Tuesday, 28 January 2014

Super Strength Batteries

I've been blogging a few years now, and in that time I've had many a guest blog. However, I've never had one from a fellow ambulance blogger! To be honest I don't read many blogs, least of all ambulance ones. I just don't have enough time! However, I recently made contact with Binder, from not-on-my-shift.org after discovering his gem of a blog on Facebook! Despite having been blogging longer than me, I'd never seen it! I also saw his glowing recommendation for me, so felt compelled to make contact and say hello! (seriously, go and read ALL of his blog, it will have you laughing hard!)

To cut a long story short, a week later, I was in a harness, attached to a rope, and stuck 30ft up a wall hanging on for dear life. Far below me, was Binder, trying to convince me that letting go of the wall was a good idea. After a discussion with my inner psyche, I finally made peace with the fact I was sure to die, and let go of the wall. To my surprise, I didn't plummet to my death, I just hung there. Moments later I was back on the ground, stood next to a grinning Binder ready to go again. 

The afternoon passed with the exchange of war stories and as with most conversations between paramedics, it ended up being about foreign body insertions! EMS Rule #97 states that: 'Fellow paramedics always have a better story than yours.' Well ain't that the truth! I felt this story needed sharing, and who better to do it, than Binder himself! So, with all the pomp and circumstance it deserves, and without any further ado, I introduce my friend and colleague, Binder, author of not-on-my-shift.org.


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Super Strength Batteries

"You can feel it going . . . go on, have a feel" She said through tears and gritted teeth.

I placed my hand on her tiny stomach and sure enough, I could feel it . . . .


"Wow!" I said, genuinely impressed. I looked back up at our patient and smiled . . . not that this helped in any way. You see, our patient had managed to get a vibrator stuck in her rectum - and it was switched on at full speed.

She certainly was in a tizz. Tears were streaming down her face as she fought off vibrations from within and tried to bear down and force “it” out. Every now and then her hapless "partner" received a flurry of abuse and bore the brunt of her frustrations.

"You ARSEHOLE Peter*!! Super strength batteries!??? Super strength batteries!!?? Why'd you have to use SUPER STRENGTH FUCKING BATTERIES!! Oh GOD!!!"

We stood there slightly bewildered and somewhat superfluous to the poor woman's needs. Every time we'd try and calm her and make her as relaxed as she possibly could be - under the circumstances - she just burst out into a torrent of abuse aimed at her partner and then repeated another attempt at trying to get the vibrator out.

"Can you help me?!" she pleaded, squatting down and reaching round with one hand, "I mean, it's not going to go anywhere else is it?"

"No, I don't think so," I said, "you just need to relax more . . . sort of, let nature take it's course"

"I've drunk shit loads of the Colace, do you think that will help?"

"Um . . . "

"Look," she went red in the face as she bore down extra hard, ". . . I'm sure I can get it out, can you . . . Peter! PETER! PETER, you BASTARD!!"

Peter's muffled response came from within one of the cupboards, "What?!"

"GET THE FUCKING CRISP-N-DRY!!! I think I can . . . "

"Look," the other FRU said, "I think it's best we just pop you up the Hospital eh Tara*. We're not getting anywhere here are we. And I think it best a Doctor has a look yeh? Especially as you say Peter put in super strength batteries"

"Hospital?! Oh god no!" In between gritted teeth, a red face and streaming eyes, Tara gave us all wink and a smile, "I bet you lot are loving this aren't you!"

"No. Of course not Tara" We all shook our heads over theatrically.

Tara sighed deeply as if resigned to her lot, "Right . . . come on then! Let's go"

So, with a little assistance and a muffled BZZZZZZZ - BZZZZZZZ coming from her bellie we helped Tara onto the ambulance and left the crew to it. The Hospital were simply going to love this one.

*not their real names of course

Binder Smiff (2 f's)
A Paramedic Blog
"When life-saving adventure meets fiction! . . . . well, definitely more fiction really"

Wednesday, 22 January 2014

Emergency Medicine - Part 2

'RELATIVES: Ignore any first aid advice you’ve ever been given and just throw a glass of water in your loved ones face. Works a treat.'


“61 year old male, burns to chest.”

Burns to chest isn’t that common except in cases of major burns. Normally it’s legs and arms, either from spillage or stupidity. Burns kit in hand I headed inside. The air was ripe with the smell of burnt hair. The patient was lying on the kitchen island topless. He’d lent over the hob whilst it was on. He had been trying to change the bulb in the extractor hood and set his shirt on fire. Apart from being a candidate for a Darwin award he was also beginning to look like an entry in The Great British Bake Off! 

There he was, lying flat as if he was planking, being buttered. Yep! His wife was scooping handfuls of butter out of the pot and basically basting him. He was only a few steps away from being floured, rolled out flat and being put in a pastry tin ready for roasting. 

“No more butter!”

“But he has a burn!”

“I know, but no more butter! We need to get him into the shower room and run cold water over it and keep it clean, OK?!”

She un-trustingly nodded at me. I am only trying to help! 

Once he was out of his cold shower, I dressed the wound with aqua-gel and layered some cling film on top. He also got treated to some morphine and entonox. 

I was fully expecting his wife to say ‘I can’t believe it’s not butter’

Sorry! That was awful!

“27 year old female, breathing problems, ?panic attack”

On arrival I was greeted with what had become a very familiar sight. Patient hyperventilating. Relatives fanning patient and running around like headless chickens. Often it’s the relatives that need the most help! The patient was crying and wasn’t being quite about it. She was also full flow in her panic attack. 

“Why is she soaking wet?”

“We poured water on her head?”


“To calm her down.”

Almost as she said it a hand flashed past my face. Then in slow motion I watched a glass full of water empty and start making its way through the air towards the patients face. With unerring accuracy the entire contents hit her square in the face.

Sure enough, the crying elevated to new levels. I don’t think she needed the second glass…..

“Stop it! What are you doing?!”

“Trying to calm her down.”

“I don’t think throwing cold water on her face is going to do that. All it’s going to do is make her wet and cold. I am now also wet. No more water. She’s not on fire!”

“OK, sorry, she needs to calm down though.”

The classic home treatment and I’d had the pleasure of witnessing it in all its glory! I can’t think of any situation where this would be my first choice or treatment. No one like having cold water poured on their face. No one! Least of all those who are already stressed or panicked! It is just such a bizarre thing to do! I would love someone who frequently uses this technique to let me know their rationale! 

“25 year old male, burns whilst cooking”

I blogged about this job before at length in Getting Egged, but I’ll share with you the highlights once again!

This guy had been cooking for his friends. He had used an industrial sized saucepan to cook a spaghetti bolognese for his friends. He’d decided to cook wearing only his pants, as you do. During the motion of transferring the vat of bolognese from the hob to the table he slipped on the wet floor and poured the entire contents of the saucepan over his torso, arms, groin, neck and legs. Probably close to 50% burns. It was actually really bad! 

Anyway, his friends knew exactly what to do in such perilous circumstances. Crack eggs onto the burns. Not just a 6 pack or even a Waitrose 9 pack. Nope, a Costco 24 pack of eggs. Every single one, cracked over his burning body. When you combine eggs with heat they begin to cook. By the time I walked in to the chaos, it was basically a giant omelet with a head. 

What followed with one of the most difficult and painful scrambled egg removals I’ve been involved in. The poor guy was an absolute trooper and to get morphine inside of him I ended up having to cannulate his feet! 

As is always the case, before we left to take him to the trauma centre I gave some excellent health promotion and financial advise to his friends. Namely, by telling them to use tap water, not eggs in the future….

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This little lot would make an excellent sketch! TV producers, take note!

People really do the strangest things and never ever cease to amaze. I genuinely wouldn't be surprised if I walked into a house to find a patient in a bath tub full of tined mackerels for treatment of a sore throat! It seems to be the done thing! No doubt I’ll have more to share in the near future but this should keep you all going for now! Anyone else experiences any particularly bizarre treatments for medical emergencies?! Please share! 

Anyway, this has made me all hot and bothered. I must go and throw water in my face, crack an egg on my head, douse myself in vinegar, bathe in olive oil and rub myself with butter and apply my potato skin body scrum. It what all the cool kids do, right?!

Tuesday, 21 January 2014

Emergency Medicine - Part 1

'RELATIVES: Ignore any first aid advice you’ve ever been given and just throw a glass of water in your loved ones face. Works a treat.'

I laughed when I tweeted this the other day. I know it’s a poor reflection on myself to be laughing at my own jokes, but I was just reliving the countless times I’ve gone to patients and found myself asking ‘Why are they soaking wet?!’. Invariably, the answer isn’t that they’ve just been out in the rain but that they just had a glass of water thrown in their face. It’s like some mythical sick joke! ‘I know, this person feels sick, let’s chuck water in their face! That’ll make them all better!’ It’s absolutely bonkers! Anyway, to that end, I thought I’d share some of my favourite home remedies that I have encountered! They range from the bizarre to the outright ridiculous. I wonder if JRCALC would consider putting any in our treatment guidelines! 

“52 year old male, cardiac arrest”

I had finished work for day but on hearing a cardiac arrest on the general broadcast with no units assigned I offered up for it. It’s what we are here for right?! I rushed to the address and was bet at the end of the road by a franticly waving man. Once he had my attention he literally sprinted like Usain Bolt down the road and into the house. This level of urgency must mean it was as given. I grabbed every bit of kit I could possibly need and headed up the stairs. I could hear the wailing and the crying, everyone was stressed and despite carrying the payload of a jumbo jet I bundled my way past all the screaming relatives to the patient. 

He wasn’t in cardiac arrest. He wasn’t even unconscious. He was however laying on the floor having possibly had a faint or panic attack or a combination of the two. He was soaking wet and absolutely stunk of vinegar.

“Why is he wet, and why does he smell of vinegar?!”

“We poured a bottle of vinegar on his head.”

She said it like I was being the idiot for asking such a stupid question! 

“Why? Why have you poured a bottle of vinegar on his head?”

“Because he wasn’t breathing properly.”

Aaaaahhh, I didn’t realise that the treatment for dealing with breathing problems was vinegar on the head! This will be helpful for so many patients! My next VDI will go something like:
-Paramedic Drugs  
-Tech Drugs  
-EZ-IO drill and needles  
-Diagnostic equipment  
-IV fluids  
Good to go! Vinegar!! Amazing! Needless to say, I left this particular cardiac arrest at home with advise and some adjustments to their next Ocado delivery.

“15 year old female, burns to leg”

From what I could gather, she had spilt a hot drink on her legs. The history wasn’t exactly forthcoming due to the circus of panic that was surrounding the patient. If I didn’t know any better I would have thought her legs had just been amputated. A woman barged past me as I was trying to get closer to the patient they had called me to see. The woman had two handfuls of potatoes. I would go on to found out that these were extra potatoes on top of the ones that had been used prior to my arrival. 

Eventually I managed to fight my way through the crowd to get to the patient. Standing over her was a relative. Frantically peeling potato skin onto her scalded leg. Yep! Potato skin. Sod all that running under cold water lark! Who needs that, when it’s much easier to turn your daughter into what was essentially a giant human potato rosti! 

“What are you doing?!”

“She has a burn, we peel potatoes.”

“I can see that, but can we stop, and get rid of the potato peels please?! We need to run it under cold water! Not dress her like a hash brown!”

“No more potatoes?”

“No, no more potatoes!”

It was a minor scald. Once she was clear of starchy veg and cleaned I was able to put a burns dressing on. She was then taken to hospital. Again, shopping list and future treatment advise was given. Will we see potatoes joining aqua-gel and cling film any time soon?! Hmmmmm!

“47 year old female, collapsed”

I find that when jobs have very little information to go on, it’s a sign that the patient isn’t going to be that unwell. On arrival, the familiar signs of overreaction and panic were evident! I’m always amazed how many people can fit into such small rooms! When someone becomes unwell the entire world, their wives and extended friends of friends seem to congregate in the room when the invalid lies! As I entered the room I had to ask all non-essential well wishers to wait outside so I could have room to do my thang!

As it turns out, I wasn’t needed. They had it all under control. My under control I meant the patient was lying on her back, legs being held up in the air whilst having olive oil massaged into her feet.  And by massaged, I don't mean a relaxing spa massage with relaxing oils. I mean a frantic, verging on violent massage or some kind of weird, lubricated tickle torture. Admittedly, it wouldn’t have been my first choice of treatment for a panic attack but what do I know?! 

“What’s with the oil?”

“She faint, we oil her feet.”

“Ah, OK, how about we stop that and sit her up so she can breath, I imagine holding her legs over her head will be making breathing a tad difficult.”

Sure enough, once the room was less like the mosh-pit of a Slipknot concert and she was upright and not being contorted in an oily mess, her breathing improved. I left her at home, again, with advise on what to do should a similar situation arise again. Somehow, I don’t think Olive Oil will be joining Sodium Chloride and Glucose any time soon. You never know though…..

To be continued......

Monday, 20 January 2014

No More, No Less

"RTC, car vs car. Injuries unknown. Police on scene."

We happened to be on the road the RTC was on when we got dispatched to it. It was about two miles away but due to the nature of the relatively narrow and winding road, any RTC always caused absolute chaos in the area. The traffic was already building up, even where we were so it took a little while for us to get there. For every five cars that move out your way, there is one that just sits there and doesn't move. It's most frustrating! Ahead, we could see the blue lights of a police car and after a final push we were there.

As far as RTC's go, this was a minor one. Three car were involved all with relatively minor amounts of damage. There were five patients, all with pretty minor ailments, but all needed assessing and treating. Injuries ranged from minor head injuries to mild chest pain. Once we had parked our 3.5 tonne vehicle traffic was now well and truly blocked in both directions, but whilst the two of us were working our way between the three cars, that was what was happening. The two cops were having to take statements, try and clear the road, act as mediator between the feuding parties as well as making sure everyone was safe until we had arrived. I didn't envy them one bit!

Sat in the traffic, near the front was a brand new white Audi. A guy, mid 20s leaned his head out the window and spoke at one of the coppers.

"Oi, how about you clear the road."

"How about you don't refer to me as 'Oi' for starters."

"How about you just do your job."

"Can you provide me with more officers to assist us, because that is what we need?"

"Ain't my job, I pay my taxes, how about you clear the road like you're paid to do, fucking idiot."

"We can only do so much. There are only two of us. We would love more officers to help but there aren't any. You'll just have to be patient."

"Just move the fucking cars so we can get on our way. It's your job, it's not rocket science. Are you all as incompetent as each other?"

"Stop swearing at me."

"Or what, what you going to do. How about instead of wasting time whining about swearing you do your job and clear the road."

At this point the copper walked away and continued doing the huge list of things that needed doing. I just stood there open mouthed. Had that really happened?! Some people are so unbelievably selfish! And arrogant. And in this case, just a total arse!

"Oi, move your ambulance so we can get past."

Oh, he's talking to me now! I felt that warm feeling inside, one full of joy and excitement! I composed myself for a moment and walked over to his open window.

"You are a rude, nasty, LITTLE man. You will wait like everyone else is waiting. There is nothing you can say, or do to make me move my ambulance any faster. All that you stand to achieve with this attitude is ensuring you wait longer."

With that I begun walking away! 

"Go fuck yourself."

"Very intelligent response. Well done." I said with a smile.

"Fuck off."

Clearly, I don't have the same levels of self restraint that coppers do. I am often found guilty of taking the bait but someone needed to tell him he was being an arse! The police face this abuse on a daily basis and most people get away with it, because there simply aren't enough officers to arrest and process these morons.

I asked the police officers on twitter how many units / officers would be needed in an ideal world to deal with a 3 car RTC with 5 patients on a busy road. These were some of the responses:

"I'd like 6. However I think that 4 is probably all I'd get. And that's on a good day." 
"Ideal world an officer per car, 2 for the road block and 2 for the witnesses so 7. That would almost be my whole team!" 
"6 in an ideal world, but you should be so lucky! 4 would be safe and manageable" 
"Ideally 6, but safe with 4. No less than that." 
"4-6 for scene management, arranging recovery, taking witness statements etc"  
"Depending on the road 6-8 ideally, not less than 4, too much to do." 
"Probably 6 I reckon but that would be most of my team!"

So, I think it's fair to say that the one police car with two officers was not enough to safely deal with the scene. Unfortunately, there was no one spare to send. In previous blogs Please Sir, can I have some more? and A Special Relationship I highlighted what effect the cut of 16,000 front line officers was having. Those two posts highlighted extreme cases which is easy to get outraged about but RTC's like this are part and parcel of every day policing and there simply are not enough to spread around. What you're left with is two officers trying to mange 3 angry families, a blocked road, the irate public, 5 patients, 3 drivers to process and breathalise, vehicles to help arrange recovery for and an ambulance crew to ensure are kept safe! It simply doesn't add up does it?!

As a bonus, as the road was being cleared the chippy chav opened his abusive mouth one to many times! The cop went over to the car and asked him politely to get out the car. The driver don't take kindly to this and his threatening manor and verbal threats landed him in handcuffs. To top it off, due to a faint smell of alcohol he too was breathalised. In what was a beautifully poetic moment, he blew over the limit and was promptly arrested for drink driving. One more scum bag off the road! If only he'd kept his mouth shut!

Despite the pressures, everything got done. The abusive moron was ignored, then arrested! The road got cleared, the patients got treated and discharged and after a good hour or so all that was left was the two cops with an absolute mountain of paper work, an ambulance crew and a clear road. The upshot is though, the public are left blaming the police for not doing enough to ensure their smooth journey! It's not the cars crashing, it's the police not working fast enough to clear the road. That moron happened to voice it but you can be sure others with thinking it. The emergency services shouldn't be left in a situation to just cope and muddle through. These ill conceived cuts to front line services have a huge effect on day to day services and there simply are not enough left to keep the public safe. Then again, lets not forget police should "Cut crime, no more, no less". These non-police matters will sort themselves out, eh Terese May....

Sunday, 19 January 2014

Dead Man's Hand

"25 year old male, playing cards, now not talking"

Call me a cynic, but I suspected this was going to be yet another waste of a resource. I may be wrong, he may well be having a stroke like the NHS111 triage system had determined, but at the age of 25, this was highly unlikely. There are always medical phenomenon, where teenagers have strokes, heart attacks and other conditions that are not expected to be a risk for at least 30-40 years. However, they are rare, especially when there are no risk factors. With no other symptoms listed, it was pretty staggering to the me that a) I was even going to it and b) it was such a high category or call! Anyway, who am I to form these opinions and question these decisions?! I'm just the Band 5 warrior who gets to see these people in their own habitat! I'm just the one who treats them. I'm just the ambulance driver who merely takes them to hospital. Questioning NHS111 is way above my pay grade! Anyway, only time would tell if it was NHS111 1 - 0 Me or the other way around. I suspected I would be taking home the points today! 

I pulled up to the house around 1am. It was the only house in the road with lights on so was pretty easy to spot. The door opened as I was walking down the path and a young guy came out to meet me.

"Thanks for coming, you really shouldn't be here."

"No problem, what happened tonight?"

"Between you and me, he's a friend of a friend. We have had a poker night and he has lost money. He kept buying back in over and over and now owes about £70. He collapsed to the floor, we got him up and put him in a chair and he hasn't said a thing since. Every now and again he opens his eyes but just closes them. It's a bit odd, I reckon he's putting it on to avoid paying but a couple of the guys were worried and called that 111 thing."

"OK, thanks for the heads up, let's go and see him."

I was led through to the living room where the perfect 'lads night' was on display. Sky Sports News on the TV, remnants of a curry lying around, poker table set up and a fair few empty cans of lager all over the place. They were actually a really nice group of guys, polite, courteous, offered me tea / coffee etc. 

"Coffee, milk and 2 please!"

Lying in the chair was the patient. I've seen a lot of unconscious people in my time and I've also seen plenty feigning unconsciousness and he was DEFINITELY not unconscious. I don't know what it is exactly, we just know! Unconscious people have a look about them.

"Come on James, open your eyes.......James, open your eyes."

Nothing. I lent forward and gently touched his eyelashes. Sure enough, they twitched. Shocker! 

"James, I know you can here me, stop playing around and talk to me."

Nothing. I pinched the muscle on the top of his shoulder as my 'pain stimulus'. Sure enough, he recoiled from it but still continued the pretence of unconsciousness.

"James, an ambulance is on its why. I'd like to cancel them so they can be used on one of the dozens of seriously sick people who are currently waiting for one. The reason they are coming here is because you are pretending to unconscious. Do me and them a favour and start talking to me, this has gone far enough.........James!"

Nothing. I went for the shoulder again and he slid himself down onto the floor and started 'fitting'. It was one of the worst fake seizures I've ever seen, complete with spitting and drooling. After about 20 seconds he stopped. I picked up his arms, held it over his face and let it go. Sure enough, instead of dropping and hitting him in the face he moved it to one side at the last second. 

"Red Base, this patient is not co-operating, could you request the police to attend this CAD as the patient is preventing the emergency services carrying out their duty." (Forgot to press the transmit button, oops!)

*cue the miraculous spontaneous recovery*

James started moving around slowly and feigning confusion. 

"What happened, what's going on?"

"You pretended to be unconscious and then pretended to have a fit, are you recovered now?"

"What do you mean?"

I could have continued in the same vein but it was easier to just ensure he was fully recovered so I could cancel the ambulance. AMAZINGLY within about a minute he was fully recovered, fully alert, fully cooperative and fully embarrassed. 

"Does he need to go to hospital?" said one of the guys.

"Nope, certainly not, he'll be just fine!"

"Excellent! Pay up bro! Mans have to pay their debts!"

Sunday, 12 January 2014

24 - Season 3: Episode 4

The following takes place between 03:26am and 12:00pm


Despite that sudden burst of energy that the RTC had yielded, 03:00 in the morning is a friend to no one. As quick as the energy and invigoration arrived, it was gone again, leaving two, very sorry looking individuals left slumped in the cab of an ambulance. I could feel myself slipping into that place between being awake and being asleep, where your dream kind of starts but you eyes are still kind of open. The piercing noise of the MDT soon erred me towards my eyes kind of being open.


“21 year old female, chest pain. From NHS 111”

“On a scale of 0-10, 10 being central crushing chest pain, pouring with sweat, ashen in appearance and an impending sense of doom, and 0 being……..whatever.”

“ A 1. Panic attack. Fully recovered. Said the words chest pain. Likely car and ambulance.”

Off we went. The conversation wasn’t as bubbly as it had been. We were both staring at the road ahead, struggling to keep our keeps open. I did however summon the energy to make a joke about me not wanting to drive any more! 

When we pulled up on scene, as predicted there was a car there. We took a walk, similar to that of a zombie up the garden path and into the open door. Sitting on the sofa in the living room was our patient. She looked perfectly happy, not in any pain, not hyperventilating. The handover from the FRU went something a little like this……

“Hi guys, this young lady thinks she may have had a panic attack this morning. It has fully resolved now and she has no symptoms. She called NHS111 for advise on medication and they insisted on sending an ambulance because she said that during the panic attack they was tightness in her chest whilst breathing. Because of the ‘chest pain’ they said she had to go to hospital. She told them she didn’t want an ambulance and here we are!”

*little high-5 behind our backs*

Well, this going to be simple! All her OBs were completely fine, as you’d expect them to be and her ECG also resembled the perfect heart of a 21 year old. Needless to say, we did our paperwork and left! 

As you can see, NHS 111 causes a monumental waste of resources on an hourly basis. It’s not the people who work there’s fault. They follow a computer and the computer tells them what to do. When the computer says jump, it also tells them how high. Or in this case, it told them an FRU and an ambulance would be needed to deal with a 21 year old female who had had a panic and din’t want to be seen. 

Just for the record….. 21 YEAR OLD FEMALE DON’T HAVE HEART ATTACKS. OK, so maybe one did once because of having other medical problems and all the risk factors one could have, but surely this doesn’t mean that for ever more any 21 year old with pain in or near their chest, jaw or arms is having a heart attack?! Seriously! 

Anyway, off job time! 


Luckily a job came down pretty much straight away. Well, I say luckily….I hadn’t the patient yet!

“48 year old male, chest pain, ?intoxicated. At bus stop.”

“On a scale of 0-10, 10 being as blind drunk as they come, vomiting, urinating and requiring carrying, 0 being sober as a judge, how intoxicated is he?”

“6. Drunk, probably an alcoholic, the smell will make your eyes water, but sober enough to answer questions, walk and swear at me.”

My crew mate chuckled. It was knowing chuckle! Mainly because she knew I’d be correct! Social drinkers tend to be drunker and are normally scooped up and hospitalised by 3am. Angry, smelling alcoholics tend to be perms-drunk and therefor somewhat more capable of being encouraged to walk. They are generally much more abusive and tend to sit on benches or at bus stops which are near the 24/7 off-licences! Call me sceptical but this particular bus stop was right outside a 24/7 ‘Food and Wine’! Finally. he was 48. Generally 48 year olds don’t get blind drunk and call themselves ambulances at this time of the morning! The binge drinkers are the young ones, the alcoholics are the old ones. Normally! I may be proved completely wrong. 

I wasn’t. 

Sitting at the bus stop was a regular patient of mine. A vile, abusive drunk who calls an ambulance because he lives near the hospital. I was correct on every single count.

*little high-5 behind our backs*

“What’s the problem today Sir?”

“I’ve got fucking chest pain, I already told ‘em that.”

“Well you hadn’t told me that. How long have you had the pain?”

“Stop asking me fucking questions and just take me to hospital.”

“If you have chest pain, we need to do your ECG and check you over.”

“I don’t want one, just take me to fucking hospital.”

This could work one of two ways. I could say exactly what I was thinking about his abuse of the service for a lift home, probably wind him up further and end up with him being arrested, or I could open the ambulance door, let him on, drive to the hospital and let him run off to his house. There would be no winners for doing the right thing, but at least by giving into his whim, we’d be off on time. You could try and argue the morality or this with me, and tell me it just encourages that behaviour, and you're probably right. But at 5am, I am right. The end!

Off we went, conversation was hardly flowing and all inane questions were responded to with a battery of swearing. Sure enough, the back door opened, he staggered out, and wondered off down the road. Paperwork done, slurp of coffee and we were done. Finito. Fine. Time for bed! 


Free from the risk of another job we begun driving back to station. I took the opportunity to double check my rota for tonight's shift. Doing so much overtime means it’s easy to forgot where and when you were working. I had booked a late shift somewhere which would mean a relatively short turn around but it was my choice so I couldn’t moan…….

12:00!!! 12:00!!! I had mad the ultimate shift fail! I booked overtime thinking I was in at 18:00 but no! I was due in at 12:00 on a core shift, not overtime! I was due back in work for a 12 hour shift in just over 6 hours! Factor in travel, eating and showering time and I’m left with no more than 3 hours sleep. I felt sick. I had that pitted feeling in my stomach. My crew mate simply laughed, out loud, in my face! What could I do?! It was no ones fault but my own. I couldn’t change or cancel my core shift at short notice because I’d done overtime the night before. I’d just have to suck it up! 

We got back on station and I rushed everything away and headed off on my bike! 


I finally got into bed. Needless to say I laid away for ages, panicking about having to be up in a few short hours! I set my alarm for the last minute possible but that didn’t alleviate my fears!


THAT NOISE! Urrrrrgggghhh! I felt like I’d been hit by a bus. Nothing could console me. I was a wreck! I did everything as quick as I could, no time to make lunch and dinner though! Today was going to be a McFried Kingway kind of day! 


I arrived at work. Here we go again.


Thursday, 9 January 2014

24 - Season 3: Episode 3

The following takes place between 00:00am and 03:26am


It was fair to say we had broken the back of the shift! It’s always nice on nights when you consider yourself to be on the home stretch! We tucked into our cold dinner as the clock ticked down to when we had to green up for the next one. Sadly, that time arrived far to quickly and once again we were off. I was also starting to yawn which with 6 hours to go, isn’t ideal! Again, I tentatively suggested we swap round but the only thing I got was laughter in return. Worth a shot! 

“30 year old male, DIB, Asthma. From NHS 111”

You’ll be shocked to hear I was sceptical! As far as I’m concerned, people who have asthma no what an asthma attack feels like and know what to do when they have one. They also know exactly when they need to call 999 so I find it odd for an asthma patient to call 111 for advice. As had been the theme of the evening, my cremate posed me a simple question:

“On a scale of 0-10, 0 being breathing so perfectly it makes me feel positively wheezy and 10 being unable to breathe, requiring ventilations, a silent chest, tracheal and sub-costal tug all needing immediate inspiration and a blue call, how bad is his DIB?”

“I reckon a 2. Possibly a 3. He’s probably got a cough. In fact, change that to a 1. Normal everything, no wheeze but thinks A & E will be some kind of great adventure!”

We pulled up at the block of flats. The address details said ‘4th floor’. There was no lift. Can you imagine the joy that was flowing through my veins?! By the time we got to the top, both of us were breathless and therefore, by my prediction, more in need of an ambulance than the patient. 

BINGO! *takes a bow*

There was our treasure of a patient, sitting on the sofa grinning away. There was no cyanosis, no increased respiratory rate, no obviously distress or difficulty, just a big grin. The grin itself was mildy unsettling! 

“Good evening Sir, what’s the problem tonight?”

“I’ve had this awful cough and cold. I think I’m wheezy with difficulty in breathing.”

“How long has this been going on?”

“Since the afternoon.”

My crewmate, complete with wry smile, did all of his OBs. All normal. Oxygen levels were 100%, there was no temperature, blood pressure and heart rate were normal. I couldn’t find anything wrong with him other than being sniffly. 

Despite my sound medical advice and suggestions of alternatives to accident and emergency he wanted to go and get ‘Antibotics’. I didn’t think he needed Antibiotics but there was definitely no indication for ‘Antibotics’. Rest assure though, he had taken ‘Paretomol’ and ‘Buprofen’


Anyway, overnight bag packed he headed back down the stairs to the ambulance and headed off. On route I had a fascinating conversation with his wife about diabetes. She had been diagnosed with type 2 diabetes a year ago at the age of 26. I can’t say I was surprised, she must have been in excess of 20 stone and rather short. Diabetes was somewhat inevitable. However, she assured me that she’d ‘caught it’ of her mum. Yep, that nasty contagious strain of diabetes mellitus was at it again, jumping from host to host, catching people unawares. It was just sheer coincidence she happened to be morbidly obese, a smoker and didn’t exercise. But yes, blame the parents! 

What these two need is the health promotion version of the ‘birds and the bees’ chat. An actual in depth conversation about lifestyle, risk factors, causes, what constitutes being ill and PRONUNCIATION of very common medications! Every time someone says ‘Buprofen’ a puppy dies. Spread the message and help cure the madness!


Thoroughly frustrated and now verging on irritable I no longer felt on the home straight. It felt like there was absolutely years to go until the end of the shift. Urrrrrgggghhhh!!

“23 year old female, tearing abdo pain, From NHS 111”

Really?! ‘Tearing’ seems the new buzzword that NHS 111 seem to be asking patients. Tearing abdo pain is a symptom of a very dangerous, life threatening Abdominal Aortic Aneurysm. (AAA). These patients often die. Unfortunately, if you ask someone who is ringing for advise if the pain is ‘a tearing pain’ it is highly likely a fair few will just say yes. Cue the Red 2 response of FRU and an ambulance. 

“On a scale of 0-10, 0 being calm, relaxed and whistling ‘ Always Look On The Bright Side of Life’, and 10 being the worst abdo pain since records begun, causing eventual loss of consciousness and a necessity to anaesthetise immediately, how bad do you think the pain is?”

“Definitely a 2. No more. But I want a bonus if she says 11 or 12 then laughs.” 

Up ahead of us were blue lights, we slowed down by the police car and saw the wreckage of a car. 

“Evening! Need a hand at all?!” 

“Yes please, we’d just requested you, got 1 trapped”

“RUNNING CALL: RTC, Car vs Tree, 26 year female trapped, injuries unknown.”

Pulled over and the road was subsequently closed. In the passenger seat was a young lady very distress and upset. The wouldn't open and her leg was trapped. A second ambulance was on scene within a minute or so and one of them got into the back, much to his annoyance! Everyone else claimed seniority so it was he who hat to sit in the back, holding her head for probably an hour whilst we got the fire brigade to cut her out. 

As I’ve said before, the fire brigade are great at what they do and we can’t get these patients out of the car without them. They arrived on mass much to the amusement of the police and myself. A sea of daffodils bundled out of all 3, yes 3 fire engines plus a specialist rescue unit. There was at least 24 of them around this tiny Nissan Micra. 

“I can’t stand around here watching them all swinging their bollocks around in some blue light mating ritual. I’m taking the driver to the truck and see how he is!”

Well, that was my cremate gone! And she had a point. Despite explaining that I just wanted the door off they seemed determined to take the roof off! My patient had no neck pain or back pain but was trapped and her leg was hurting. I wanted to get her out with as little faff as possible but that was proving an impossible task. The ‘white helmet’ ( 1 of 3) attempted to patronise me with phrases such as ‘Look here luv…’ which went down a treat. They didn’t need to take the roof off, the door would surface so much to their annoyance I pissed on their parade and stuck to my guns. Rolled eyes and head shakes followed but I didn’t care. It was freezing cold, raining and my patient needed to be in the warm with some decent pain killers. This wasn’t the time of the place for a training exercise. 

With the door off we got her fitted into a KED (fancy extraction devise) and promptly pulled her out of the car sideways onto the bed. She had escaped with minimal injuries so was taken in the other ambulance. We took her husband to the same hospital and left the 24 deflated egos having a collective bitch about that stupid paramedic! Ooops!

This encounter had woken me up somewhat! By the time we were fed and watered and ready to go again it was approaching 03:30 so time for 1, maybe 2 more depending on the customer! Winning!

Time to press the button again…..

To be continued…..

Monday, 6 January 2014

24 - Season 3: Episode 2

The following takes place between 22:12pm and 00:00am


Partially caffeinated and well snacked we green’d up for the next one. We had to wait the all of 5 seconds!

“? drunk, ? at a bus stop, ? fall. NFDA”

Call me a cynic but this sounds like a drunk at a bus stop. I know, I know, you mustn't pre-judge a call before you get there, blah blah blah. Sure, it could be a confused diabetic patient having a hypo, who has collapsed to the ground by a bus stop and hit his head. The resultant head injury could have caused him to have a seizure and due to him being crunched up against the bus stop, the resultant positional asphyxia and subsequent hypoxia has caused him to go into cardiac arrest. At this point a member of the public has seen him, phoned 999 and started resuscitation.

Anyway, we were on our way to a drunk at a bus stop! If it wasn’t, I’d eat my hat!

We pulled up and I was disappointed that there was no one lying on the floor. Had I been wrong?! The disappointment did not last long when we were suddenly treated to the member of the public that had phoned us! And believe me when I say ‘treat’! Picture Dr. Emmett Lathrop "Doc" Brown, Ph.D, from back to the future barring down on us walking like John Wayne! Now, keep the hair and facial expressions of the Doc but add the glasses of Garth from Wayne’s World. Now dress him in a Christmas jumper, a Columbo trench coat and some rather fetching white leather snake belly cowboy boots! Across the top of the boots, drawn in marker pen was his name! Nige! It was a sight to behold! My cremate almost choked on the dried mango she was chewing. I just starred in amazement and wound the window down! 

“Good evening ladies!” he said with a letchy grin!

“Good evening, is it you who has called us?!”

“It sure is!”

“What’s the problem tonight?!”

“Well, I think someone needs your help. There was a homeless Polish man who fell over. I think he was drunk. I chatted to him and gave him £5. He seemed very cold so I offered to go and fetch him the spare duvet from my house. Can you believe it, he didn’t want it?!”


“I’m not! He just got up and walked off! He’s going to get so cold!”

“How long ago did we wonder off?!

“About an hour ago maybe.”

“So what would you like us to do tonight?”

“Well I’ve invited you here, and the police too, so we can have a group discussion of how best to proceed. It’s not normal behaviour to refuse a duvet when it’s this cold.”

“So you want us to wait here for the police arrive, so we can discuss with them, and your good self, how best to provide assistance to a drunk, homeless, Polish man, who doesn’t want any help and who we have no idea where he is?”

“Yep, I think it’s important, especially as it is so cold.”

A.M.A.Z.I.N.G! I know I moan about being sent to utter nonsense with worrying regularity, but jobs like this make a night shift thoroughly enjoyable! I could happily have played along with Nige for hours and hours. Unfortunately, they were holding calls so I had to gently let Nige down and tell him that the multi-agency conference would not be happening and that we would be leaving! I wished him a merry Christmas and complimented him on his taste in footwear! 

What a great experience that was! Now, back to the mango!


“50 year old male, chest pain”

Why can’t we ever just be left alone for 10 minutes to enjoy exotic fruits in peace! It’s as if they think we are an emergency service and patients come before dried mango! Anyway, we had to travel a bit of a silly distance to this one so I had time to eat on the run!

We pulled up outside a block of flats and my crew mate instantly recognised it. She didn’t know why, or who but recognised the flats, which was ominous to say the least! We got to the front door and just as I was about to knock the door swung open! Standing there was our patient, dressed like he was about to brave the arctic circle and very much ready to go! He looked a bit like Stanley Hudson from The Office US! As we ushered him towards the ambulance my crew mate lent over to me and said:

“Have fun with this one!”


Once on the back of the truck, the rigmarole of removed the 847 layers of clothing begun. Conversation wasn’t forthcoming despite my best efforts and the history was rather vague! He was also rather drunk and a tad creepy! 

“What’s the main problem tonight?”

“I have this funny old pain in my chest.”

“And how long have you had that for?”

“About two years or so.”

“Two year?! What’s different tonight?!”

“Nothing new.”


I did all his OBs and everything was fine. He was keen to go to hospital but I convinced him that A & E probably wasn’t in his best interest. I started filling in all his personal details and realised I have completely forgotten his name! This often happens despite my concerted effort to always remember so rather than go through the embarrassment of asking their name again, I ask how to spell it. Obviously, more often than not I can get away with it, but names like Bill make me look stupid! 

“How do I spell your name?”

“K as in Kevin, E as in Evin, V as in….Vin, I as in Ivin and E as in Evin.”

“So Kevin then?”


Well, that was suitably bizarre way to dictate the spelling of a name, but then again, he called an ambulance for a two year history of chest pains. I won’t get him to phonetically spell EMERGENCY! If I did I have no doubt the joke would be lost on him! 

Eventually the paperwork was done, referral was made and all 847 layers were in position for the 10 meter walk back to his house! 

“Good night Kevin”

“Thank you.”

Another life well and truly saved! It's too early in the morning to rant about NHS111 and patients with 2 year histories of anything! He wasn't rude, provided some entertainment and didn't need carrying. I can assure you, that is all anyone ever wants on a night shift!

To be continued…….

Saturday, 4 January 2014

24 - Season 3: Episode 1

For some it’s the season to be jolly. For other’s it’s the season to reflect on what an utterly crap year it’s been. For me, it’s overtime season. It’s the time of the year where I literally sell my soul to the ambulance service in the vain hope of affording a holiday at the end of it. Tonight was a self inflicted overtime shift, but with someone I very much wanted to work with so you won’t catch me complaining. 

I couldn’t write that with a straight face! Of course I’m going to complain!

The following takes place between the hours of 12:00pm and 18:30pm


Despite volunteering to work a night shift I wasn’t happy about it. I had given up a lovely little 8 hour day shift on request of my crew mate who going to be single on the night and wanted someone to do all the work for her. As requests go it was pretty outlandish! Asking ME to do a night shift instead of an early! Despite my faux protestations I was more than happy to and even offered to provide the grub. I’m nice like that!

So, instead of sleeping before the night shift I slaved away in the kitchen! Mainly because I can’t sleep during the day and also, because I predicted severe hunger throughout the night and didn’t want to leave anything to chance! 

Food made, washed and groomed, packed and dressed I was just about ready to head off in to the night. All we needed now was pleasant patients and we would be in for some easy money!


That ominous feeling that every night shift brings was well and truly upon me as I walked into a rather strange looking ambulance station. I chucked my stuff on the vehicle and headed for the kettle. Caffeine was going to feature heavily! 

‘Breakfast’ was prepared by my crewmate and we feasted like kings. It made a nice change from my usual routine. The bliss didn’t last long…..


“36 year old, asthma attack”

We headed off into the night. True to form, my cremate was driving and I was writing. When I suggested that maybe at some point she could write and talk to patients she laughed. And laughed hard! This was going to be me for the night!

We pulled into the alley way where we’d been sent to. It was in a particularly grotty part of town and the alley itself didn’t offer anything up, other than a bad smell and sludge. Up the metal staircase we trotted, full of unparallelled enthusiasm. The front door was open so we headed into the smoke filled hovel. It was like walking into a cloud of irony. Sure enough, sitting in the smoke filled room was our patient, wheezing away like a good’un. He had been treated in hospital that day already for his asthma and unsurprisingly, was having a relapse. They really didn’t seem to grasp that sticking an asthma patient in a smoke filled room would cause a problem. In fact, they blamed the bad treatment of the hospital for his current predicament! Gotta love the NHS! Failing patients at every turn….by not making them immune to cigarette smoke! The scoundrels!

Anyway, my crewmate handed out a speech, laden with sarcasm and health promotion do’s and don’ts whilst I gave him a nebuliser and off we all went to hospital like one big dysfunctional family! We handed him over to the nurse, making sure she was aware of the environment in which he was found and headed back to the ambulance to eat some dried mango. Yep. Mango. If you don’t like it, you have no place being here!


“66 year old male, chest pain.”

I’ll be honest with you. From the information we were given I wasn’t holding out much hope for this being a job that could hold my attention. Some chest pains read like proper chest pains, others read like chest pains for a quick ambulance. This looked like one of them. It had all the tell tell signs. Abdo bad, DIB, symptom after symptom, and eventually chest pain chucked on at the end for good measure. All was just itching to be revealed. 

We pulled up, grabbed our stuff and headed inside.


That is what we heard as we walked down the corridor. In the living room, sitting in the chair was a beard. Well, the beard had a rather large man attached to it, but the sheer magnificence of the beard was overwhelming. It made Santa Claus look like he only had designer stubble! I’m serious! It was most off-putting!


“Hello Sir, what’s the problem today?”


This could be a long conversation….. Luckily, I was quickly interrupted and told that he doesn’t speak any English. So, all history taking was done through a translating relative. I was dubious about some of the answers because I asked about the pain score the patient spoke at lighting speed for about 10 seconds only for the relative to say “8”. 


I muddled through and established he’d had chest pain for about 3 days but this evening it was much worse. I also learnt that trying to stick ECG leads onto someone who effectively has a mature weeping willow hanging off their chin requires a unique set of skills and preferably three arms! Eventually we were good to go!


*presses print and waits*


*’analysing ECG…….’*


*prints out ECG*


MASSIVE HEART ATTACK! Shit! My cremate quickly vanished to get the chair whilst I stuck a cannula in. We gave all the drugs, wheeled him to the ambulance, put in the blue call and headed off to the cath lab!


Once there, we handed over to the cardiologists and assisted transferring him to the operating table for the procedure. During the transfer my cremate was unfortunate enough to get an eyeful of old-man-penis. (“Wheeeeeeeyyyyy.”) I didn’t ask for details but going by the beard on his face and the pained look on her face, I imagine there is more to that encounter that met her eye. Poor lass. Bet she wished she was on the board! As if……

Despite the short period of excitement we’d just encountered, we needed coffee and some more mango so we quickly made our exit and headed back to the safety of the truck! As we wondered down the corridor all that could be heard was “Wheeeeeeeyyyyy.”. I'm still not sure what that noise was all about!