Accents

A few weeks ago, for an entire twelve-hour night shift, my accent turned from being generally-screwed-up-due-to-moving-house-too-many-times to generally-screwed-up-with-a-terrible-Aussie-twang. 

I blame this guy - an Australian paramedic with a taste for worldwide EMS experiences. 

You can read part one his account of the night shift here. There's even a clue as to my real identity, with a partially disguised photo. 

According to MrsInsomniac, my accent has yet to recover...

(Part II is now up too!)

Bernie

The sky is once again dark and menacing. The threat of more of the snow that plagued us a few weeks back is on the not-too-distant horizon. There have even been a few flurries, just to whet our appetite this morning. Not really sure I'm all that hungry. During the last batch of snow more cars crashed, more roads were closed, more people fell and broke limbs, fewer trains and buses ran, and more people couldn't (or possibly wouldn't) get to work. We don't seem to cope with it very well, and now there's more on the way.

Someone should probably warn Bernie.

He's a nice old chap is Bernie, although when I first met him it was difficult to reach that conclusion, given the fact that he was lying in the snow in a heap, not responding. Another, younger man stood over him, barking orders at Bernie to get up. He even tried to physically lift Bernie from the wintry pavement, but his seemingly lifeless body wouldn't cooperate. It was at that point that I was driving past, on the way back from a separate call. I called in a "Running Call" to the control room, and asked for an ambulance to attend for an unconscious patient.

Bernie was unconscious but at least he was breathing regularly. It was one of those shifts where I had an observer with me (told you that they do sometimes get to see things happen), and I sent her back to the car for a couple of blankets. Always handy to have an extra pair of hands, as well as an extra blanket. One to put under Bernie to try keep him off the frozen ground, if only a little, and one to go on top of him. I asked the other man if he was a relative or if he knew what happened.

"Never met him before. I just bumped into him and he fell down. Now he won't get up!" He seemed unaware of the fact that he was shouting, much like someone conversing whilst listening to music plugged into their ears.

Bumped into him? Staggered was probably nearer the truth. The smell of several pints of alcohol on his breath would probably have made him fail a breath test whilst stood 30 feet from the machine. He instantly became aggressive and I had some difficulty moving him away from the patient and us, so as well as an ambulance, I asked for police back-up. Just in case.

Turning our attentions back to Bernie, we'd put him on oxygen, tried to get some baseline observations and elicit some sort of response from him. None was forthcoming. The roads were as treacherous as the pavements, and the call rates had increased exponentially, so we knew that back-up in the form of either the ambulance or the police may take a while. Just as I'd finally managed to get one arm out of a sleeve to check Bernie's blood pressure, he sat bolt upright, the look of bewilderment on his face complemented by the confusion in his voice.

"Where am I?"

"You're on the floor, sir, in NearBy St. Can you tell me your name?"

"Bernie".

"Hi Bernie. I'm Ben, and this is Shelly. We're from the Ambulance Service. What are you doing out and about at this time of night?"

"I've just been out for lunch. Now I'm going to meet Jerry. Where am I?"

And there, in one discombobulated sentence, the repeated question, the lack of time awareness, was our main problem. Was Bernie confused before the fall? Did he know where he was going when he left his house? Did he ever get there? Was it the fall itself that left its mark in the form of possible concussion? More importantly, did he fall, or did he collapse?

We tried to keep him still, but he kept threatening to get up off the floor and walk off. We compromised by Bernie agreeing to move as far as the back of the FRU. At least it was light, dry and warm in there.

The ambulance turned up, closely followed by the police, each to deal with one customer. We handed the once unconscious Bernie to a slightly disbelieving ambulance crew, and the once aggressive drunk, now sitting on the floor shouting at nobody in particular, over to the equally disbelieving police. I apologised to both for the call not being exactly as it had originally been described.

Bernie was moved into the ambulance, where the observations were repeated, the questions reinforced, but the confusion remained. The police had no reports of any missing person, Bernie couldn't remember where he lived, although he was adamant that he was going home, and the crew spent a while convincing him that hospital was the best option. At least for now.

At least until he doesn't have to wander the snow-covered streets in the middle of the night.

At least until we can find out more than the fact that his name is Bernie.

The Curse

The curse is well known. You can be busy as anything for days before, then on the day itself, nothing happens. Closely followed by something happening, but it'll be very mundane, dull, even boring. It is the Curse of the Observer. I've had many observers out with me over the past few years, some on a Vanbulance, and some on the Carbulance, but the vast majority have been the same. Cursed. Not every shift with an observer is so, but it does seem to be more often than not.

In fact, just as an illustration, I once had a very eager young lady join me for a shift. She worked for one of the big medical supplies companies, and had travelled from overseas, sent by her bosses, to see first hand how one of their new pieces of kit worked out on the front line. I was one of six people in London trialling it. She spent eight of the twelve hours of my shift hours with me and we did nothing. I mean nothing. We didn't see a single patient for the whole eight hours. Later that afternoon she had a flight to catch, so I dropped her off at a train station, and off she went. Moments later I was called to a hanging, and she missed exactly what it was she had come to see. I also had another few calls before the end of the shift, all of which requiring proper intervention. She missed them all. See what I mean? Cursed.

Having an observer has its positives too. It gives me the chance to learn from these people. Often they are medical students, nurses, or doctors. All cleverer than me, and will instantly fall into the trap of being asked a million questions about one of the many things I don't know or understand.

More importantly, however, is that it gives me the chance to show off. Not necessarily my skills per se, but to show off the world of Prehospital Emergency Medicine. To show how far the Ambulance Service has come in the last few years. To show how we are able to deal with situations that even the best doctor would find challenging. To show off what happens before the patient arrives in the hospital and is presented packaged, 4 foot high, and horizontal. And I love doing it.

Now, whereas I do my little bit in this promotion of EMS to the non-ambulance world, there are those out there who have gone above and beyond the call of duty, and have started a small revolution. This weekend coming, is the premiere of a production called the "Chronicles of EMS". What started as a trans-Atlantic, glorified shift swap between two of my fellow bloggers, 999Medic from England, and HappyMedic in San Francisco, has turned into a huge project that promises to try to change the Ambulance world forever. The initial idea of sharing and swapping thoughts and working practises between two people, has now got thousands involved through all sorts of media, social and otherwise.

The whole concept has taken off in ways that no-one had envisaged. It'll give us all a chance to pool ideas and ideals, to highlight what separates us and, more importantly what we share, and to make us all think about how we can go about improving what we do, as well as how we do it.

So as I go on entertaining observers and their curse, really and truly, I should count myself lucky. More than that. I'm not really cursed at all. In fact, I'm anything but.