MedWorm: Ambulance Crew

Please leave a message after the bleep...

Random Acts Of Reality — Thu, 15 May 2008 07:00:00 +0100

"Tom is asleep right now and cannot come to the website. He was going to write about what has recently happened to JonnyB, however Zinnia has beaten him to the punch I believe the Americans would say, 'You snooze, you lose', although perhaps not as literally as has happened in this case. Please leave your message after the bleep..." Bleep. (Source: Random Acts Of Reality)

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For all you ems types...

A Day In the Life of An Ambulance Driver — Thu, 15 May 2008 00:21:00 +0100

...I have a new column up at EMS1.com.I'm putting on my Nomex skivvies in anticipation of the indignant howls of protest by Mr. Fixit, Detail Medic and others... (Source: A Day In the Life of An Ambulance Driver)

One major milestone down...

A Day In the Life of An Ambulance Driver — Wed, 14 May 2008 18:51:00 +0100

...only a couple more to go until the finish line.Today, my lardassitude just took another kick in the crotch. Weight as of this morning, 299 pounds.I broke the 300 pound barrier, folks! That's 63 pounds lost in 3 1/2 months.I am made of win. (Source: A Day In the Life of An Ambulance Driver)

Utterly fed up

Random Acts Of Reality — Wed, 14 May 2008 06:29:00 +0100

I'm going to apologise, for this post is a complete moan. Nothing positive about it in the slightest. I'm on night-shifts at the moment and they are hitting me particularly hard. Last night I was feeling nauseous, which lasted into the next day. My eyes felt as if they had been taken out and rolled around in hot sand before being returned to their sockets. At one point I had double vision. I was in an incredibly bad mood, something that turned into depression for the next day. For much of the night my legs were 'jumping', both annoying and painful. It also meant that when I could try and grab a moment's sleep I couldn't manage to do anything other than close my eyes. So I'm feeling wrecked. What then was I here for? Surely some sick person needed my aid... Here are the calls we took, along with their need for an ambulance or A&E treatment. * A two year old with a bump on their head after falling over. Needed neither ambulance or A&E. Was a 'blue light' response. * A twelve year old with a cut finger. Needed A&E treatment but he and his mum could have walked 200 yards to the tube station that would drop him off outside A&E. It didn't need an ambulance. * An emergency transfer from one maternity department to another. we got there before they were ready but the transfer otherwise went well. Needed an ambulance and hospital treatment. Was perhaps rightly a 'blue light' response. * A young man with a sore throat and temperature for four days, had taken two of the antibiotics that his GP had given him. Needed neither ambulance or hospital treatment. Was a 'blue light' response. * A teenager with back pain after drinking and smoking pot at a nightclub. Was a 'blue light' response, needed neither ambulance or hospital treatment. * A woman, new to this country, with a blocked ear which meant she could hear her heartbeat. Another 999 call that apparently warranted a 'blue light' response. Not a busy night in the grand scheme of things, but it was enough to keep us away from our station. And I get to do it again and again and again. But first, while the glowing dayball is in the sky, I need some sleep before I start thinking about killing those who annoy me and then myself. Go on, practice saying it, “He seemed such a quiet man, kept himself to himself...”. This is why I need a new job. (Source: Random Acts Of Reality)

Life imitates art...

A Day In the Life of An Ambulance Driver — Tue, 13 May 2008 21:25:00 +0100

...which imitates life, which in turns rips off stories from some guy named Ambulance Driver.I've just had my Major Caudill moment, although mine wasn't as traumatic as Marko having one of his better essays ripped off and passed around teh Intarwebz and attributed to someone else.Actually, I found mine rather funny.I was going through some conference evaluations that arrived in the mail today. Inside were the usual mix; 90% excellent evaluations, some beefs with the venue's sound system and climate control, a smattering of people who obviously wandered into the wrong session or didn't bother to read the description in the program, the usual five percent or so that think I have a potty mouth, and ten or so that reminded me that my closing keynote speech should never run fifteen minutes long, especially since it was the last session of the day and there was, you know, beer to be drunk.Nestled among the evaluations was this gem:What a load of BS. The guy just told a bunch of stories straight off an internet site like they had actually happened to him.Heh.Aside from the popular jellyfish story - which I identified as a possible internet hoax - all the personal anecdotes I shared were either straight from my book or this blog. They have appeared nowhere else.That means, as far as I can tell, that the fellow I'm accused of plagiarizing so blatantly is...me.For some reason, that just tickles the shit out of me. (Source: A Day In the Life of An Ambulance Driver)

Shoelaces, belts and other items of harm

Random Acts Of Reality — Tue, 13 May 2008 08:00:00 +0100

We have a number of hostels in our area, some are for young people, some are for people living with mental illness, some for alcoholics and others are for people coming out of prison. For this latest call we were called for someone who was 'suicidal', we pulled up outside the house and realising that it was the same place that my crewmate had her bag stolen while we were inside dealing with a patient. We walked in (after making sure that the ambulance was securely locked) and spoke to a member of staff. We had a bit of trouble making ourselves understood, but this is not really unusual any more. The patient, who was in his room was said to be feeling distressed and had apparently tied a noose in a bit of spare string. The staff seemed very proud that he had taken the string away from the patient - so now the patient was safe. I asked him if he'd removed the patient's shoelaces, belt, power leads or drawstrings for the curtains. He looked a bit sheepish and told us that he had forgotten about those things... We went up to the patient's room. He didn't want to talk to us, except to tell us that the 'noose' had just been him fiddling with the bit of string out of boredom. We tried to persuade him to come with us to hospital, it covers our back should he then go on to hurt himself, and it means that he might get some specilist help from the mental health team. But he refused and in my opinion he was full competent to refuse treatment so we left him. Going back downstairs to the staff, they seemed very disappointed that we weren't taking the patient to hospital. I had to roll out one of my set monologues, the one where I explain that we can't kidnap people. The staff shook their heads and asked us what they could do. It was night, so there wasn't a chance of a GP or of a mental health team so the only advice that I could give was that they speak to their support staff in the morning. And so we left, hoping that he didn't go on to hang himself with the belt that the staff had left in his room. I'm on night-shifts at the moment. After some time being able to keep the same hours as reasonable people it's come as a bit of a shock to the system. So while the weather is lovely I find myself sleeping through it - it's just depressing really. Especially when people annoy me by dancing in the road in front of me while I'm trying to drive on blue lights. One day... (Source: Random Acts Of Reality)

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Alone

Random Acts Of Reality — Mon, 12 May 2008 08:00:00 +0100

Wow, loads of people editing the holiday wiki - many thanks for all the ideas although if I were to take them all on it'd take me a year to see it all. I've seen my future, well it'll be my future if I'm lucky and don't drop dead in my 50's. It was a lovely day, one of the first sunny days we'd had all year and our patients were obviously riffing off the change in the weather, everyone was being really nice. We were sent on a 'green' job, essentially a transport job with no blue lights or sirens. We were to pick up an elderly man from his flat and run him into hospital. No emergency, no stress, no worries. One of his neighbours in the block held a key to his flat, so we opened the door and announced ourselves. The interior of the flat was grimy. Junk mail and bills spread on every flat surface. Underpants were hanging over the bath, and a few empty cans of beans spilled over the bin onto the floor. Sepia photographs lined the walls, men in army uniforms, women with babies in arm looking stern. The reason for the flat being in this state was because of the patient's heart failure, it had caused the lower half of his body to swell up with retained water. He couldn't move around the flat, he was pretty much stuck in his chair, watching the horse-racing on a tiny television. We had a chat with him, he'd lived in the area all his life, seen his family grow up and move away. He'd seen the population of the area change from English people to Afro-Carribean people to Bangladeshi people, he didn't seem upset by this. He'd only moved house once, when they knocked down where he'd been born and put up this block of flats in it's place. The only person he saw was the woman who held his key, she hadn't been to visit for some time as she couldn't stand the state of the flat. We talked about different subjects, from football to politics, the odd joke and the odd tale. We drove him to hospital - none of our medical skills were needed but it still felt like we had used our expertise to put him at ease. He seemed sad to be wheeled into the A&E department. It was as we went to leave him that he turned to us and with moist eyes said, "Thank you for the company, it's a shame you can't stay with me". It upset me to leave him there, we had probably been the first human beings that he'd spoken to in quite some time. He'd been living out of that chair for some months. We were company to him for that short time and now he was probably going to become another meat parcel passing through the hospital system. Hopefully the nurses on the ward will have the time to sit and chat with him, maybe they can refer him to the social services and they might try to place him in a residential home. I think that the company he'd have there would do him a lot of good. (Source: Random Acts Of Reality)

Happy mother's day

A Day In the Life of An Ambulance Driver — Sun, 11 May 2008 21:36:00 +0100

You'll find last year's ode to my mother on my left sidebar: A Love Song For Joyce.Aside from being a professional martyr, my mother also was a talented artist with a wickedly funny sense of humor.On a Mother's Day over twenty years ago, she presented all each of her children with an identical painting - five in all. The painting depicted a peaceful cemetery on a lovely spring day, fresh flowers colorfully adorning each headstone......and smack in the middle, one ugly headstone fashioned to look like a beaten, weathered outhouse. The inscription on the door read:Here lies Joyce Hazel Felts Wroten Grayson,Who lived without an inch of backbone or an ounce of spine.If you missed your chance to shit on her in life,Please feel free to do so now.Heh. That was my Mom.And yes, I was on the crapper when I remembered what today was, and that memory came wafting back, so to speak.Mom would be so proud. (Source: A Day In the Life of An Ambulance Driver)

Observation shift: 3 - depressed

Nee Naw — Sun, 11 May 2008 19:39:55 +0100

Our third call was to the local council estate for a middle aged man who was, apparently, feeling depressed and suicidal. Now I like psychiatric patients. Maybe it’s because I’m a bit nuts too, but I seem to have a certain affinity with them and often find myself having long, drawn out chats with them on quiet night shifts. We rang the intercom and Raymond, our patient, unhurriedly let us in. Silently, he beckoned us into his bedroom, flopped on to the bed and sighed. I wasn’t surprised he was depressed; his bedroom was one of the most depressing places I have ever been in. Walls stained nicotine brown, carpet sticky, furniture ancient, it was severely in need of a make over. “So, Raymond, what seems to be the problem today?” said Steve cheerily. “I’m feeling very depressed,” said Raymond in a flat drone. “Worn out and worthless. I shouldn’t be here. I need to be in a home. With people looking after me.” “Well, I’m afraid we can’t take you to a home,” said Steve. “Do you want to go to A+E? Or have you been an inpatient at a psychiatric hospital before? We can contact them and see if they will take you back?” “I don’t want to go to A+E,” whined Raymond. “They can’t do anything for me. And you have to sit there for hours. And I’ve been in the psychiatric hospital too. I don’t want to go back there. I tell you, I need to be in a home.” I couldn’t see any reason why Raymond should need to be in a care home, but it is not the ambulance crew’s job to question this, so Steve suggested to Raymond that he should see someone who could arrange a care home - his GP. Steve’s crewmate rang the GP for an urgent appointment, and Steve told Raymond that we’d run him up to the GP surgery in the ambulance. “Can you take me back home too?” muttered Raymond. “Sorry, no - we’ll be sent on another job as soon as we drop you off,” said Steve. “I don’t think I’ll go, then,” huffed Raymond. “It’s too far to walk. And I can’t afford a taxi.” The GP surgery was actually five minutes’ walk away, and Raymond had no noticeable mobility difficulties. “Well, what would you like us to do then?” said Steve. “Is there someone we can call for you or something else we can do?” “I’ve told you,” said Raymond. “I need to be in a home. I don’t know why I bothered calling you. You can’t help me. No one wants to help me. The whole NHS is useless.” “Raymond,” said Steve, with an admirable show of patience. “I can’t help you get into a care home, because we’re an emergency ambulance crew and we take people to A+E. But I’ve told you how you might be able to get into one, and you don’t seem interested. We can’t help you unless you want to help yourself.” “No,” said Raymond. “Thank you, but I don’t think I’ll bother. It’s just not going to work out.” And he opened the door and motioned for us to leave. Since we’d made the appointment with Raymond’s GP, we decided to go anyway, even if our patient was not with us. We piled into the surgery and a very harassed looking GP sat us down, pulled Raymond’s details up on his computer and turned the screen round to face us. I could see that Raymond rang the surgery several times a day, usually demanding to be put in a care home but occasionally wanting other things done for him too. He had a history of not taking his medications and of accusing the doctors of mistreating him in various ways. He would be deliberately misleading about what the other doctors had said to him on previous visits, and because of this he was now only allowed to see one doctor (who I assume drew the short straw). “Raymond’s been assessed and we don’t believe he needs to be in a home,” said the doctor. “He needs to comply with his care plan and start taking responsibility for his own health. I’ll give him a call when you leave, but it’s nothing he hasn’t heard a thousand times before.” I found Raymond to be a most perplexing character. On one hand, I know it is the nature of depression that patients feel everything is hopeless and won’t work and that would partly account for why he was so unco-operative. On the other hand, and I know this is a total cliche and supposedly the worst thing you can ever say to a depressed person, but I really did want to say “Pull yourself together! Take some responsibility for yourself! You don’t need looking after, you need to look after yourself. No one else is responsible for the way you feel but you!” I know how the whole argument goes, Raymond can’t help being depressed, it’s an illness, you wouldn’t say that to someone who had cancer, would you? The thing is that while I agree that it is and illness and he can’t help having it in the first place, he can change the way he deals with it. You wouldn’t say “pull yourself together” to someone with cancer because you don’t need to. Anyone I’ve ever known who has had cancer has been determined to fight it. They grasp any opportunity to make themselves better and take any treatment, however painful or expensive. Whereas Raymond just wanted to lie back whilst someone else sorted out his life. Perhaps I should be more sympathetic. Perhaps I couldn’t possibly understand unless I was in his position. But then I thought back to Elaine, the old lady with the broken hip, and how brave she was and how thankful she was for our help, and I didn’t worry about Raymond any more. (Source: Nee Naw)

5:1

A Day In the Life of An Ambulance Driver — Sun, 11 May 2008 17:59:00 +0100

That's the ratio of patients I've seen to the patients the nurse has seen, over the past two shifts.You know, the nurse that gets paid 50% more than I do. The one who is actually supposed to be assessing and triaging these patients, rather than just affixing her signature to the charts as she flits through the department every few hours like a phantom.I think I'm about to go jam a pack of cigarettes up somebody's ass. (Source: A Day In the Life of An Ambulance Driver)

Yes folks, i'm still alive...

A Day In the Life of An Ambulance Driver — Sun, 11 May 2008 17:54:00 +0100

...but my muse is on life support.What with being unwillingly single, overworked, stressed, impending job changes, and just plain being depressed, I haven't found much worth writing about. Everything that comes out just has no...flow.And for someone whose best writing flows straight from brain to keyboard without much thought, that just sucks.Bear with me, though. Go read my archives or something. I'll be back up and posting something worth reading in a day or so. (Source: A Day In the Life of An Ambulance Driver)

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Nothin' doin'

MaddogMedic — Sun, 11 May 2008 04:00:00 +0100

It's a fill-in night at the firehouse. I've asked Helga to cover for me in the past and I'm paying her back now.There's this kid. Her mom and my Mom went to Nursing school together. Her older sister is a doctor and she's thinking the same thing.In the interim, she's decided that being an EMT-B is a good idea as a start on her road to her MD. An application, background check and a physical exam (Ironic?) later, she's a member.Now, she's my problem. The only time we roll the ambulance tonight is to go get ice cream at 11:00 at night. Exciting times, no?She fits in so well that I feel she's been here all along. This is one of those cases where someone is well suited to be here contrary to all assumptions. I don't have a blog-name for her yet. She plays it too close to the vest for that at this point. For now, we shall call her, "Sis." She is more like a sister to me than anyone I've ever known at the firehouse. She's beautiful, confident and capable. I have great hopes for her. Tonight, she joked with us, commented on bad movies with us, made a senior member blush and was first on the engine when it got toned out for a fire. I watch this person for 4 hours and realize that nothing will stop her and she will do well in all she puts her mind to. That's some powerful stuff. 'Go, Sis, GO!'--maddog (Source: MaddogMedic)

Observation shift: 2 - expect the unexpected

Nee Naw — Sat, 10 May 2008 15:24:00 +0100

The second call was to the canteen of the local police station, for a member of staff choking on a fishbone. Great, I thought, a rare opportunity to watch a police officer get punched in the back without anyone getting in trouble! (I jest, of course I love the police. I couldn’t do their job, dealing with breaking bad news and horrible criminals all day long. It would drive me mad.) Anyway, I was disappointed when we arrived because the patient, Alan, a) wasn’t a police officer, he was a handyman doing some work at the police station b) was standing up chatting to some other members of staff and it wasn’t entirely clear which one we were supposed to be attending to. It turned out that Alan wasn’t so much choking on the fish bone but had swallowed it and could now feel it in his throat. The “waste of time and taxpayers’ money” buzzer in my head started to sound. Still, Steve and his crewmate were very professional and took Alan back to the ambulance for a full set of obs. Steve stuck something resembling a spatula and a torch down Alan’s throat and tried, without any success, to locate the offending fishbone. He explained that he couldn’t see anything, but if Alan wanted, we could pop him up to the hospital for an x-ray. “Do you think this needs a blue call?” joked Steve’s crewmate. And I laughed my head off. Then Steve took Alan’s temperature, and his blood pressure, and his oxygen saturation levels. And his pulse. And raised one eyebrow. “I think there’s something wrong with this machine,” he muttered, using his fingers to take the pulse at Alan’s wrist instead. In highly technical terms, a normal pulse is between 60-80 beats a minute and goes like this: be-dump, be-dump, be-dump. Alan’s pulse was 44 beats a minute and went like this: bump, bump, be-dump-bump, bump, bump, be-dump, be-dump, bump, bump. As Steve put it, it was almost regularly irregular. It was not at all the sort of pulse you’d expect from a otherwise healthy 40 year old with a fishbone stuck in his throat. “Alan,” said Steve. “Have you ever had your heart tested?” “No?” said Alan, a bit confused. What had this got to do with fishbones? “Well, you’re about to,” said Steve, firing up the 12-lead ECG (a machine which records heart rhythms). Minutes later, we had a print out. A normal ECG looks something like this. Alan’s printout looked something like this (or at least it did to the untrained eye). I understood the writing on the printout, though - the ECG machine’s option was that there was ST elevation and therefore Alan was having a heart attack. Steve, his crewmate and I all looked goggle-eyed at the print out, then set about asking Alan if he had any other symptoms at all, in particular chest pain. Alan told us that he’d had chest pain on and off for the last two years, but at this moment felt absolutely fine. Except for the fishbone in his throat. He was looking at us like we were a bit mad. “Do you think this needs a blue call?” said Steve’s crewmate again, and of course, this time he was serious. “It could be a silent MI,” (MI = heart attack. Silent MI = heart attack without the normal symptoms of chest pain etc.) muttered Steve. “But he’s got no symptoms at all… and he’s only 40… and he’s had chest pain for two years… my guess would be that he’s got an ongoing cardiac condition which has been undiagnosed. Let’s take him to the nearest and get a doctor to have a look at the ECG, and if they suspect an MI, we can always take him on to the hospital with the cardiac unit.” So with that decided, we explained to Alan what was going on and wasted no time in getting him to the nearest A+E and summoning a doctor to look at the ECG. She agreed that Alan almost certainly wasn’t having a heart attack and this was an ongoing problem, but nonetheless he was wheeled into Majors to be seen immediately. “What about the fishbone?” whimpered Alan as we bade him farewell. “I can still feel it, you know.” And the moral of this story is that you should always take a full set of obs, however rubbish you think the call is. (Source: Nee Naw)

My wiki holiday

Random Acts Of Reality — Thu, 08 May 2008 22:41:00 +0100

OK. Time for something stupid... I have a holiday due in a few weeks, from the 16th to the 29th of June. No work for two glorious weeks. This makes me happy. The idea is that I get to travel around the UK visiting places that I've never seen. But how do I avoid just going to places that are hiding in the recesses of my mind? I get you folks to write my itinerary. I've set up a wiki (an website that anyone can edit), and I'll leave it up to you folks to edit in some interesting places to go and/or people to meet. So please, go to this website, and write down some interesting places for me to go. I believe that this is the first time someone has done something like this. Consider it an open-source, public domain, user-generated holiday. Or an experiment in being really silly. (Source: Random Acts Of Reality)

Observation shift: 1 - broken hip

Nee Naw — Thu, 08 May 2008 07:58:10 +0100

A few weeks ago, I went on an observation shift with Steve and his crewmate. We had a touch of Observer’s Curse - only four jobs over the whole shift, about half what I’d expect for a busy station like theirs - but all the calls were interesting in their own way and I’d rather see four “real” calls than eight cases of flu! There was also a rather amusing incident when we took our rest break at another ambulance station, and all the crews at that station, not knowing who I was or even that I wasn’t just another paramedic/EMT, decided to launch into a diatribe about how much they hate control staff, how evil we all are and how all we care about is screwing them over and giving them rest breaks. I covered my “Emergency Medical Dispatcher” epaulettes and sank into my seat. I now know how it feels to be a mouse in a room full of cats. All I can say is that if the offending crews were on my sector, I’d have them attending every projectile vomiting call I could get my hands on for the next week!! Anyway, on with the four calls. I don’t have time to write about them all at once so each will get a separate entry. Just to keep you on tenterhooks, the last one is the most exciting! The first call of the day was to an elderly female on the floor. In Control terms, this is about as simple as you can get - it is non life threatening, so you do not have to bust a gut getting someone there, but it is also a valid call, so as soon as someone is available, off they go. But I was about to discover that something simple for us is not so simple for an ambulance crew. Elaine, aged 80, has lived alone her house since the death of her husband. Her younger friend, Sandra, comes to visit every day and helps out with the shopping. She also has meals on wheels and a home help. Despite having arthritis, bilateral knee replacements, heart trouble, mild confusion and depression, she gets by. On this bitterly cold morning, she was getting out her electric fire and, carrying it to her bedside, slipped over. She felt awkwardly against the bed and an agonising pain shot through her right leg. Luckily, Elaine had fallen by the phone so she was quick to summon help. Not wanting to bother the emergency services so early in the morning, she rang Sandra. Sandra had come straight round but after a quick examination she had realised Elaine had hurt herself badly in the fall and that an ambulance was needed. Enter us. Elaine was in good spirits and not a lot of pain when we arrived. Her sense of humour was intact, laughing at herself for falling, and she was very apologetic about calling us out. The genuine callers always are. I wondered if it was going to be an “assist only” job, where the crew lift the patient, put her back to bed and make her a cup of tea. However, as Steve straightened Elaine’s legs, I could see clearly that one was shorter than the other and drooping to one side - a clear indicator of a broken hip. Seeing the concern on our faces, Elaine became worried. “What is it? What have I done?” “I’m afraid,” said Steve, “you’ve broken your hip”. “Oh!” said Elaine, relief coursing across her face. “Is that all?” I wondered what she thought we were going to say. Now came the difficult and unpleasant part. With the aid of some Entenox (pain relieving gas), we tried to assist Elaine into the carry chair so we could get her downstairs and into the ambulance. But the slightest movement had her in complete agony. The gas seemed to be making her confused, too, and she forgot what had happened to her and kept yelling out: “What’s happened to me? What could be causing all this pain? I have never felt this uncomfortable in MY ENTIRE LIFE!” She was shaking and turning terribly white. It wasn’t pleasant to watch. As control staff, you are generally distanced to people’s pain. You get all the emotional upset and lurid descriptions of gory events, but the physical pain is something you don’t think about. You tend to think - broken hip - non life threatening - simple without really getting your head around what it is like to have one. Elaine’s agony is something I will remember every time I have a “broken hip” call waiting on my screen. Once we stopped trying to move Elaine, her pain subsided somewhat and she returned to the cheery old lady we’d first encountered and apologised profusely for “being a big baby”. Meanwhile, Steve’s crewmate, who is a paramedic, decided Entenox alone was not enough to get Elaine out of here. It was time to bring in the big guns. He fired up a vial of morphine and injected it into Elaine. Then we sat around a bit and waited for it to work. Sandra conducted some breathing exercises whilst I helped pack up Elaine’s belongings. Eventually, Elaine started going a bit woozy and getting a big grin on her face and we were able to lift her into the carry chair. There was a lot of hollering as we moved her, but this was immediately followed by relief from everyone as we all announced “Well, that’s the worst bit done! Off to the hospital!” It’d taken over an hour to get her into the ambulance. By now, Elaine was away with the fairies. Steve tried to get her to give a score to her pain. Earlier, she’d given it nine out of ten. “Oh,” she said, flapping her arms dismissively. “Hardly anything!” “I need a number,” said Steve. “Erm, I really don’t know,” said Elaine. “I can’t remember any numbers!” “Elaine,” smiled Steve. “I’m not taking you anywhere until you give me a number!” “Um….. sixteen!!!” announced Elaine, and broke into fits of giggles. Steve gave up at this point and we went off to the hospital. I am sure Elaine will be fine although it is clear her bones aren’t what they used to be and perhaps she will have to give up living in a two-storey house by herself. It is sad that such a lovely person who is so cheerful and friendly and has clearly lived such a full and rich life has ended up being let down by her own body and even sadder to think that whatever I achieve with my life more or less the same will happen to me. I shall never look at “old woman on the floor” as just a simple, boring call again. (Source: Nee Naw)

Inappropriate

Random Acts Of Reality — Wed, 07 May 2008 16:58:35 +0100

After the last post Cookie left a comment asking if I still wanted to leave my job... We were sent on blue lights and sirens to a young woman who had 'collapsed'. We arrived and found her writhing around on the floor. She wasn't too happy to talk to us, instead she kept pretending to be unconscious. It transpired that she was having period pain. My crewmate (who is female) asked her if she had taken any painkillers for it, after some grunting, groaning and flailing around she was told that, no, the patient hadn't taken any painkillers. "Do you have painkillers?", asked my crewmate. "Yes", said the patient and named a rather good painkiller. "Why haven't you taken them then?" The patient then pretended to be unconscious. We asked a couple of times, at no point did she answer. Instead she kept 'passing out' in a way that wouldn't win her any Oscars. So we popped her in the carry-chair (because otherwise she would be throwing herself about) and popped her to the hospital. She was given two Paracetamol tablets and sat out in the waiting room. By London Ambulance Service numbers, 8 out of 10 of our jobs are like this, not needing an ambulance or hospital treatment. I think I get more than my fair share. I find myself going to people younger than me, often healthier than me and yet having to carry them downstairs because their 'flu' makes them unable to walk. I'm glad I don't have 'proper' jobs all the time, I also like it when my patient can walk on and off my ambulance at both ends of the journey. What does happen is that these 'inappropriate' calls* eventually grind you down, the endless parade of people who don't need any of the skills I have except the ability for me to write down what they say and drive them to hospital. I knew it would be like this before I joined the job. It's not the main reason why I want to change jobs, not by a long chalk, I'd say it's around reason #17. But the jobs that make me want to stay, the serious jobs where I can make a difference, are few and far between. *Of course there are, according to people on much higher payscales than me, no 'inappropriate callers', only 'inappropriate responses'. Which is why we spend so much money on dealing with people who don't need hospital treatment but can't be bothered to see their GP or local walk in centre. At times it seems to be our main focus as an ambulance service. (Source: Random Acts Of Reality)

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Official nee naw reopening

Nee Naw — Wed, 07 May 2008 08:54:04 +0100

Right folks, this blog is back in business! And what better way to get things started but with my favourite topic, a rant about care homes? The call went something like this: Me: “Nee Naw Service, what is the address of the emergency?” Care home worker gives an address which is not the address the phone is registered to. This is not unusual for care homes as they sometimes go via a switchboard. But I can’t get a match for the address she gives me. Computer says no. Computer says address does not exist. I try to get her to spell it, but she just keeps repeating the address. Then she gasps, and says “No, actually, it’s…” and gives me the address the phone is registered to which has been sitting in front of me all along. Great. Several minutes wasted. Me: “What’s the problem?” Care home worker: “She’s dying!” I type “dying” into the computer and a similar uphill struggle ensues whilst I try to get this woman to explain what she means by “dying”. Unfortunately, it seems like suddenly “dying” is the only word she knows and that if she repeats it to me over and over again, all will become clear. It doesn’t. After all, someone with terminal cancer is dying. Someone who has just had their jugular slit is dying. A lot of the patients who ring with stomach ache *think* they are dying. If you want to be philosophical about it, we are all dying! The ambulance is halfway there by the time I manage to establish that the patient has actually stopped breathing. Not so much dying as dead then. But not necessarily irreversibly dead, if this has just happened. I press on with getting CPR started. Me: Does anyone there know how to do CPR? Her: Yes Me: Have they started? Her: No Me: Are you right next to her now? Her: Yes Me: Right, get her flat on her back on the floor, remove any pillows and kneel next to her and look in her mouth for food or vomit. Her: (instantly) Okay. Me: Do that now. Her: (instantly) Okay. I can still hear her breathing at the other end of the phone so I know she hasn’t done it. We have to be very careful about calling the callers liars so I just press on with the next line - “Is there anything in the mouth?” thinking that she won’t be able to answer the question until she does it. Me: Is there anything in the mouth? Her: I don’t know. Me: Have you looked? Her: No. I am in the next room, I can’t see her. Me: (Thinks: But you said you were with her! And you just said you were doing the instructions, you great big liar! Do you think I am telling you to do these things for fun?) Okay, go and do it now. Come straight back to the phone and tell me what you find. Line goes silent. Caller goes away. Caller doesn’t come back. Five minutes pass. Two ambulances and a FRU approach scene, lights blaring. Caller still does not return to phone. The FRU is a minute away by the time she gets back. Her: “Cancel the ambulance! She’s fine! I put her on the floor and she complained and told me to get off her. I must have been mistaken! She was just asleep.” Strictly speaking, ambulance service procedure is that if the caller says “cancel the ambulance”, we cancel the ambulance. However, there are exceptions to this rule and I decided that this was definitely occasion to make one. I had absolutely no trust in this care home worker who didn’t know her own address, could not answer a simple question and who appeared to have great difficulty in telling whether her patients were alive or dead. I noted what had been said on the ticket (since really it is the dispatch desks who should be making decisions such as sending an ambulance even when the caller says one isn’t needed) but finished the ticket as a complete call, rather than one which had been cancelled midway. Dispatch evidently agreed with me, and none of the ambulances were cancelled. I kept an eye on the ticket, and nearly an hour later, one of the ambulances was off to hospital with the patient on board. Next, what should appear on the ticket, but blue call details! That means that the patient is in a very serious life threatening condition. The crew had established that she had actually had a seizure of unknown cause and now had a very rapid pulse, very low blood pressure and a GCS of 11 (ie. semi conscious). (Medical types - any idea what was wrong? All the other obs were normal and there was no mention of an ECG). So, in summary, due to this “care” home’s incompetence, there was a delay of minutes reaching this critically ill lady, CPR was almost performed on her whilst she was still alive (which would have given her broken ribs to add to her problems) and she was almost denied medical aid at all because the care home went from thinking she was dead to thinking nothing was wrong in the space of five minutes! And this is why no member of my family will end up in a care home, even if I have to move in and look after them myself. I appreciate there are a lot of care homes that aren’t like this, and plenty of care home workers who are caring and skilled, but incidents like this are far too common for me to ever take the risk. (Source: Nee Naw)

Squeeze

Random Acts Of Reality — Mon, 05 May 2008 19:42:24 +0100

Squeeze I'm covered in the urine from the five year old child. Squeeze We get the call as a child having a fit. Squeeze There is a solo responder there, he's giving oxygen to the child while it lies on the floor. Squeeze I look at the child's eyes, he's still fitting, his body isn't moving but his eyes are darting around in an unnatural fashion. Squeeze His chest isn't moving in the the way it needs to in order to breathe. Squeeze I pick him up, covering myself in the urine and race downstairs. Squeeze I kick the door release button to the block of flats, my crewmate jokes about me being able to get my leg up that high. Squeeze I lay the child on the stretcher in the ambulance. My crewmate hands me the ambu-bag. Squeeze Fitting the mask over the child's mouth I start squeezing the bag, I'm now breathing for the child. Squeeze My crewmate jumps into the cab of the ambulance, she weaves through the traffic towards the hospital. Squeeze I sit calmly, I explain to the child's mother what I am doing. Squeeze I keep checking the child. Good pulses and an oxygen saturation level of 100%. It means the child is getting the oxygen it needs. Squeeze We reach the hospital. I scoop up the child and jog into the Resuscitation room. The nurses and doctors take over. Squeeze Someone else is squeezing the bag now. I stay and watch a while, the child stops fitting. Squeeze We head back to the ambulance station, I need a shower and a change of uniform. I have to shower with cold water as it appears the heater is broken. I sit on the station sofa, I can still feel the ambu-bag in my hand. I sit and look at the TV, my mind is empty. (Source: Random Acts Of Reality)

A new job title?

Random Acts Of Reality — Thu, 01 May 2008 02:15:51 +0100

I should have a new title added after my name. 'Professional waker-upper'. Two calls in the space of one shift to people who are sleeping in a public place. One person fell asleep in a magistrate's court, waiting for his friend to be finished in one of the courts. His friend must have been so excited not to receive a custodial sentence that he left his friend behind. Smelling slightly of alcohol he'd bedded himself down and fell asleep. We were called by one of the security officers, no-one seemed too happy to shake him awake. One application of slight pain from the nice ambulance man and the patient woke up, thanked me n his own language and walked off home. The second patient was asleep on a bus, he'd had a bit more to drink and needed a bit more... ahem... stimulation to wake up. No thanks from this patient, but at least he didn't make good his threat to punch me. And we didn't need to call the police on him either. A good result all round really. It's strange that some people seem to think that you need an ambulance in order to wake someone up. I've even been called to nursing homes when one of their patients has been asleep at 3am in the morning. In fact the whole shift was like that, fourteen jobs in twelve hours with only five of them travelling to hospital. Ho-hum. Easy money I suppose. (Source: Random Acts Of Reality)

I feel so relieved

A Day In the Life of An Ambulance Driver — Wed, 30 Apr 2008 18:03:00 +0100

For the past eight years, I have held a terrible secret, one that has caused me no small amount of sleepless nights. On at least two occasions during that time, I've had the opportunity to level with the authorities, and neither time did I avail myself of the opportunity to cleanse my soul of its terrible burden.But now, as of this morning, I no longer feel like a hunted man. It feels as if a weight has been lifted from my shoulders. The monkey is off my back.That is, if the monkey weighed fifty-five pounds.You see, as of this morning, for the first time in eight years my actual weight has matched the number printed on my driver's license.Just makes me want to prance naked through the DMV calling neener neener neener...In other news, it looks as if I may soon be leaving my comfy, well-lit ER here at PGHNSTRACH and going back to work on the bolance. If that happens, I'll post a couple of before and after weight-loss pics. I'll wait until the day before I start work at the Big Green Army, so at least my beloved goatee will be memorialized before the powers-that-be force me to shave it back to a simple porn star moustache.*Sob* (Source: A Day In the Life of An Ambulance Driver)

Every time i try to get out, they drag me back in

Random Acts Of Reality — Tue, 29 Apr 2008 08:40:38 +0100

This blog has been many things over the years, it's been a place to rant, a place to explain what us ambulance people do, a place to celebrate what we do well, a place to defend the service from inaccurate news reports and a place to criticise some of the planning that occurs. The benefits of this blog are many and varied, I've met people I never would have otherwise, done things that I'd never have imagined and made some very good friends. Doors have been opened to me. I enjoy writing this blog. I like having a place where I can write and people listen to me - I know that sounds egotistical but I'm not alone in liking an audience. Sometimes it's hard to motivate myself when I'm coming off a twelve hour shift, but other times I can't sleep because of something I need to write. Why am I telling you this? I've been sitting on an application form for the position of Press Officer for the LAS for the past week or two. The reasons for even having this form are many and varied and will be a subject for a future blogpost. I'm not qualified for the post, even though I think I would bring a breath of fresh air into the role. The chances of me even getting an interview are tiny, if not non-existant. But it was only this morning that I realised that I can't go for the post. It's all to do with credibility. Would you trust me, dear blog reader, if you knew I was now part of a PR machine? Would I still be able to rail against some of the inadequacies of the NHS, the Government or the LAS if I were further on the 'inside'? Would such a job role completely neuter this blog? I think that it would, so the application form (no shift work, less heavy lifting, more money, just as much fun) has gone into the bin. It's a damn shame, but this blog has come to mean so much to me over the years that doing something like this would make me feel like I've 'sold out'. It would have been nice to have a kettle always within reach though… (Source: Random Acts Of Reality)

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Further to a previous post

Random Acts Of Reality — Tue, 29 Apr 2008 08:28:36 +0100

Ambulance Nut works for the Trust mentioned in the last post and has a few important things to say, things not reported by the news story that I linked to. It's important to see how media reports differ from reality. (Thanks go to Ambulance Nut for drawing my attention to this). (Source: Random Acts Of Reality)

Me elsewhere

Random Acts Of Reality — Mon, 28 Apr 2008 15:03:00 +0100

For those that are interested, I was invited onto the Radio 5 Live show to talk about this very sad story. The BBC are lovely so I had a cab to a studio in London, while the presenter sat up in Manchester. Stephen Nolan the presenter obviously plays the devils advocate while I play the voice of reason. As is normal with talk radio there are some… interesting viewpoints, although I'm quite sad that no-one surpassed the first caller in comparing me to the Nazis. You can listen to it again here, my segment starts 1:08:50 into the stream. I don't think it will be up for too much longer. I am grateful to the ambulance and police workers who phoned in to support me - It just goes to show that I'm not mad, or at least I share my madness with other people. (Source: Random Acts Of Reality)

My first letter of thanks

Random Acts Of Reality — Mon, 28 Apr 2008 12:15:00 +0100

I had my first letter of thanks yesterday, the first one I have ever had. It was a lovely simple job, one of those jobs that you tend to do a lot of. The call was to an elderly woman who had maybe collapsed. The problem that faced us was that she had collapsed behind her front door and no-one was able to gain entry. We never really know what to expect from this sort of job, sometimes the person is fine, they've just fallen over. Sometimes the person is seriously ill and this is the reason behind the collapse. Occasionally the person will have died in the night. The, also elderly, sister had gone to our patient's house and was unable to raise her. She'd then gone to the police station and they had contacted us. We arrived to find the police already there, they were waiting for the officers who had the battering ram as there was no other way to get into the flat. An officer had just brought the sister of our patient with him back to the house. So the door splintered inwards and the police officers entered the flat. We follow them in and listen to see who finds her first. Thankfully she is alive and lying on the bedroom floor. She's a stick of a thing and well into her late eighties. We quickly check her over to make sure that she doesn't have any injuries, then pick her up and lay her in bed. What then follows is little more than a more extensive examination of her and a bit of the old 'chat'. We talk to her and her sister while checking her blood pressure and the like about such diverse subjects as dead husbands and playing 'knock down ginger', about how out patient hates doctor yet how kind her GP is. It's nothing unusual, it's nothing that we don't do for all our patients in order to put them at ease. We arrange the GP to come and visit her and leave. But somehow a card of thanks makes it's way to us, the sister walked up to the hospital and asked the ambulance crews parked outside to make sure that we got it. So I return to work, look in my letter tray and find the card. It's a simple little thing, it just says 'thank you', but it means a lot to me. (Source: Random Acts Of Reality)

The 123 book meme

A Day In the Life of An Ambulance Driver — Sun, 27 Apr 2008 17:18:00 +0100

Tagged by Expert Witness, and as it seems, I'm the last person in the blogosphere tagged with this one, so I won't tag anyone else.The rules of the meme go:1. Find the nearest book of 123 pages or more. No cheating!2. Turn to page 123.3. Find the first five sentences.4. Post the next three sentences.5. Tag five other bloggers.Okay, the nearest book to hand was enthusiastically endorsed by LawDog, and loaned to me from his personal library.*It's a bit hard to read, what with all the dog-eared pages, notes scribbled in the margins, and passages of text highlighted in pink, but here goes......damn. Pages 118-123 are stuck together. Page 124 is an illustration that looks like Robert Mapplethorpe has found a career illustrating children's books. Page 125 is......eureka! Okay, the first five sentences are partially obliterated by some sort of stain, but sentences 6-8 read:"But Grandma, what great, big teeth you have!" breathed Little Red Riding hood, her ample breasts straining against the thin fabric of her bodice."All the better to eat you with, my dear!" snarled the Big Bad Wolf lasciviously, as he leapt from the bed, ripped off Grandma's kerchief and gown and stood there naked, proud and erect."Oooh Wolfie," chuckled Little Red Riding Hood throatily, "I do love it when you talk dirty. But do be a dear and put the gown and kerchief back on, and never break character again, mmmkay?"The title is MILF Goose's Adult Fairy Tales, and the cover is illustrated with a goose wearing a leather corset, spanking a woodsman who looks vaguely like Fabio. Odd, but I don't remember the fairy tales from my childhood quite this way. But I intend to keep reading to look for further discrepancies, and when I'm done, I'll fire off a strongly worded letter to Naughty Bitch Press. *Not really, but I just couldn't resist the dig at LawDog. In reality the closest book to hand is Special Ops, by W.E.B Griffin. The applicable sentences on page 123 are:"Yes, Sir," Sergeant Thomas said."Put your heart in it, Sergeant," Lunsford said. "We don't want to keepLieutenant Portet waiting around, do we?""No, Sir," Sergeant Thomas said, visibly fuming.Personally, I liked the first version better. ;) (Source: A Day In the Life of An Ambulance Driver)

Groovy, baby! yeah!

A Day In the Life of An Ambulance Driver — Fri, 25 Apr 2008 21:12:31 +0100

I scored a Far Out90% on theQuiz by SheGoddess:Probably because I grew up listening to my brother's music. It was a steady diet of 70s rock bands. Hell, the first song my own daughter ever sang was Drift Away. (Source: A Day In the Life of An Ambulance Driver)

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If pounds were playing cards...

A Day In the Life of An Ambulance Driver — Fri, 25 Apr 2008 19:17:00 +0100

...I'd be down a full deck right now. Fifty-two pounds lost since February 4th.My friends have always described me as being a couple cards shy of a full deck. How little they knew... (Source: A Day In the Life of An Ambulance Driver)

Keeping the worry off my face.

Random Acts Of Reality — Thu, 24 Apr 2008 10:36:59 +0100

His wife lets us in, it's one of those houses that are so clean I feel bad about traipsing my boots all over the carpet. Our patient is a man in his eighties sitting in a chair. He's spotlessly clean, wearing a shirt and a tie, hair brushed back. He looks like a ghost, the blood has drained out of his face. As I enter he looks up at me and smiles. We had been called from pretty much around the corner, the wife has already thanked us for getting there so quickly. She's called us because, as she describes it her husband had a fit. He's normally fairly healthy, a bit of a cardiac history but no epilepsy or diabetes, nothing that would suggest a seizure. I bend down to his eye level and start talking to him, my hand snakes out and automatically takes his wrist. I feel for a pulse. Bom………Bom………Bom……… His heart is beating around 25 times a minute. It should be sixty or more. It's no wonder he looks so ill. I give my crewmate the look. The look that says, "Uh-oh, something's wrong here, we need to speed it up a gear". I tell her, "Let's get the gentleman in the back of the ambulance eh?" She understands and jogs out for the carry chair, we don't normally move faster than a stroll. Given the type of call it was given as we've brought loads of equipment into the house with us, we can't always carry the chair in as well. "I feel sick", says the man and his face drains of even more colour, something I didn't think was possible. He vomits, his eyes roll back in his head. Warm brown liquid flows over his tie, down his shirt and onto his lap. I look at this and scrabble to find that pulse again. I'm just about to grab his ankles, pull him off the chair and start CPR when he opens his eyes. "I feel a little better now", he says. His wife tries to help me remove his tie, but I'm the one with the gloves on so I tidy him and wipe him down a little while I wait for my crewmate to return. It's only been seconds but it felt much longer than that. After being sick his pulse had come up a bit but it soon starts to drop again. We bundle him into the chair and rush him out to the ambulance. We are only three minutes from the hospital and normally we wouldn't 'stay and play', but there are medicines that we can give to speed up his heart, fluids we can give to bring up his blood pressure and an ECG to do to see if the cause for this sudden slow pulse is due to a heart attack. If it's a heart attack we'll be bypassing the hospital three minutes away for the angioplasty centre, which depending on the traffic, is at least twelve minutes away. The ECG show a complete heart block not a heart attack, something I'm extremely grateful for. I often joke with patients that they should only worry if I look worried. In this case I'm trying to keep the worry off my face. "Let's get a line in him and give him some atropine", I say to my crewmate - then make a mental note to apologise to her later, she's the paramedic she knows her job. It's just that when things start to get serious I can get a little… directive. I think it's because I tend to think aloud and because I used to be a nurse - a rather bossy nurse sometimes. Despite the medicines his pulse remains the same but at least his blood pressure is coming up with the fluids and with him being laid down. We blue-light him into the hospital. Three minutes later he is on the hospital bed being looked after by two nurses and a doctor. His wife is in the relatives room, the resus room is full and another call is coming in (another patient with much the same problem as ours), so the staff can't take the time to talk to her. I fall back into my nursing mode. I sit with her and hold her hand, she thanks me again and I apologise that the hospital staff haven't spoken with her yet. I explain that they are very busy and she tells me not to worry. I explain to her what the doctors are doing and that the likely outcome is good now her husband is in hospital. Meanwhile in the ambulance the timer is ticking up, someone in Control is watching this and will be wondering why we are spending so much time at the hospital. I don't even give it a thought. I pop my head back into the resus room, the doctors are happy that our patient is stable - he's looking a lot better although his pulse is still a little low. I let the wife know. She thanks us again. We clean the ambulance and get ready for our next call. A little later one of my colleagues takes our patient to another hospital to have a pacemaker fitted, I hope it's all going to go to plan and that there is a happy outcome. (Source: Random Acts Of Reality)

A press release

Random Acts Of Reality — Tue, 22 Apr 2008 06:55:00 +0100

London Ambulance Service celebrates best year, but urges public to ‘use us wisely’ SERIOUSLY ill and injured patients in the capital are getting a quicker response from ambulance staff than ever before, but those who do not really need emergency help are once again being urged to use the 999 system wisely. The 2007/08 year was the best in the London Ambulance Service’s history, despite a further rise in demand which took the number of emergency calls received up to nearly 1.4 million. A total of more than 943,000 incidents were responded to, an increase of more than three per cent on 2006/07, and included 315,700 Category A calls (assessed from information received as being serious or immediately life-threatening). Of these, 79 per cent were reached within eight minutes, which represented the Service’s best ever performance against the Government’s national target of 75 per cent and was helped by improvements in the time taken to answer calls in the control room. The news caps a very successful year for the capital’s ambulance staff. The Service was named the highest-rated in the country by the Healthcare Commission in October and the survival rate of people suffering out-of-hospital cardiac arrests in London has more than trebled in the last five years. The improved speed in responding to patients was made all the more notable by the fact that November and December 2007 were the busiest months in the Service’s history, and that demand has also remained comparatively high since then. Now, in an effort to remind the public of the other healthcare options available before calling 999, the Service has produced a newspaper advert to appear in a range of publications across the capital. Chief Executive Peter Bradley CBE said: “Staff from every department in the organisation have played their part in what has been our most successful year ever, and we can be confident that the high-quality care and treatment we are providing to our patients is continuing to improve all the time. “Londoners can also help us to help them by using us wisely and only calling us in an emergency, so that we can really focus on those people who genuinely need our help.” The way in which ambulance response times across the country are measured changed at the beginning of this month, meaning that the ‘clock’ now starts as soon as a call is connected to the control room, rather than after key information has been obtained from the caller. This new system – along with continued high numbers of calls from patients who do not really require emergency medical help – means that the Service will face a very challenging 12 months ahead. Peter added: “The new way of measuring our response times is very good news for patients as it will require us to respond even more quickly to calls, and this should help save even more lives. “What it does mean, though, is that more than ever we are urging those people who are not seriously ill or injured to consider other ways of getting help before dialling 999. This can include looking after themselves at home, calling NHS Direct on 0845 4647, or even making their own way to hospital, as arriving in an ambulance does not mean that they will be seen more quickly.” The Service is now in the second year of an improvement programme running up to 2013 and which aims to move right away from a one-size fits all way of responding to patients. Peter said: “We are planning to increase both our number of frontline staff and vehicles over the next year, and are looking to ensure that we can provide the most appropriate care for our each and every patient – whether that means caring for them in their own home, taking them to hospital or an urgent care centre, or to a specialist centre best placed to treat them for their particular condition.” • In 2006/07, the Service reached 75 per cent of Category A calls within eight minutes • Until the beginning of April this year, the clock started after the caller’s telephone number and the patient’s location and nature of their illness or injury had been established (Source: Random Acts Of Reality)

Child not breathing

Random Acts Of Reality — Tue, 22 Apr 2008 06:47:00 +0100

I've just had two weeks off work, two glorious weeks where I could maintain a reasonable body clock, could sleep and could be normal for a change. The constant nausea that has crept up on me vanished and tension drained from my shoulders. Then on my first shift back at work I suddenly get insomnia and that familiar nausea returns. I'm making an effort to eat some decent food and to get some good rest. Perhaps I may even have an attempt at exercise. We were called to a ten year old who'd fallen down some stairs, nothing serious and on further discussion, the sort of thing my crewmate and I used to do for fun. Would we take the happy, healthy and fundamentally unhurt child to hospital? Well yes, you see the mother was conviced that the child stopped breathing for three minutes. Apparently the child was fully awake and looking at her mother during this 'respiratory arrest'. It's one of those weird things, that parents will often state that their child stopped breathing - now, given my medical training, I find this hard to believe. But the trick is never to mock the parent, they were there and witnessed the accident, so we take the child into hospital and let them sort it out. While I'm sure that it's the parent panicking, no-one ever lost their ambulance job by taking someone to hospital. And besides, the family were nice, so it wasn't a hardship to keep them happy. (Source: Random Acts Of Reality)

Bonnie ames and scott millar...

A Day In the Life of An Ambulance Driver — Mon, 21 Apr 2008 05:37:00 +0100

...are EMTs involved in a serious ambulance accident in West Nyack, NY on April 14th. They need help.I don't know them. I only heard of their accident through an EMS news feed.I also know that just recently I asked you to donate what you could to the family of another rescuer killed in the line of duty. And here I am asking again.One of their co-workers reads this blog, and asked me to get the word out.I also know that I've let many of my regular readers down a bit over the past couple of weeks. Pain, fatigue, work stress and plain old lack of inspiration have conspired to limit my posting here over the past couple of weeks. In the past month, I've lost a girlfriend, begun to rediscover her as a best friend, and had a few job plans fall through. It's been a bit tough to focus on writing.But if you could bear with me for a bit longer, and in the meantime click on the link and donate what you can to help these EMTs and their families through the long and expensive road ahead, I'll get back to posting something worthwhile here very soon.Please. It's important to me. (Source: A Day In the Life of An Ambulance Driver)

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Dear americans

Random Acts Of Reality — Sun, 20 Apr 2008 21:52:00 +0100

You may be interested to know that you can now get my book in the colonies without having to pay huge amounts of postage and packaging. My publishers over there are Andrews McMeel Publishing who I like a lot even if they won't pay for me to fly out and publicise it. It should also be available in shops, so feel free to ask them to order them for you. While you are there ask them to order a few extra to put on the shelves. It is also freely available under a Creative Commons License at Archive.orgThis lets you remix the book in any way you can think of as long as you don't charge for it and as long as you credit me. So please, go and buy it so that I might retire to a beach somewhere to drink fruit based cocktails until I go mad with boredom. Also to give these lovely publishers some profits as well. (Source: Random Acts Of Reality)

Sunny day

MaddogMedic — Sat, 19 Apr 2008 04:00:00 +0100

It's the first beautiful day of Spring. temperatures creeping into the 80s. Lovely. Around 11 am, he puts his favorite lawn chair in a sunny spot, grabs a cup of coffee and has a seat in the sun. He's 93 years old. It's a beautiful day. Nine and a half hours later, we find him. Still sitting in the char, still holding his (now empty) coffee cup. From a distance, it looks like he just rested his chin on his chest and went to sleep. Up close, I see the signs. For him, I think this beautiful day never ended. For us on the engine and ambulance crews, we smile quietly and look inward. Passing is sad but, somehow, this one seems to fit. Not a bad way to go. -maddog (Source: MaddogMedic)

Knock three times

Random Acts Of Reality — Thu, 17 Apr 2008 08:22:47 +0100

The boiler in my place is knackered, so I'm typing this wrapped up and hoping that the laptop heat will warm my legs. Once I get going it'll be fine (for I am completely cleaning and rejigging my flat). Any typos are due to me not being able to feel my fingers. On our data terminals we have a 'special information' section, often this causes more problems than it solves. "Elderly woman, unwell, called by relative not on scene, ring three times so she thinks it's her relative calling or she won't open the door". What? Now, we don't have extended contact with patients, but what we do is try to form some sort of relationship with them. Sometimes I take on a parent role while the patient is the child, sometimes it's a partnership and sometimes I'm the child and the patient is the parent. It all depends on what works with the patient. It's one of the skills that we ambulance people develop - to quickly determine the best way to approach the patient.* What we don't do is start off with a deceit. It's never going to go well if the first contact that you have with the patient is to trick them. Things tend to go downhill from there. We were cancelled for a higher priority call (probably a twenty year old with the sniffles, so it goes) but I wondered what I would have done had I arrived on scene only to be greeted by a closed street door. The options are simple assuming that the relative isn't nearby. Knock normally and hope that the patient opens the door. It's unlikely that she would. Then shout through the letterbox that we are an ambulance who've been called by her relative. Lots of elderly people try to avoid going to hospital (they aren't daft - people die in hospital), so that wouldn't guarantee success. Knock three times. The patient then opens the door expecting to see her relative and instead there is a 6'1" tall stranger in green asking if her can remove her from the house. I can't see anything possibly going wrong with that. Knock normally, give up and wait for the relative to make their own way down to the house. This may take some time depending on how far away the relative is. Knock normally and when she doesn't answer get the police to kick down her door. Hmmm I suspect (quite rightly) that the police might refuse to do this. Be grateful I'm cancelled off the job and am on my way to do something far less stressful. My job is simple - most folks could do it with the right bit of training - but it can get very complicated over the strangest detail. *I used to know all the special names for this sort of thing, and much, much more. Now it's so soaked into the very fibre of my being and I've forgotten the 'proper' terminology because I use it unconsciously. I'll leave it to the experts to use the long and impressive words. (Source: Random Acts Of Reality)

Leaving on a jet plane...

A Day In the Life of An Ambulance Driver — Thu, 17 Apr 2008 03:15:00 +0100

...headed to Myrtle Beach for the South Carolina Emergency Care Symposium in the morning, due to return on the 19th.I know I've been light on the real posts lately, but I'll try to put something meaningful up here and on Star of Life in the next couple of days.God knows I'll have plenty of time between a gazillion plane changes and layovers. (Source: A Day In the Life of An Ambulance Driver)

My views on comments

Random Acts Of Reality — Wed, 16 Apr 2008 08:22:33 +0100

Only a quick post today as I'm in an extremely busy part of my life at the moment. Reading the comments on my last post reminded me that I haven't really commented on comments. Here is a rough FAQ. I like reading comments, it lets me know that people are reading this site as I don't pay much attention to site statistics any more. I value almost every single comment. All comments, no matter how far back into the archives they stretch get emailed to me. I read every single one. I delete all spam, just as a matter of principle. I don't delete comments with three exceptions - If the person who wrote the comment emails me and asks me, if it breaches patient confidentiality, or if they are nothing but abuse. Feel free to disagree with me in the comments, I like having to change my mind about something I've written or having to defend myself. It gets what tiny spark of academia I still have burning again. Just try to be polite and if you can bring evidence to the discussion I'll thank you for teaching me something. (See my post on Home births for example). I may completely disagree with you, but we can still be civil. So far I am so incredibly happy and proud that almost every comment thread has been reasoned and calm, even when discussing quite controversial subjects. If you write utter twoddle then other commenters will stamp on you. I tend to ignore the trolls but others won't. The verbal beating you get will make me laugh. You cannot insult me in the comments, nor upset me, nor cause me harm. I spend my day job being verbally and physically abused. Words on a website do not bother me in the least. If I have a sleepless night it won't be because of something you've written. I have no dark secrets in my past that you can bring to light and embarrass me. If you are a fool I will laugh at you. I may use comments as inspiration for further posts. Sometimes far in the future. If comments get silly (like calling other commenters Nazis) I will shut that thread down. I try to answer direct questions, if I seem to have forgotten and it's important do feel free to send me an email - I'm awful at answering emails but I will get to it eventually. The timing depends on what shifts I'm working. Likewise if there is a good comment thread I'll get involved, but unfortunately I have little free time so please don't feel I'm ignoring you. I love comments, I really do. If you want to leave a comment you need to 'create a reader account'. This was put in place to stop the frankly astounding amount of spam I was getting (over 500 a day). If you have a long comment to make and a blog of your own, post a précis of it here and direct me to your own site - we can continue the conversation between the two blogs, just like the good old days of blogging. I like getting comments of all sorts, but this means I can send some linky-love your way. Keep commenting I really do love it. When I was promoting the book a lot of people asked me my favourite thing about blogging, and each time I answered, "my commenters". Really, each time I get even the slightest glimmer about packing in this blogging lark it's you folks that keep me going. Yes, pretty much most of that list can be boiled down to, "I like comments and read them all, but don't be an arse", but it sometimes needs stating. All comments gratefully received. UPDATE: And then I hit my Bloglines subscriptions ands see that Diamond Geezer has posted a much more entertaining view on the same subject. (Source: Random Acts Of Reality)

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Announcements for you emt types...

A Day In the Life of An Ambulance Driver — Tue, 15 Apr 2008 22:11:00 +0100

The National Association of EMTs is holding elections for Regional Board members. Voting can be done online, and closes at midnight EDT, April 27th.What's that, you say? You're not a member of NAEMT?Then today is a perfect time to join.What you may not know is, the recent bylaws changes allow for direct election of board members by the general membership. That allows you a direct say in electing the leadership of the biggest - and the only truly national - EMS advocacy group we have.Candidates from several regions have contacted me privately and asked for my endorsement. I won't go far as to use my blog for that, but I will point your attention to the two I know personally. Both of them are committed and forthright individuals who have the best interests of EMS at heart.Julie Scadden is seeking to represent Region III. Jules is a street medic at heart, and that's who she seeks to represent - the interests of the street medics, not the Ivory Tower professional committee members.Daniel Gerard seeks to represent Region IV. Daniel's a passionate advocate for EMS and a former president of the NAEMT Paramedic Society.Read their candidate statements here, and you can find a map of the NAEMT regions here.On another note, I also have a new column up at EMS1.com.Enjoy. (Source: A Day In the Life of An Ambulance Driver)

Good causes

A Day In the Life of An Ambulance Driver — Tue, 15 Apr 2008 16:44:00 +0100

Greater love hath no man than this, that a man lay down his life for his friends. John 15:13I know it's National Buy A Gun Day, but if you happen to have a bit left over from Uncle Sam's gracious repayment of the money he extorted from you in 2007, consider the following...The Louisiana EMS Memorial Bike Ride, our state's tribute to our fallen EMS professionals, has extended its registration deadline to April 18th. Go read about it. If you're from Louisiana, you can still sign up to ride. If riding isn't an option for you, you can volunteer, or ask the organizers about helping sponsor a rider.MonkeyGirl tells the tale on her blog of Joe Snow, a local Emergency Response Team member who died while trying to save two kids drowning in a rain-swollen creek.Joe left two sons of his own behind, two young boys who will be forever deprived of the love and guidance of the father, left with only the memory of him and the pride in knowing what kind of man he was.It's not enough.Joe's co-workers have held a benefit bass tournament for the past two years, with proceeds going to his two boys, Matthew and Michael.Swing by her blog and hit the donate button, would you? Only if it's a pittance, every little bit helps. (Source: A Day In the Life of An Ambulance Driver)

Let me introduce y'all to a rembrandt

A Day In the Life of An Ambulance Driver — Tue, 15 Apr 2008 05:43:00 +0100

After KatyBeth was born, and we came to realize that she'd have disabilities, learned all the twenty-five dollar words no parent should have to learn, we set about getting her the help she needed.We applied to all the various governmental programs that she was qualified for, and it didn't take us long to discover one thing: those programs aren't about minimizing a child's disabilities. They're about managing parental expectations so you can learn to deal with having a handicapped child.I can boil 'em all down to this: Sorry your kid's a turnip. Now buck up and learn to deal with it.A lot of wonderful therapists worked for these programs, and they were frustrated at every turn by unworkable standards and governmental controls. The Missus and I decided rather quickly that we'd find a private therapist for Katy, even if it broke us.Enter Melanie Massey.We'd long heard that she was the best physical therapist around, and she specialized in early childhood development, a niche all too hard to find.During KatyBeth's initial evaluation, Melanie bluntly asked us, "What are your goals and expectations?"We both answered, "Zero disabilities. That's our goal. Our expectations, we'll manage along the way. But if our daughter has limitations, we want them to be defined by God's plan and the limits of human capability, not because we were willing to settle."She smiled and said, "Good, because that's exactly what we shoot for around here."To be a good physical therapist, you have to have a healthy streak of sadism in you. You have to be able to find satisfaction in pushing people farther than they thought possible. That's how you push those limits, and redefine your expectations of what is possible.Well, Melanie and her staff were the most dedicated and gentle bunch of sadists God ever put on this Earth. They understood that therapy for children is far more than cleverly designed exercises and fancy machines. Their particular brand of magic is making even the most arduous of exercises fun.There's a short essay called Welcome to Holland that they give to parents of children with special health care needs. I've quoted it here before, but it bears repeating:I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this...... When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting. After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland." "Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy." But there's been a change in the flight plan. They've landed in Holland and there you must stay. The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place. So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met. It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandts. But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned." And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very very significant loss. But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.Those wonderful people in Holland that you'd never meet otherwise? Those Rembrandts?That's Melanie Massey.She gave us something more than just a child with greater strength and mobility. She gave us hope, and that's something that no insurance carrier can put a price on. If they could, I'd be paying the copayment for the rest of my life.Yet, despite all the hope and joy she restored to so many parents, she still had not been blessed with a child of her own, something we all wished for her.Well, I see that particular prayer has been answered.And that just makes my year. (Source: A Day In the Life of An Ambulance Driver)

Another job

Random Acts Of Reality — Mon, 14 Apr 2008 12:32:57 +0100

The sun is going down behind the horizon, thick clouds overhead. I can feel the first drops of rain. My knees, my back are screaming in pain, but I can't move, I have to hold my patient's head still. Blood runs from his head pooling beneath my boots mixing with the puddles from that afternoons rain. The blood is red but as twilight approaches it gets darker in colour before fading to a sticky black. Beneath my hands the patient twitches, I wonder if it is because he is cold and drunk or if it is because of a serious head injury. Not for the first time I wish for eyes that could peer into his skull to see the damage. Instead I stare at his face, his eyes closed only sometimes opening to my shouts of his name. We enlist the help of bystanders to help roll his body onto the stretcher. We bind him to it using straps that were designed for other equipment. We make do and mend. Finally he is in the ambulance, on the stretcher he holds his arms in a position that I hope means that his brain is largely undamaged. We head for the hospital, lights and sirens blazing, weaving through traffic. I keep looking at him, checking and rechecking to make sure that he hasn't taken a turn for the worse. I hold my breath that he doesn't start fitting. At the hospital the resuscitation room is a place of noise and light, full of doctors and nurses and radiographers, all in lead aprons. They listen to me tell the story of the last hour of this man's life. Numbers roll from my mouth, the mechanism of the injury, my findings and things that I didn't find. They hear me hope that it is the alcohol causing this. We go back to the ambulance, in the center of the floor is a perfect bootprint. Mine. Formed from his blood. (Source: Random Acts Of Reality)

Caught out

Random Acts Of Reality — Sun, 13 Apr 2008 12:39:00 +0100

Maverick ambulance service managers risked patients' lives in an over-zealous drive to achieve the quickest 999 response times in England, the government's health watchdog disclosed yesterday. The Healthcare Commission said Staffordshire ambulance NHS trust used poorly trained volunteers to act as "community first responders" to get to emergencies ahead of paramedics. They were authorised to drive at speed, using blue lights and sirens, without the necessary advanced driving training. The trust supplied ambulance staff and volunteers with controlled drugs that they were not legally allowed to possess, including the sedatives diazepam and midazolam. It also failed to keep proper records of medicines, which regularly went missing from ambulance stations. Patients were sometimes given larger packs of controlled drugs than they needed and told to dispose of the excess themselves. It's not the London ambulance service, but it just goes to show what lengths trusts will go to in order to hit these targets. A strange first sentence though, "Maverick". Will the police be looking into whoever illegally supplied the Controlled Drugs? It said Thayne, a former army officer, was described by senior staff at the trust as "a benevolent dictator". From what I hear, that's not what the ambulance crews on the road called him... The commission blamed regional and local NHS managers for not asking searching questions. "This complacency was brought about by the trust's ability to exceed the Department of Health's targets," it said. In other words, "They were hitting their targets, so we didn't look too closely at how they were doing it". I think that community first responders are a good idea, out in the country every little town can't have an ambulance sitting waiting for someone to become ill. However, they shouldn't be whizzing around on blue lights, not without training. And with blue-light training you may as well train them to ambulance technician standards - but, oh, that would cost money. (Although as far as I know the legislation about driving an emergency vehicle is a bit wishy-washy - any experts reading this, please do chip in). The commission report has this to say, Some of the problems may have arisen because the trust perpetuated the belief that the role of a CFR was broadly equivalent to that of an ambulance technician. Although the trust, when compared with other ambulance trusts, provided more training for CFRs, this was not comparable to the training given to ambulance technicians. From the Healthcare commission themselves, The Commission points out that the trust was a good performer in terms of response times for emergency calls. It was considered to be innovative in its introduction of new equipment and services and had good relationships with patients and the public. But, the investigation found that these achievements were undermined by a culture and approach that did not prioritise safety and that put patients at risk. So once more, evidence that the ORCON target puts patients lives at risk, (Source: Random Acts Of Reality)

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Hey everybody...

A Day In the Life of An Ambulance Driver — Sun, 13 Apr 2008 05:11:00 +0100

...yesterday was Sedate The Head Injured Drunk But Not Control His Airway Day!Yeah, nobody told me either.But Dumbass Paramedic was celebratin' like a mofo. (Source: A Day In the Life of An Ambulance Driver)

Yeah, but i'm really chewy

A Day In the Life of An Ambulance Driver — Fri, 11 Apr 2008 17:34:00 +0100

Created by OnePlusYou I'd probably go really well with some fava beans and a nice Chianti.Just for perspective though, the 48 pounds I've lost since since February 4th could feed thirteen cannibals. Hopefully, by November I'll be little more than a decent appetizer rather than the Family Bucket of Deep-Fried Paramedic(TM) that I am now.Tuesday, I volunteered to be a guinea pig control study for the professional vampires in the lab while they were calibrating their equipment, and my lipid panel came back as:Total cholesterol: 167Triglycerides: 136HDL: 36.8LDL: 103HDL/LDL Ratio: .357 So apparently, I am also a heart-healthy meal for the discerning cannibal.Now if I could just walk without my left knee giving me fits, I'd be great. I see an MRI and a visit with an orthopedist in my near future. (Source: A Day In the Life of An Ambulance Driver)

Celebrities

Random Acts Of Reality — Fri, 11 Apr 2008 09:52:50 +0100

I've yet to look after a celebrity in this job - while the chances aren't that high, we do occasionally find ourselves in the more central parts of London. There is also a rather famous heroin user who lives on the edge of our patch, although I suspect that they do most of their 'partying' in rather more salubrious establishments than can be found in my patch of East London. The closest to celebrity that I have dealt with is the daughter of one of our 'pillars of the community'. She was with her friend, working as a prostitute and had been hit when the punter had expected more or his £20 than a quick 'hand shandy' behind the bushes. Lots of foul language in the back of the ambulance, none of which directed at me or my crewmate while various bits of anatomy were nearly falling out of the clothes. There were no serious injuries and the girls just wanted to return home, just down the road from where I was bought up as a child. They didn't want the police involved and to be honest I suspect that the police officers present were more amused by the protestations on innocence by the man and the complete and frank disclosure by the women. Such are the high social circles I move in. (Source: Random Acts Of Reality)

Preach on, brother!

A Day In the Life of An Ambulance Driver — Thu, 10 Apr 2008 17:33:00 +0100

911Doc over at M.D.O.D. vents about JCAHO and Press-Ganey:JCAHO and Press-Gainey and 'core measures', I submit, are the health care industry's version of protection rackets. I stand to be corrected so all you fans of JCAHO and Press-Gainey please do comment here and tell me why I'm all wrong, but here's the essence of my case......JCAHO and Press-Gainey are parasites. They are solutions in search of a problem. With rare exception none of the JCAHO or Press-Gainey folks are practicing physicians. These companies have grown eighteen heads and can not be killed. They are feasting off the detritus of the piles of money that get shuffled around in the medicine game. Unfortunately, hospital CEOs and ER group directors have signed on because, I guess, having some information (however shitty it might be), or some way to put intangibles on a graph (and to show the upward trend), is worth something to someone.A great rant snipped for brevity's sake, but it's worth it to read the whole thing.We have the same thing in EMS, 911Doc. We call it CAAS.It's a prestigious little merit badge to have, and many ambulance services pay handsomely for the privilege. It's not even a bad idea in the abstract.But having worked for one company that went through their accreditation process, I can say first-hand that it's mostly window dressing that has jack shit to do with quality patient care. (Source: A Day In the Life of An Ambulance Driver)

Elsewhere

Random Acts Of Reality — Wed, 09 Apr 2008 15:37:01 +0100

Today's blogpost is elsewhere. Little does the crew know that the woman has just told the call-taker that she has a knife and is going to kill the paramedic about to come through her door. ----- The Guardian asked me yesterday to write about violence on ambulance staff, this was a strange coincidence as that was the exact subject I was going to write about today. Here is another example of how Call connect is a danger to ambulance crews that wouldn't fit into the article. It's nine a.m. in the morning, we have been sent to a young male with a 'head injury' in a residential property. WE have no details of how this occurred so I ask Control if they know anything. They have to ring the patient up again to ask him. He's been assaulted and the assailant is still with him. The caller promises that the person who inflicted the injury is not going to be a danger to us. What makes this dangerous is that Control had to ring the patient back, they didn't note that the injury was caused by an assault when the call first came in. All in an effort to get us to the scene to stop that all important ORCON clock. It would not surprise me if some time this year an ambulance person is killed because of there not being enough information gathered before they arrive on scene. I'll also predict that the trust involved will use the phrase 'Lessons have been learned'. (Source: Random Acts Of Reality)

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What i believe

A Day In the Life of An Ambulance Driver — Wed, 09 Apr 2008 02:55:00 +0100

Had occasion to think of that movie quote after an exchange of e-mails with Babs. The reasons why we broke up are not important, except to say that lack of love for one another was not one of them.A lot of our talking over the past couple of months has been at each other, and not to each other. She struggles to explain the changes in her outlook since discovering God, and I struggle to explain why it doesn't really matter to me that she's a very different person now, emotionally and spiritually. Lots of misunderstandings there, on both sides.We may never get back together. We may, but not anytime soon. No one can say right now.But both of us agreed that we don't want to lose what we first found in each other - a best friend, a confidante, a kindred spirit. And so, we begin anew the task of learning who the other is, with our eyes wide open this time.It occurs to me that a good way to start is by doing what I do best - plagiarize somebody else's best stuff if you can't come up with anything better on your own:Sometimes the things that may or may not be true are the things a man needs to believe in the most. That people are basically good; that honor, courage, and virtue mean everything; that power and money, money and power mean nothing; that good always triumphs over evil; and I want you to remember this, that love...true love never dies. You remember that, boy. You remember that. Doesn't matter if it's true or not. You see, a man should believe in those things, because those are the things worth believing in.Wise man, that Hub McCann. (Source: A Day In the Life of An Ambulance Driver)

The answer you're looking for...

A Day In the Life of An Ambulance Driver — Wed, 09 Apr 2008 01:13:00 +0100

...is, it depends.If you're really, really sick..I mean like, need an ambulance sick, you may only have minutes to live.But we EMTs are the ones most qualified to make that determination. We have hours years of training, and we make the determination that a person is really emergent based upon a finely honed assessment process, years of experience, and something we like to call prognostic indicators......the first of which basically states that if a patient begins a conversation with the words "I Googled it," they are unlikely to die any time soon.And that's a shame. (Source: A Day In the Life of An Ambulance Driver)

I r an anatomee perfesser...

A Day In the Life of An Ambulance Driver — Tue, 08 Apr 2008 23:01:00 +0100

I just entered a request into the computer for a hepatic function test, AP and lateral chest film, and rib views for a kid who had fallen onto a pipe. But the doctor didn't specify on which side he wanted the rib detail.So I trudged my sore knees all the way down the hall, poked my head in the door, and asked the kid's parents where his injury was. The mother thought for a moment, then pointed to an area in the upper right quadrant of the abdomen, right at the rib margin.Like, right where the liver is.DUHR.I scare myself sometimes. (Source: A Day In the Life of An Ambulance Driver)

Wasting police time

Random Acts Of Reality — Tue, 08 Apr 2008 10:05:43 +0100

In the LAS we have a thing called the 'high risk address' register - it's where we make note of any houses where an ambulance staff has been abused or attacked. We put addresses on it ourselves after the fact. It's something that will be part of a larger post sometime this week. It was no surprise to see our current call tripping the alarm, I'd put it on there myself. The woman who lives in the flat suffers from some pretty severe mental health problems, the flat is always a tip and she calls us for some rather strange reasons. I'd been to her when she had thought she was pregnant, about twelve months pregnant. I'd done nothing to provoke her, but her and her boyfriend had started shouting and screaming at us, so we'd retired to a safe distance; then called the police who calmed the situation down. I'd then filed the paperwork and the address was duly marked. So we found ourselves parked up the road waiting for the police to come. We'd been called because she was 'hearing voices', then she'd told the calltaker that she had knives in the house. Yeah - I'm brave, but I'm not stupid. So we waited for the police, for they are braver than me and have much more experience in dealing with aggressive people in a 'physical' manner than myself. They soon arrived, two officers, both about the same size as me. I may not have much of an ego, but even so it can be a bit bruised if I find myself hiding behind two female officers who are five foot nothing. Especially considering that they could probably 'take me out' in short order. The police knocked on the door, I cowered behind them. Our patient opened the door with a smile. "Come in, sit down", she said joyfully. We walked into the flat - you couldn't pay me to sit down, it was a little tidier than before, but not by much. "I'm fine now, I found my pills". A little chat and we filed out of the house. It's embarrassing when you ask for the police and don't need them - though they never moan about being used unnecessarily, it just feels like you are wasting their time. But in this case it saw the officers off duty without having to fill in reams of paperwork, so it wasn't all bad. I wonder how she'll be the next time I see her? (Source: Random Acts Of Reality)