Advice Please

You're a solo responder on a FRU/Rapid Response Unit.

You're called to a nursing home.

You have a poorly patient who needs constant monitoring and fairly rapid transport to hospital.

45 minutes after you arrive, you're still waiting for an ambulance, but none is yet available.

Control tell you that they have nothing to send for at least the next twenty minutes, not even another solo.

Then you're told that at the other end of the corridor is another poorly patient.

Very poorly.

Breathing at 60 times a minute, sweating buckets poorly.

With one pair of hands, one set of equipment, no further resources available, and the patients 200 feet apart, what do you do, other than hope that the 20 minute extra delay is somewhat reduced?

Spitting Distance

One of the disadvantages of working solo on the FRU is that I don't have the luxury of being able to walk out of the room if I get a fit of the giggles. And it happens. All the professionalism in the world doesn't prepare you for some of the funniest moments that we have.

The 30 year old woman who stripped off in the middle of the street telling us we should do an ECG as she thought she was having a heart attack.

The lady who uses a phrase that we always laugh about on station, but nobody really says, or do they?

The elderly gentleman who called an ambulance to tell them that his phone wasn't working.

The elderly lady who was spotted in a phone box, playing a violin, topless.

The teenager who challenged his young siblings that he could beat them in a running race if he was running backwards, then tried, then fell and cracked his head open.

Sometimes, patients say and do the funniest things. Sometimes you can laugh along with them, and the joke is appreciated all round. Sometimes you have to wait until later to laugh. Sometimes, for no apparent reason whatsoever, you just get a fit of the giggles, and have to walk away.

And very rarely, you get to go back to the same patient, and have a laugh about the last time you had a laugh.

*****

Mr and Mrs Oapsky are an elderly couple who live on the top floor of a 3-storey apartment block. At the moment they are sitting on a bench outside their flat, watching the fire brigade tackle a fire in the place they've called home for the last 15 years. They got out before the fire really took hold, and as per all the rules, stopped for nothing. Except Mrs O's make-up box and comb. Can't go anywhere without them. They're uninjured, having only inhaled a very small amount of smoke, if a little concerned for all their belonging, but are stoic in a way only the older generation tends to be these days. The smoke billows out of the windows, and one of the firefighters comes over to tell the couple that although the fire is out, the flat is heavily smoke damaged, but most of their belongings were still intact. They seem relieved, and decide that for now, as it's about 2am, they won't wake their relatives, but will go to the hospital and make all the arrangements in the daytime.

Mr and Mrs Oapsky seem familiar, but I can't place why I seem to know them, until, just before they leave in the ambulance I need their details for my paperwork and ask for their first names. "Oh, I'm Gillian, and this," she says, nodding her head in her husband's direction, "is Jacob. But everyone calls us Jack and Jill." I can't help it. I laugh out loud, and my memory is finally jogged to the call a few months earlier, when I was on a proper ambulance.

*****

The call comes in for an elderly gentleman, confused and talking nonsense. Sounds like my kinda guy. We're greeted on our arrival by Gillian "Please call me Jill" Oapsky, who's looking mildly confused herself.

"He keeps saying the strangest things! First he wanted to know where the cat was, when we've never had a cat, and then he started picking up the telephone and telling it off as if it were a small child!"

"What's his name?" I ask.

"Jacob, but everyone calls him Jack." The corners of my mouth turn up ever so slightly. Reena, my crewmate, gives me the "don't-you-dare-on-pain-of-death" stare. I can't help it. The giggles are lurking. Somehow I regain my composure, and approach Jack to ask him how he feels.

"I'm alright. Nothing wrong with me. Don't know what she's making all this fuss for." He denies having any pain, knows his name, date of birth, who the prime minister is, and can count backwards from 100 in sevens. I can't do that under normal circumstances.

Then, all of a sudden, he yells.

"PASS ME THAT PHONE. I'M THROWING IT OUT THE WINDOW. IT KEEPS SPITTING AT ME!"

Well, that does it. My composure is destroyed. I look at Reena, look at Jill, look at Jack, and finally I look at the phone. It's the phone's innocence, just sitting there placidly, not even ringing, that does for me. I crumble into giggles. I'm given the threatened death-stare, but it's a lost cause. Jill tries to look disapprovingly, but eventually gives in to the giggles too. Through all the laughter we check Jack's observations and ask Jill what medical problems he has. Apparently, for a 70-something year old, he's as fit as a fiddle.

"The doctor's just started him on some new medicine, but I'm not sure what it's for." We have a look and find that it's a tablet for diabetes. Having just checked his blood sugar and found that it's very low, we're not at all surprised. Most people I've met with the level he had were unconscious, but Jack was just talking to us as if nothing was wrong, except for intermittent bursts of phone-rage.

"WILL YOU STOP SPITTING! DIDN'T YOUR MOTHER EVER TELL YOU IT WAS RUDE TO SPIT? COME HERE! I'M THROWING YOU OUT THE WINDOW!"

On and on he went about throwing this phone out the window. How it kept spitting and swearing at him. The more he continued, the more raucous the laughter became. We tried to give him some oral glucose as well as a glucagon injection to bring his sugar levels up, but neither seemed to help. Eventually we decide that the only choice we have is to give him IV dextrose. It's not an ideal solution, as it tends to mess up the sugar levels for the next few days, but it is a miracle cure.

Jack lets Reena cannulate him and give him the IV, and within no more than about 2 minutes he looks up at us with a very confused look. "Who are you two? What are you doing in my house?"

"Welcome back Jack! We're from the ambulance service and we're here because your blood sugar was very low. Your wife was worried because as well as not being your normal self, you also threatened serious violence against your phone." Once again, Reena, Jill and I all collapse in hysterics. The treatment has done the trick. Jack is back to normal. A little bemused at all the merriment around him, but it's soon explained, and he laughs along too. We take him to hospital just so that he can have a check-up and make sure that his new medication is the right one for him. I've just about managed to calm down by the time we have to hand him over to the staff.

*****

Several months later, back at the scene of the fire, Jack takes one final look out of the ambulance, and just as I'm about to close the doors he calls after me.

"Oy! Make sure they don't throw my phone out the window! I still need to tell it off about all that spitting!"

You

You.
You waste of space.
You waste of time.
You waste of energy.
You wasted your money on too much vodka, and now,
You're wasted.
And while I'm here,
while you're swearing at me,
while you're swinging punches at me,
while I wait for either the police or the ambulance that's backing me up,
I listen.
I listen to the radio.
I listen to the calls going out.
And I hear.
I hear the chest pain calls waiting for ambulances.
I hear the breathing problem calls waiting for ambulances.
I hear the RTC calls waiting for ambulances.
And I freeze.
I freeze because now the radio calls once more.
I freeze because there's a baby who's not breathing. And I'm here.
Here with
You.

Handover

This month's Handover Carnival has been published over at Medic999's site. I'm once again honoured to be included in a list of other blogs worthy of reading. This month's topic was "The First Emergency". All the other ones are definitely worth reading and give a wide range of different views on the same basic idea. Go have a read.

Thanks again to Mark for starting the Handover idea and hosting it this month. Next month's will be hosted over at Life Under the Lights, and has the heading of Funniest. Call. Ever. I'll have to see what I can come up with...

Proof of Creationism

I know that the title doesn't sound like the sort of thing I'd usually post, but stay with me. I found the item below completely by accident months and months ago, and just saved it as a document on my home computer. I apologise to the person from whom I stole, as I can't give you any credit. Credit, in any case, is not mine.

*****

When God made paramedics, He was into His sixth day of overtime. An angel appeared and said, "You're doing a lot of fiddling around on this one."

So God said, "Have you read the specs on this order?
A Paramedic has to be able to carry an injured person up a wet, grassy hill in the dark, dodge stray bullets to reach a dying child unarmed, enter homes the health inspector wouldn't touch, and not wrinkle his uniform."
"He has to be able to lift three times his own weight. Crawl into wrecked cars with barely enough room to move, and console a grieving mother as he is doing CPR on a baby he knows will never breathe again."
"He has to be in top mental condition at all times, running on no sleep, black coffee and half-eaten meals, and he has to have six pairs of hands."
The angel shook her head slowly and said, "Six pairs of hands??? No way!"

"It's not the hands that are causing me problems," God replied. "It's the three pairs of eyes a medic has to have."

"That's on the standard model?" asked the angel.
God nodded. "One pair that sees open sores as he's drawing blood, always wondering if the patient is HIV positive," when he already knows and wishes he'd taken that accounting job, "another pair here in the side of his head for his partner's safety. And another pair of eyes here in front that can look reassuringly at a bleeding victim and say, "You'll be alright ma'am when he knows it isn't so."
"Lord," said the angel, touching His sleeve, "rest and work on this tomorrow."

"I can't," God replied. "I already have a model that can talk a 250 pound drunk out from behind a steering wheel without incident and feed a family of five on a public service paycheck."

The angel circled the model of the Paramedic very slowly. "Can it think?" she asked.
"You bet", God said. "It can tell you the symptoms of 100 illnesses; recite drug calculations in it's sleep; intubate, defibrillate, medicate, and continue CPR non-stop over terrain that any doctor would fear... and it still keeps its sense of humor."
"This medic also has phenomenal personal control. He can deal with a multi-victim trauma, coax a frightened elderly person to unlock their door, comfort a murder victim's family, and then read in the daily paper how Paramedics were unable to locate a house quickly enough, allowing the person to die. A house that had no street sign, no house numbers, no phone to call back."
Finally, the angel bent over and ran her finger across the cheek of the Paramedic.
"There's a leak," she pronounced. "I told You that You were trying to put too much into this model."

"That's not a leak," God replied, "It's a tear."

"What's the tear for?" asked the angel.
"It's for bottled up emotions, for patients they've tried in vain to save, for commitment to that hope that they will make a difference in a person's chance to survive, for life."

"You're a genius!" said the angel.
God looked somber.
"I DIDN'T PUT IT THERE" He said.

--Author unknown

Live Patients, Patients' Lives

Four months in a class-room. Four long, studious months. I've never studied for four months without a holiday somewhere in between. In fact, thinking about it, I've never really studied properly for four months ever. I actually wanted to be there. Wanted to study. Wanted to pass the exams. Wanted to finally get out on the ambulance and start treating patients. Wanted to take my 1% inspiration, put in the effort that's 99% perspiration, to become 100% ambulance-man.

The day arrives. I need to be up early, to be out the house by 6 in the morning. There's no chance of me over-sleeping. I can't sleep at all. I can't remember the last time I was this nervous. Actually, thinking about it, I think scared is nearer the mark. This is the day where I finally get to put everything into action. No more rubber dummies, no more resusci-annie dolls. This is the real thing. First day on an ambulance. For real. Blue lights and sirens. Live patients. Patients' lives.

I arrive, along with Sophie, my partner-in-crime for the next few weeks, at a station where I have never been. I meet people I have never seen, including Pete, who's going to be baby-sitting us during our first foray into the world of emergency medicine. Pete takes us round the station, shows us the important bits like toilets and drink machines, coffee and tea, the office, and eventually, the ambulance.

We talk about our training, how it's just like driving lessons. The real learning starts after you've passed. We talk about what we did before, what we want to be doing in future, why we chose the ambulance service. Then we talk reality. We discuss how things are changing, people are changing, expectations are changing. We hear how the the ambulance service doesn't only go out to people who are severely injured or seriously ill, but also to very minor ailments, lonely people, selfish people. And lots and lots of drunk people. At the sound of that, I almost walk out on the spot. I'd done my homework, I knew it wasn't all blood and guts and all things nasty, but I hate the thought of having to deal with drunks. I guess I'd have to learn to live with it.

We go through the ambulance, making sure all the kit's there, that everything works, the lights flash, the sirens wail. Eventually we tell control that we're ready to go. There are a number of crews on station, but as we're trainees, we get to take the first call that comes in. Apparently, it's unusually quiet, and the phone is silent for some time. My nerves are frayed, and I sit waiting for the call to come in.

The talk turns back to previous lives and jobs, and I tell Pete and Sophie (although she's probably heard it all before) that as a stop-gap before I started my training, I worked as a security guard. I hate the word hate, but I hated it. I stood for hours on end, mainly at schools, hoping that nothing happened. Which thankfully it didn't. I still hated it. I hated the boss too. He'd regularly "forget" to pay the staff or claim there was some bank problem for over a week or two every month, and then tried to underpay as well. I couldn't wait to get out of there. The job filled a purpose, and it was a means to an end, so I survived it. I didn't get a good-luck card on my last day, I didn't leave a thank you card when I left, and I didn't tell anyone where I was going.

Finally, in a heart-stopping moment, the printer whirrs and the phone rings. The first call has come in. I look at the piece of paper with fear and trepidation to see that it's a car crash, or RTC. Two patients, middle-aged female and 20-something male. As if to haunt me, my inspiration for joining in the first place, my recurrent nightmare, has returned as my first ever call. This was something Sophie didn't know about me, and I wasn't about to reveal it either. I tell them that I know loads of 20-something year old males around the area where the RTC is, and we leave it at that. Pete's decided that as it's the first day, he'll do all the blue-light driving to the calls, and one of us can drive to hospital if necessary.

We arrive at the scene to find that there's already one ambulance there, and no patients actually at the roadside, so presume that both the patients must be in there. We knock on the door and open the back of the ambulance to find the crew dealing with the middle-aged lady. The 20-something male is sitting with his back to the door, so we can't quite see his face, but he's clearly not too badly injured.

Pete takes a handover from the first crew about what's happened, and it's agreed that we'll deal with Craig, the 20-something male. My ears prick up at the sound of the name, and eventually he turns round. I'm not sure who's more shocked. Craig, as he finds that he has to look me square in the eye, and realises that I'm there to treat him, or me at the fact that Craig's now a patient and I have to be courteous and professional.

I'm starting to realise more and more how much the world goes round in circles. How every action has an equal and opposite reaction. And how revenge is sometimes a dish best served cold. Or not served at all. Just threatened.

Craig was my boss in my previous job.

Now, he needed my help, and was ashamed to have to ask for it. That in itself was enough for me. He received a very quick lesson in karma, and I received a very quick lesson in how to immobilise a live patient after an accident. It wasn't a life-threatening call. It wasn't blood and guts. It wasn't all the excitement that this job could be. But it was my first job.

I was told that you never forget your first job. I never expected it to be so true, on so many levels.

The Whistle

September, 1940. Stepney. East End of London. 3am.

It's that whistle.

That terrifying, blood-curdling whistle. And then the silence. The ghostly quiet. The terrifying stillness that brings with it so much death and destruction. All the while the sirens blare. They warn of the imminent danger. People scurry for cover, looking for anything that will protect them from the shower of terror that's about to rain down. Church halls, basements, underground train stations. Anything. Anywhere. Renee runs into the nearby tube station. She's 20 years old, Archie, a baby in arms, only a few months old, is too young to understand. Eric, husband and father, has been drafted and lies hundreds of miles away, fighting the enemy that's now attacking his young, frightened family. Crowds throng into the station along with them, waiting, hoping, praying for an end to the endless wave of fear. An explosion rocks the surrounding streets. Mothers weep, children scream in dread, Air-raid Wardens hurry the populace off the highways.

It's that whistle.

Whistle after shrieking whistle. Then the silence. Then the explosion. A seemingly never-ending cycle. Archie cries. Renee can do nothing to comfort him, but tries anyway. She sings to him, her voice broken by her fears. She smiles at him, the glint in her eyes betraying the tears that she tries to hide. She has nothing to offer other than her warmth, her touch, her love.

After what seemed like hours, the siren stops its wandering wail. The explosions cease. The quiet is a calm one. The frightening whistle stops its whine. She knows it will come again tomorrow.

*****

2009. A long way from Stepney. London. 3am. Called to Elderly lady, ? Fallen in the street.

The old lady stands in the street. She must be nearly 90 years old. She's confused, scared. She calls for Archie. She calls for Eric. Neither come to her aid.

I ask where she lives, and she tells me she's from Stepney. A real East-Ender.

She's frantic. "I have to find Archie! I don't know where he is! The sirens will start again soon! We have to get into cover!"

"Who's Archie?"

"He's my son! He's only a baby. He won't know what to do!"

I know the police are on the way too, as someone at control thought the same as I did when they saw the call. It's very strange that an elderly lady should be out on the street, alone, at 3 o'clock in the morning.

"Renee, I'll help you find Archie, but you need to tell me a little more. How old are you?"

"I'm 20. I'll be 21 next month. I hope Eric comes home before then. You see, he's away, on the front, and I don't know when he'll be back. We've only been married for just over a year."

There's a nursing home just down the street, and I wonder if Renee should be there. A phone call later they confirm that there's no-one missing from the home.

"Please," she begs, "please help me find my baby!"

I promise to try, but don't really know how I'm going to do it. The only plan I have is to take her to hospital while the police try to work out who she is and where she's from. At least in hospital she'll be safe.

The police siren wails somewhere in the distance. Even in her old age, Renee's hearing doesn't let her down. The noise reverberates through the clear night air, and Renee's look turns to horror.

"They're coming! They're coming! And I can't find Archie!"

I do everything in my power to calm her down, to tell her it's not real, to convince her that Archie's safe, but have little success. The police car pulls up a few feet away, and I explain to Renee that they're here to help. She composes herself, if only for a short time, appreciative, if not understanding. I go over to the officers and explain the situation. They agree that my solution is probably the best one for now. It's either hospital or a police station. For a change, hospital seems the nicer option. The officers have been listening to some music in the car on the way over, and as they approach Renee, one of them still has the tune stuck in her head, and she's absent-mindedly whistling it. Renee looks to the sky, waiting for that shower of terror to resume it's assault.

Its that whistle.

That terrifying, blood-curdling, shrieking whistle.

Faith

It's all just so depressing. I'm sitting in the FRU car on standby, listening to the radio presenter and all the callers moan about society's ills. Nobody has the time to be polite. Nobody stands up for a pregnant woman on the train. Nobody helps the elderly with their bags of shopping across a busy street. Everyone's far too busy to take a minute to be nice. For a country supposedly known for it's friendliness and manners, we seem to be losing the plot.

The programme glides smoothly and disturbingly from society's ills in general, to neighbourly relations in particular. Dave calls in to say that he wants to burn down his neighbour's house because of all the loud music she plays. Mary rants about the apartment downstairs always cooking spicy food and making her place smell. Den thinks that his neighbours' house is a drug den... Not one single caller has a positive view on life next door. So much anger, so much frustration, so much to make you lose faith in humanity.

I'm snapped out of the gloom by FRED, the computer dispatch system. He's got a call for me. An elderly lady's collapsed. Time to move. No time to sit and get all melancholy about all that I've been listening to.

I arrive on scene, greeted by a frantic windmill-like man. Rose is at the back of the house, lying on the floor. Her eyes are closed, her face pale and clammy, and she's surrounded by vomit. She makes a feeble attempt at responding when I call her name. Her breathing is weak, her oxygen levels low, her pulse about half what it should be. I place an oxygen mask on her face and check the rest of her observations. The ambulance arrives only a short time later, and we move Rose off the floor, into the chair and onto the ambulance. We continue to treat her, give her drugs to try to improve her pulse, check that there's nothing else obvious that we've missed and could be dealing with. Then the ambulance pre-alerts the hospital that they're on the way with Rose, and they leave on lights and sirens.

I get back in the car to finish the never-ending task of paperwork. As I'm doing so, there's a hive of activity. The neighbours. It was one neighbour who'd first heard Rose's strangled cries for help and gone to investigate. It was another neighbour who'd stood by the road-side waiting for the ambulance. Yet another who'd now gone to get a mop and bucket to clean up where Rose had vomited. They were together now working out the best way for them all to help, who had keys, who would arrange to take some clothes and other essentials to the ward, who could collect Rose from hospital when she was discharged. I watch this outpouring of selfless activity and think back to the radio that I was listening to just half an hour earlier. I want to call in and tell them how wrong they are. That there is still kindness, there are still generous people about, that there are still neighbours who thrive on being able to help. I want to call but I'm too late. The programme is now talking about something else.

I want to go up to these neighbours and say thank you.

Thank you for caring.

Thank you for helping.

Thank you for restoring my faith.

She

Apologies in advance. This is likely to be a rant. I may write it in one go, not bother re-reading or editing, and I might, if I remember, just spell-check it once. Because, in case you hadn't gathered from several of my previous posts, or in case you're new, kids, in my view, take priority. They need looking after. They need to be cared for. They need attention.

They need to be kept safe.

*****

"How dare you move my children?" She screams like a madwoman. She's running round in the middle of the road, tearing at the bandage that we've placed on what's left of her ear and throwing it to the floor in fury. Immobilising her is out of the question.

"My children are my life. I wouldn't do anything to hurt them!" She's restrained by police while we have the unenviable task of cutting her children out the car and immobilising them on spinal boards.

"Don't you dare touch them! I've done nothing wrong! I'm a good mother! A safe driver! You're hurting them. You're gonna take them away!" Damned right. They're going to the hospital so they can put them back together.

It takes all my self-restraint not to answer her back. This is all her fault in the first place. These children, who she so vehemently claims she would never hurt, are now being scared to death by the fire-brigade who have to cut them out of the ruins of the car. It's her fault. She's the cause. This is the effect.

Another maniacal scream follows.

"YOU DON'T CARE ABOUT MY CHILDREN! YOU'RE TRYING TO KILL THEM!" And I can hardly take it any more. In the recesses of my mind, my self-restraint gives way to my red-headed temper and I tell her what I think.

If only you hadn't have loaded your car with a 2 metre long heavy box that was placed between your children.

If only you hadn't have had that can of beer sitting next to you.

If only you weren't concentrating on eating the hot chips that were in your lap while you were driving.

And if only you'd have actually placed your kids on proper seats and strapped them in.

Then maybe I'd struggle a little less with your claim that they are your primary concern. Maybe I'd stop thinking that actually, the person who was really trying to kill them, was you. Their mother. I don't mean to, but I can't help thinking it. She's no mother.

She had her ear practically torn off by the box as it flew through the windscreen. It could have been one of her kids.

She's lost control of the car, either through drinking or eating whilst at the wheel.

She's lost the right to tell me what's best for her kids.

She's lost the right to tell me my job. I need to do my job. I feel like I need to do her job too.

She's almost, very nearly lost a hell of a lot more.

She almost lost her kids.

Late

My shift finishes at 3am. The call comes in at a quarter-to.
*****
The door's open. A bad omen I fear. Nursing homes are almost never ready for us when we arrive. It doesn't seem to matter what the emergency is, it always happens to be somebody else's job to meet the ambulance and direct them. That Somebody Else who's almost never to be found, so finding the door as it was seemed more threatening than welcoming. The building, however, is huge. Two storeys with at least two dozen rooms on each floor, and as usual, despite the open door, Somebody Else wasn't there again. I yell "Ambulance" several times up and down the corridor, and eventually a member of staff hears me and without so much as a glance in my direction yells back "It's upstairs".
*****
The call came in as "patient fitting". Something told me that unlike the vast majority of calls we receive to patients who are having seizures, this one probably still was, so I took all my luggage with me, ready for anything, and waddled up the flight of stairs. (I've worked out that if I take everything in with me, it weighs about 20 kilos. Or 40 pounds. Possibly more. About the same as normal luggage allowance on a European flight.) The lift was the other end of the corridor and would have involved double the waddling distance, so I decided on stairs. That and the fact that I don't really like lifts.
In the room is Barbara. And about seven members of staff, all of whom were trying to tell me a story, none of them really succeeding. After ascertaining who was in charge, I found out that Barbara needs full time care due to various medical problems, hence the nursing home, but has never before had a fit. This one had been going for a full 15 minutes before I got there, and was still in full force.
Barbara's eyes are open, but the vacant stare just looks back, pleading for help. I give her a first dose of medication, hoping that it would bring a stop to the seizure, but it has no effect at all. I get IV access, so I can give her some faster acting medication. It all seems to take forever, but looking at my watch as I time the drugs, it's not really the case. I start to give IV drugs, slowly watching and waiting for it to take effect. At this point the ambulance arrives, having received my message that the patient was in Status Epilepticus, or an ongoing seizure.
One of the side-effects of giving Diazemuls IV, is that it can reduce the patient's respiratory rate. The drugs are taking effect, and Barabara's seizure finally stops. Unfortunately, her breathing rate is now less than six a minute. We assist her with ventilations through a bag-and-mask, ensure she is as settled as possible, and then take her to the ambulance. We put a priority call to the hospital, and I travel with the crew. An extra pair of hands with a very poorly patient is always helpful.
Barbara's respirations don't pick up on route, but with our help her oxygen levels remain at 100%. The blood gas test when we arrive would show that despite an exceptionally long seizure, and despite the fact that she was hardly breathing on her own, we still managed to maintain a good airway and good ventilations. Easy to do in a sterile, non-moving environment such as a hospital, not so easy in a moving vehicle. These are basics, I know, but sometimes easy to overlook with the organised chaos that is a poorly patient.
We hand Barbara over to the hospital staff, and even get a pat on the back for our treatment. Now that IS rare. Back to reality, tidying up, writing up, restocking. Just before we leave the hospital, I go back in to check on Barbara one last time. She's breathing on her own, looking a lot more settled. Family starts to arrive, and I sneak out, pleased that my training has once again been put to good use, and with a good result. Or at least I hope it was a good result. I don't know what happened to Barbara after that.
Eventually I get back to station, start to pack up and go home. I take a look at my watch as I leave the station. 4.45am. The sun is starting to rise, the early-birds are beginning to stir, the world is just commencing it's early-morning ritual. Not for me though.
For me it's late. Very late.
But very worthwhile.

Abused. Again.

Medic999 has had enough. And I don't blame him. Go read about it first, and then come back. I whinged about the same subject a while back, and fully understand where he's coming from. He was sent back to station after his incident, to recover. Also known as have a cup of tea and fill in the paperwork. But that's where we all leave it. So what do you think? Would you take this sort of abuse or is this beyond the point that we should put up with? Would you report this type of behaviour to the police, or just leave him under guard in A&E (with hospital security, not police) and stew in your own juices?

I know what I'd do.

Damned Lies

There are three kinds of lies: lies, damned lies, and statistics. Benjamin Disraeli.

*****

Statistic 1: 99.7% of people on the planet have more than the average number of limbs. Think about it.

Statistic 2: You have a 343:1 chance of being attacked by a shark. It's probably a little higher if you actually swim in the sea.

Statistic 3: The life expectancy in the UK is 77.2 years for males, and 81.5 years for females.

*****

50 year old male, unresponsive. My sixth sense kicks in again and tells me that this is the real deal. The panic-stricken young lady stood outside the house strengthens my suspicions. The patient, lying on the floor, blue, confirms them. For a change, there are two of us on the FRU, making the resuscitation attempts that little bit easier. The ambulance is also on it's way. The young lady is trying hard to maintain her composure as she tells us what's happened. "He was in the room on his own, when we heard a bang. We came in to find him on the floor. He's not been unwell. Nothing's been wrong. But now he's stopped breathing. That was a few minutes ago". All the while, the resuscitation attempts are in full swing. The chances are slim from the outset. The family stand by and watch. A wife. A daughter. A son. All praying. We take him to the ambulance. The efforts continue. We're breathing for him. We're pumping the blood round his body for him. We're trying to stop him becoming a statistic. But we're losing.

*****

50 year old male, unresponsive. My sixth sense kicks in again and tells me that this is the real deal. The panic-stricken young lady stood outside the apartment block strengthens my suspicions. The patient, lying on the floor, blue, confirms them. Another FRU turns up at the same time, suggesting we may have a bit of a wait for an ambulance.

The young lady is trying hard to maintain her composure as she tells us what's happened. "He's been in pain for a couple of weeks. The doctor put it down to a nerve problem. The pain got worse suddenly. Then he collapsed and stopped breathing. That was a few minutes ago".

All the while, the resuscitation attempts are in full swing. The chances are slim from the outset. The family stand by and watch. A wife. A son. A daughter. A neighbour. A friend. They all stand by and watch. The ambulance arrives. The efforts continue. He's transported to hospital, all the while we keep the family in the picture. We're breathing for him. We're pumping the blood round his body for him. We're trying to stop him becoming a statistic. But we lose.

*****

Two calls. Two weeks apart.

*****

Facts are stubborn things, but statistics are more pliable. Mark Twain

*****

Try telling the families about statistics. They're lies. Damned lies.

Ginger (and proud!)

Time for a confession.

I'm the kid who got teased for most of his school life.

I'm the kid who got picked last for the football teams.

I'm the kid who always came back from school holidays with a suntan through a sieve.

And bright red instead of tanned.

*****

You see, the thing is, My name's Ben, and I'm Ginger.

*****

Well, at least the bit of hair that's still left on my head is.

But, after many years of trauma, at least it explains one thing.

I know why I hate going to the dentist!

Insomnia III

Insomnia is more than just an affliction. For some it's a fully-fledged disease. For others it's just a minor inconvenience. For a very few, sleep itself is no more than a necessary evil. Have a read over here for a different look at sleep and our need for it.

I've been a self-diagnosed insomniac since I was about eight years old. It doesn't help that during the few hours sleep I get a week, I'm a very light sleeper, and can get woken up by an ant going for a stroll at a hundred paces.

For me it seems that insomnia is different. It's a conspiracy. There are rules that govern this world. The earth orbits the sun. The sun rises in the east and sets in the west. And the most important rule is the rule that says that Ben is not allowed to have a decent sleep. Most people, especially those nearest and dearest just think that I can't sleep. But there really, truly, is a Conspiracy.

There's always something sent to keep me awake. Every time I think that there can't be anything new to send my way, The Conspiracy finds a way. Normally it's the kids. Or the train line that runs not far from my house. Or a multitude of other distractions. Today, however was different.

Having not been in bed for more than an hour, I'm woken by the sound of metallic clanging. A little like jangling keys, but just louder. I move my pillow from under my head and practically smother myself to try and drown out the noise. No such luck. Eventually I give up and take a look out the window to find that without any prior warning, someone has decided to erect scaffolding outside my bedroom window.

I yell, scream, shout, cry and eventually collapse in a gibbering wreck. I get up, decide to say good morning to the family, have breakfast (or it might be a late dinner as my world is back-to-front), and move into one of the kids rooms at the front of the house, away from the newly built scaffolding.

Which is when the lawn mower starts up right underneath the window.

So to the non-believers - NOW DO YOU BELIEVE ME? It really is a Conspiracy!

I, Robot?

I may have mentioned this before. I don't like dentists. No, I mean I REALLY don't like dentists. The last time I went to the dentist, my pulse was still at over 140 an hour later. The time before that I passed out in the chair. I get palpitations if I just phone up to make an appointment. I get chest pain and break out in a sweat if I walk past a dental surgery, even if it's not the one I go to. In fact, as I write these lines, I can feel the dread coming over me in waves. I may have mentioned this before. I don't like dentists.

____________________________

The call came in for a man collapsed, unconscious, possible allergic reaction. Easy. I can deal with that. I'm a highly trained, highly skilled, highly motivated paramedic. Most of the time. Then, I look at the address. Dr Payne's Dental Surgery, Filling Road, Phobiatown. Instantly I feel the colour drain from my face, my pulse double. The cold sweat starts on my forehead, and within moments has spread all over me. And I have to drive to the call. I'm on an ambulance, not flying solo in the car, and it's my turn to drive. To be honest, it's probably a good thing, otherwise I'd have panicked even more. At least I had something to concentrate on before we got there.

I hoped that the patient would have had the good grace to collapse in the reception area. Or the waiting room. I prayed that he would be well enough for my crewmate to say that I could wait outside and he'll deal with the emergency. I begged that it would be straightforward, so we'd be in and out in no time.

No such luck. None of my prayers were answered. Well, strictly I guess they were, but the answer was a resounding NO. On our arrival, I scoured the reception area and waiting room. He wasn't there. A frantic looking receptionist sees us and yells directions. "Up the stairs, turn right, turn left, 15th door on the right, spin around and walk in". I'm not sure that the "spin around" bit was actually part of the instructions, but I was doing it anyway. And there probably weren't 15 doors upstairs, but it was starting to look like it. Damned phobia! Concentrate!

We find Phil, a gentleman in his 50's, as if to taunt me he's still sitting in the dentist's chair, and he's not at all well. He'd just been given a local anaesthetic injection, and had reacted badly to it. His body had swelled, he'd come out in a rash and was vomiting heavily. His breathing had started to be affected, soon his blood pressure could plummet too. We'd need to treat him before even thinking of moving him. He needs oxygen, he needs a needle in his arm, he needs drugs. My crewmate checks and double checks everything as I hand him, and keeps a close eye on me at the same time. I'm paler than an ill-looking ghost.

Luckily, one of the driver's duties is to fetch whatever is necessary from the ambulance, including the carry chair. I take the minute or so outside as much needed respite. I regulate my breathing, try to slow down my pulse, and tell myself to stop being so bloody stupid. It's not me at the dentist! Once more I enter the building with the chair, thinking that at least this means we're about to leave.

Phil's improving slightly, but still we have a flight of stairs to negotiate with him on the chair. I take the top end of the chair so that I don't have to go backwards in my state, and we make it down the stairs in one piece. Once we've loaded Phil into the ambulance, I go and sit back in the driver's seat to try and regain my composure. As I look in the mirror I can see my crewmate giggling to himself at my predicament. To top it all off, we had an observer with us that day who got to witness and mock my jelly-like state.

Phil still received the best care possible, and made a full recovery. Hopefully he didn't notice the turmoil that I was going through. Or maybe that he did. Maybe his experience has turned him into a kindred spirit.

As paramedics we face all sorts of unexpected situations and emotions. We're expected to face them all professionally, at times coldly. Most of the time I try to leave my emotions to one side, push them out of my head whilst I'm with the patient and deal with them later if necessary. I have a job to do. I need to focus on the task at hand.

Sometimes, thankfully very rarely, I have to deal with the patient and with what I'm going through at the same time. I'm no robot, no automaton. I think, therefore I am. It's just that sometimes, thinking is what gets me into trouble in the first place. Sometimes, I hate to admit it, but I guess I'm human too.

Skive...

Work's been exceptionally busy recently, and it's not uncommon these days to see upwards of a dozen ambulances sitting outside the hospital at any one time, all waiting to hand the patient over to hospital staff. Probably explains why, being a single responder on a car, I seem to be waiting longer and longer for crews to come to my rescue. Whilst sitting outside the local A&E department the other night, I decided that we needed a name. What we need is an ambulance-related collective noun. Lions parade in prides. Geese gather in gaggles. Bees swarm in a... well...um... swarm.

So what would you have for a group of ambulances? I'll kick off with "A Skive of Ambulances", and hope that it translates ok outside of the UK...

If you need some ideas look here, especially at the bottom of the page for "some that might be" . Look forward to some of your suggestions!

A Bug's Life

The road snakes it's way through suburbia, a three-lane highway practically begging for its speed limit to be ignored. Especially at night. Not at all recommended. The people living by the side of the road are either fed-up with, or immune to, the buzzing of the traffic. It must be like having a swarm of bees constantly inside your head.

The traffic at 1am shouldn't be heavy, but for some reason travels at a snail's pace. Three lanes of solid chaos that I need to worm my way through. Having to use a siren at that time of night can't help the neighbours either, but I have no choice. The bright yellow car and flashing blue lights don't seem to be enough for the other drivers to see. They need to hear the high-pitched wailing too.

In the distance I see what looks like a sea of fire-flies, with all the police cars blocking the road, blue and red lights lighting up the dark night. Eventually fighting my way past the road blocks, I see it. A dead beetle. A big one. One of it's wheels still spinning in a final dance of death, it lies on its roof, shattered. It fought around one of the bends, but lost the fight. At 60mph, the chances of a new driver negotiating this bend are slim. The railings that used to be at the side of the road are now a spider's web that has been brushed away.

By the side of the road sits the driver. He's got out by himself, seems to be miraculously uninjured. The luckiest person I've met for while. I take another look at his car, and with a childish grin think to myself, there's only one thing left to say. But no-one to say it to. Oh well. I'll say it anyway...

PUNCH BUGGY BLUE!