. If I had been another minute away it could have been a completely different outcome and probably would have been. I’m just glad I’m not faced with writing about a tragedy. Instead, a rare success. I was just in the right place at the right time, and for that I am thankful. You can call it fate, divine intervention or just sheer luck. The result is the same! 

I’m still buzzing!

Friday 26 July 2013

The Voice

"88 year old male, DIB"

I was extremely tired! I'd like to say it was because I had been working really hard saving lives but I hadn't been. In fact, the reason I was tired was because I'd hit the town with fellow bloggers @jooleroo and @babberblog and they'd forced me to drink too much gin two nights previously and I still wasn't recovered. I was still feeling slightly unhinged and not back in 'work mode' when I was sent a job 9 seconds into my shift. So, not only was I tired and irritable, I felt rushed and disorganised. It's not a good combination. Time to hope the first patient is easy going and not seriously ill!

As I pulled up on scene the call downgraded to a lower priority! DAMMIT! At this time of the morning (shift change over) it was now likely I'd have to wait a while for an ambulance. I also noticed the call came from a 3rd party caller so my patient might not even know I'm coming! I grabbed my stuff and headed on up.

After negotiating entry via the remote access people, which involved a military type interrogation, followed by a Crystal Maze kind of puzzle key safe and finishing with a Da Vinci Code themed coded instructions, I made it to the flat. Far to early for all of that! I let myself in and headed to the open door. 

Inside, my patient was lying in a cot bed. He didn't appear to be struggling to breathe which was a good sign. 

"Hello sir, what's the problem today."

"He's not well." a voice said. 

I looked around, baffled as to where the voice was coming from!

"Did you hear me?" the voice said again. 

Then I saw the phone lying next to the patient on the bed.


"My uncle isn't well, he can't breathe, can you take him to hospital please?"

"I'm not the ambulance, I'm the first responder, so I'll check him over and let you know the plan when the ambulance arrives."

"No, I want to stay on the phone so I can hear what's going on."


I was miffed. It's an added pressure I didn't want or need and it felt like I was being scrutinised. 

I set about assessing him. He was alert and able to talk for himself. I was doing his obs while asking him questions on how he was feeling.

"What's his blood pressure?" said the voice.

"His blood pressure is fine."

"Right.....what is it?"

"126/84" I said and returned to talking to my patient.

"Have you been bringing anything up when you cough?"

"Yes he has" said the voice.

"I see you are being treated for a chest infection, has there been any improvement since you've been taking your medication?"

Before he could answer.....

"That's irrelevant, he's had a chest infection and it clearly needs more treatment."

"It is relevant. He's showing no signs of a chest infection, his chest is clear and is oxygen levels are normal. He seems fine to me so far."

The voice laughed.... "You haven't even checked his temperature yet!"

"Yes I have. It was normal."

"We'll you should have told me that." said the voice.

This continued for anther 10-15 minutes. I was repeatedly interrupted, questioned and argued with. Every now and again I managed to get some answers from my patient but in the main, 'the voice' did all the talking. 

Then there was a knock at the door.

"What was that?" said the voice.

I didn't answer! Oh the power! I went to let the crew in! I gave them a handover in the hallway and explained that they were on speaker phone so had to play the game!

"What was that? Is the ambulance here?"


"Right, can you take him to hospital now please."

I should probably mention now that during the handover to the crew we discussed an action plan!

"Hello there, I'm one of the paramedics on the ambulance."


"We've decided not to take your uncle to hospital. He doesn't need to go, he's expressed his wishes not to go and to be perfectly honest, he's still got 3 days of antibiotics for his cheat infection and is responding well to it. We'll refer him onto his GP so he can stay in the comfort of his own home."

I just smiled. 

"This is ridiculous. I called you to take him to hospital, now you WILL take him to hospital." said the voice.

"Sir, would you like to go to hospital?" 

"No, I want to stay here."

"Right, as your uncle is refusing hospital, we will be leaving him here."

"What is your...... Our patient picked up the phone and cancelled the call.

*sighs of relief all round*

We filled out paperwork which the patient signed and the crew referred him to the GP. I went back to my car in a foul mood. 

Why are some people so objectionable?! What do they think will achieved be being so rude?! I fully appreciate relatives being worried and sometimes worry becomes overbearing. However, I think a situation like this crosses the line and prevents us from doing our job. Do you agree? Am I overreacting?! Should I blame @jooleroo and @babberblog or would anyone have been grumpy in this situation? Discuss....

A Summer Break

Hello strangers! 

As most of you have noticed, about a month ago, I vanished! Well sometimes, it is necessary! I did so for a number of reasons and I won't bore you with most of them! I will however, explain why I stopped writing my blog for a little while. It isn't the first time I have disappeared and won't be the last. 

You've read about how we are always looking for the 'proper job'. We want the cardiac arrests, the trauma and the seriously ill. It may put us out of our comfort zone but the long and the short of it, is that is what we are there for. These kinds of job make the other stuff we do and go through worth while. In a warped way other people's misfortune is our job satisfaction. 

A few months back, I moved from ambulances, to working on my own on the Fast Response Unit (FRU). The FRUs are used for the higher priority of calls, so invariably you go to 'proper jobs' with more frequency. You see less mental health, less elderly fallers, less urine infections and less regular callers. What you do see is a lot more cardiac arrests, heart attacks and trauma. This, on the whole has been a good thing.

However, you can get too much of a good thing! I went through a phase, that seemed to never end, where every single day I was seeing death and distraction. I felt like the harbinger of death. Writing a blog about my working life is normally therapeutic, but I found myself not wanting to think about some of the days I was having. If I don't want to think about it, I certainly don't want to write about it! Some things should be left unshared! For now! 

I'm not sure if things have calmed down yet, I still seem to find myself in some of the most bizarre of situations with some of the most horrific injuries I have seen, but I think I am used to it now! 

The weather has also been bloody lovely so I've been enjoying the outdoors and avoiding some of the drama people crave on social media! It's been rather refreshing! 

Anyway, sorry for the sudden disappearance! Thank you for all your messages of concern! 

Ella x