Friday 3 January 2014

Emergency Service

Well, it's that time again. Time to introduce Inspector Michael Brown, author of award winning and acclaimed blog, Mental Health Cop. Normally, I drag him out to discuss all things mental health. However, this time, my narcissistic side, just couldn't resist sharing his words with the masses. Namely, because one of the tails of heroism he refers to is me, and to be brutally honest, I dig that shiz! It's also confirmation that the ambulance service is indeed the BEST emergency service.

So, with all the fanfare it deserves, and a dosage of pomp and circumstance, I present to you, 'Emergency Service'

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I sometimes remember to marvel at some of my colleagues and did so again over the Christmas period – ordinary men and women doing an extraordinary job, away from their friends and families whilst we were at home – (it was my turn to be off!) Their pay has been frozen for the last few years with their pensions being eroded compared to those they were promised when they joined up; there is comparatively little or absolutely no training for some of the functions that they are expected to undertake in their role; and sometimes they are patronised and misunderstood by senior members of Government who don’t really get their role at all.


A while ago, one of them was at a job where a man had attacked his partner with a knife and the man was known to have a risk history that flags up whenever you attend the address. Back up was a distance away and consumed by an instinct to protect the woman and get to her aid, she went in to that unknowable environment on her own. What she did what she got in there meant the man fled with his knife, the woman was safeguarded from any further threat and it could be declared safe for paramedics to roll the ambulance up to the door. The man was arrested a short-distance away, but that early evidence meant we could prove that he *was* holding a knife during the incident. Crucial evidence, nicely preserved by a brave professional witness who put herself at risk.

You’ll remember this blog was prompted whilst I was off work this Christmas: I remembered what it was like working on the frontline last year – Christmas Eve in particular was a real bender of a shift and resources were so stretched that by about 3am (on Christmas Day!) I was first on the scene of a stabbing. A man so badly injured that his wound was an open chasm in his neck and there were half-pints of blood all over the pavement. I was soon joined by another set of blue flashing lights and before much else could happen, my colleague and I were rolling on the floor with this bloke, fighting him to let us apply pressure to his neck wound so he didn’t bleed to death in the road. We both got knocked about a bit, but nothing serious and wondered afterwards whether this man was as high-as-a-kite on cocaine? But the ambulance crew and more officers turned up and off he went to hospital.

Earlier this year, we had a very mentally distressed lady in police custody – a person in a condition of some particular agitation and obviously very unwell. As various medical professionals have suggested we should, I remember asking the custody nurse whether we could be sure that her basic obs indicated nothing was seriously physically wrong with her – was she actually safe in police custody? The nurse checked the custody record medical forms and admitted she didn’t know. She agreed she should do them again to be certain and saw what I was getting at. Was her heart rate OK, her blood sugar, etc., etc.. The nurse being there with all of her gear, you’d hope and think that a nurse would be able to reassure someone perhaps to a greater degree than someone in uniform that they wanted to check them out, to help make sure they’re OK? This lady couldn’t see that and I patiently watched two of my colleagues spent 90 minutes of constant patient and compassionate conversation turn this into a position whereby the obs could be done and we could relax that she was not potentially seriously medically ill, as well as distressed.


I could go on and on – the point I want to make here is thatnone of the colleagues I’m referring to above are police officers.

They were all paramedics from our ambulance service. 

It was a paramedic first-responder that intentionally put herself at risk where a man had taken a large blade to his wife, to safeguard her and she unintentionally contrived to be able to provide evidence against him that helped convince the court he was a dangerous liar; it was a paramedic who got physically stuck in to a man who was bleeding heavily but fighting not to be helped; it was two paramedics who came into police custody and spent 90 minutes patiently persuading one of the most vulnerable, psychotic and distressed people I have ever met, to let them care for her.

I could still go on and on – the story of the paramedic in London who continued to provide care for a drunk man just after he’d been hit over the head with a fence post by that man; the paramedic in Suffolk this Christmas who ran into a burning building before the Fire Brigade could arrive to rescue a trapped woman and immediately give her respiratory support; the paramedic who accompanied three officers into a building where there was a risk of a gas explosion in order to assess a man inside – all were hurt when the building exploded, a risk that they knew they were taking.

It is my genuine privilege to work alongside these people – as we do every single day. Despite the very obvious differences between policing and pre-hospital healthcare, there are many overlaps and at the core of it all is dedicated public service at times like Christmas or during family birthdays and other events. It is my view that paramedics are paid peanuts for what they do and they are probably more messed about and taken for granted with the rubbish that is thrown at them, than we realise. The stories of people ringing 999 for an ambulance because they can’t be bothered to walk to hospital or see their GP; the Home Secretary contriving to refer to them as “ambulance drivers” in apparent disregard of the training and qualifications they must have and the media quick to pick up on paramedics not diving into a lake but aren’t mentioning the one who ran into the burning building.

It just beggars all belief that they aren’t considered an emergency service – I have certain views about that!

The practice guidelines for paramedics is a telephone directory sized book and it has four pages of information on about mental health, some of which is wrong! It probably isn’t as widely known as it should be, how many paramedics will say that they want to be able to do more for people in mental distress – they want to access NHS referral pathways, have options for removal to care settings that are more appropriate than A&E and be trusted to take pre-hospital clinical decisions. Let them serve us better, because they want to do it and are currently blocked from trying. We trust these people to get to grips with our heart attacks and strokes and to know what to do when time is of the essence – surely we can open up the mental health pathways and trust their clinical judgements?

So I want to circulate my admiration for my colleagues in green and help build awareness of the stuff they do for you and for all of us each and every day.

We would notice if they weren’t there to do it for us, trust me on that.


  1. Well I am not keen on you people in green (paramedics) bring me most of my work (a&e nurse). But I do admire your work. You pre alert patients in critical conditions and work with minimum staff and resources yet still nanage to often stabilise or improve their conditions enroute. You hardly get recognition for the hard work you do (like A&E staff) despite a lot of abusive and innappropriate patients you see. The focus in the news is never about all the good that is done and without any consideration for all the hard work and horror stories you hear about. I totally agree with the above blog. Id like to put forward one consideration though....maybe enroute with less serious cases you could call to a takeaway on the way to A&E you know sweeten the blow with some of the less desirable clients and make some of the miserable staff more approachable (JOKE) ;-)

  2. I can relate to this on many levels, having wrestled with suicidal and mentally disturbed patients and spent hours calming suicidal patients down. Training? Minimal.... it's down to old age, experience and gut instinct - hoping & praying that you're saying the right things to strike a chord & defuse the situation.
    More power to the boys & girls in blue who cover our backs & get stuck in without hesitation. Should rationalization occur I'd be more than happy to share a station or a vehicle:-)


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