As the clock strikes 12...

A post by a friend on facebook has started a discussion. Where have you been when the clock struck midnight on New Year's Eve? As members of the emergency services, of whichever variety, the options are endless, and have so far included a padded cell whilst covered in all manner of unpleasantness. Mine have ranged from being mid-resuscitation of a pedestrian hit by a drunk driver, to the far more sedate call of assisting an octogenarian off the floor just in time for him to celebrate with his traditional glass of sherry. 

So, as we head into the new year, and as many of you will be out there protecting and serving the public, let's start the party early: 

Where is the strangest, funniest, weirdest, scariest or any-other-est place that you have been as Cinderella turned back into a pumpkin after attending her New Year's Eve ball? Or something. 

To all of you, whether you're going out with friends or having a quiet time at home, whether partying or protecting, and especially if you happen to be able to manage both at once, stay safe and have a good one! 

The View from the Back Row of the Classroom

Over the past few weeks, I've gone back to school. I've been sitting in the classroom listening to lectures I've heard before, albeit in a different language, surrounded by a group of paramedic students who are just about ready to be unleashed on an unsuspecting but hopefully grateful public. The vast majority of the students are about to start their lives as combat medics which has made for some interesting scenarios, but one or two are heading for civilian roles. And then, there's me. I've sat at the back of the room that is fit to burst, writing bilingual, multi-directional notes, taken a few exams and hopefully come out the other side unscathed and ready for the front line once more. 

It's been a bit of a struggle to get my paramedic licence recognised and accepted here, and has involved two steps backwards of bureaucracy for every one step forward in actual physical achievement. It's been frustrating. I've been on the ambulances, but in a limited capacity. My paramedic skills have been safely tucked away until the piece of paper that I need is finally spat out of the machine, hopefully sometime very soon. 

I don't mind jumping through the relevant hoops. I don't mind sitting in classes I've heard before, because the reminders that they're providing are more than useful. It has been, however, somewhat disheartening that it has taken this long to make the progress that I'm finally making. 

Yet, as always, there is a silver lining to the cloud. Going back to school has given me the opportunity to see another generation of people who are already loving their chosen path. There are those who are looking far into their futures, planning to change the world, or at least their little part of it. There are those who are talking about being a part of something bigger, part of an EMS world that is looking to expand, to improve, to change, to evolve into something better than it already is. I've had the chance to introduce some of these students to forums, to various forms of social media, to blogs, to ideas, to people, at least virtually, who share their vision. 

(In the meantime, I have another day in the classroom tomorrow, and a rather daunting exam, the equivalent of the end of the paramedic course, on Tuesday. No public holiday here. So those of you celebrating Christmas, spare a thought and send some positive vibes just before you tuck into your turkey and mulled wine.)

From my seat at the back of the class, the future is looking good. Hopefully, once I've defeated the monster that is bureaucracy I'm embedded a little more in the system, I'll be able to be a part of that future. I might even tell them that I know the person who writes this blog... 

Rules for EMS

I have, unashamedly, stolen this list verbatim (with permission, I hasten to add). I haven't changed a word, or the order in which these rules appear, although I think that number 18 should be much nearer number 1, if not the top one itself. Rule number 38 I'd consider removing. Scene time is dictated by the scene, not by the rule book. Expediency is important; rushing, isn't. Many of these rules are not just for EMS, so even if you're looking in from the outside, take a moment. Oh, and I have no idea what the last one is trying to say. If someone wishes to enlighten me, feel free! 

(To my UK readers, this was obviously stolen from someone US-based. I haven't corrected fixed changed the spelling.) 

So, EMS providers, which would you remove, which would you change, and what would you add? I have also noticed that social media doesn't make any sort of appearance. That should probably change! 

And as potential patients (although I wish this on no-one), what would you do with this list. The floor, as they say in the classics, is yours! 

1. You are there to solve a problem, not cause one. 

2. The ABCs will save you every time.

3. The scene is not the venue for retraining. 

4. Interview the patient, not the clipboard.

5. The patient should not be the recipient of your problems.

6. Treat the patient to the best of your ability.

7. We are guests in their domain.
8. Look for reasons to transport, not turf.

9. Do not base treatments on lifestyles.

10. Expect no more from others than you can provide.

11. Handle the call you are on, not the one that might happen.

12. The acuity of the situation is due to the patient’s condition, not your anxiety.

13. We do not interrogate over the radio.

14. We do not yell at the family or patient; we explain the problem.

15. Being nice never hurt anyone or cost money.

16. Do not judge lifestyles.

17. A clean ambulance is a happy ambulance.

18. Obey your gut instinct.

19. Being nice does not indicate that you are weak or naïve.

20. Leave tunnel vision for the Amtrak folks.

21. 35 mph is good for patient care.

22. The closest hospital is not always true.

23. Document truthfully; you never know.

24. Know your equipment.

25. Continue to study; dormant minds make Jell-O look smart.

26. Show me what you know, don’t tell me.

27. Level of certification does not guarantee respect.

28. Talk to the patient first, then everyone else—when possible.

29. If nothing else, do the ABCs, treat the problem, use TLC, keep the patient warm, transport.

30. Trouble breathing equals lung sounds.

31. Regardless of whether you are a career or volunteer provider, you are there to do the “JOB.”

32. It takes less energy to be pleasant; anger festers for the whole shift.

33. Each call is a new one.

34. If they can take a tube, they needed one.

35. Be nice to yourself; you have to start somewhere.

36. Scene survey, ABCs, pick a game plan, make a decision.

37. Have people doing things.

38. Ten-minute scene times are a good thing.

39. Certification cards x patches = ????

Sandy Hook

Rivers of ink have raged, almost as the rivers of blood that flowed all too freely have now stilled. I don't know when is, or even if there is, a right time to wade in to a discussion on a tragedy as raw as that of Sandy Hook School, where those killed are only now being buried, where their families have not even begun to really grieve. Parents of children are being forced to come to terms with a reality that none of us should ever have to face. Families of adults who died protecting the innocent battle with conflicting emotions; pride in the bravery displayed by their loved ones fighting for space in amongst the utter sadness at their deaths. 

And in the midst of it all, the all-too-familiar rhetoric begins. Pro-gun versus anti-gun is too simplistic. It's like saying that there are those who wish to live in a constant state of war against an enemy and those who want peace with the very same. In reality, everyone wants peace. It's just a question of how to get to that state. Rhetoric alone will not answer the questions that will race around the minds of a nation, particularly a nation in mourning. 

I have only questions, no answers, but feel the need to raise them here, if only as an outlet. I struggle to understand why this happens. Why it happens in America. Why is it that I live in a country where guns are a part of the daily view, yet we have mercifully been spared the awful scenes that have now been shown all over the world. 

I am torn. Torn between believing that weapons should be available so that it is not only the criminals and terrorists who possess them, and believing that they should be almost impossible to come by. Several times in the past, terrorist incidents in Israel have been halted by a passer-by who happened to be there and happened to be armed. Right place, right time. On the other hand, the readily available weapons allow for easier access to those who would use them to harm the innocent. 

However, one cannot walk into a gun shop here and buy an assault rifle "off-the-rack." The number of civilians carrying weapons is actually surprisingly low. Assault rifles are seen in the streets, but they are carried either by members of the armed forces or by members of response teams in the more volatile parts of the land. They can't just be stored at home as yet another item on a list of fixtures and fittings. Licenses are hard to come by and are enforced by strict regulation.

Arguments will appear on every media outlet, on social media, in conversations between neighbours and friends. Both sides will voice their opinion, all too often based on that cyclical rhetoric, bandied about by populace and politician alike. Slogans don't solve the problem, they just accentuate and polarise it. They certainly do not reunite grieving families with those that they have lost. Falling back on rights is as helpful as quoting often irrelevant statistics. It is, however, clear that something has to change, probably on both sides of the great gun divide. 

I don't have the answers. I may not even be in a position to ask the questions. I do know one thing for sure. I never want to see these scenes again. Not as a parent, not as a news reader, and not as a paramedic. Not on my own doorstep, nor on anybody else's. 

Yet another community will have to rebuild itself, brick-by-brick, one family at a time, united in grief for now, but hopefully in strength in the future. And all the while, the answers must be found to prevent anyone else from facing yet another unspeakable tragedy.