Saw It Coming…!

May 18, 2007

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Looking at a post on Trainee Paramedics site reminded me of a job that I attended some time ago. It was one of life’s mishaps that could befall any one of us…even the expert!

It was the first day for the twenty or so kids in the woodwork shop at the local junior high school. As with any activity involving sharp things, pointy things, cutty things and machinery things safety was of paramount importance.

To this end the woodwork teacher embarked on a series of health & safety lectures to instill in his young students the importance of concentration and adherence to strict procedures.

After covering the basics of tool care and displaying the sharpness of finely honed chisels he moved onto the machinery that can be found in any woodwork class in any school. Firstly the importance of using the correct tool/machine for the job was stressed.

Secondly the all important bright red safety stop buttons were pointed out. Thirdly he moved to the circular saw machine to demonstrate a simple example of good working practice. With the class gathered around watching patiently to see the master at work passing on his years of experience, he started up the machine.

With a low humming the great vertical disc of serrated steel whirred away waiting to slice through pieces of wood like a hot knife through butter. Placing a long strip of wood on the machine the woodwork teacher pushed towards the spinning teeth of the disc. The low humming was replaced by a high pitched grinding as the teeth bit into the wood.

As the piece of wood got towards the end the teacher used another block of wood to push it all the way through. Thus not risking his own fingers becoming a dessert for the ever hungry saw. This sequence was repeated several times to show the class the safe way to do it.

Then, in a momentary flash of inspiration to reinforce the learning, he went on to show them how not to do it. And this is where after teaching thousands of kids over many decades the craft of woodworking he had a momentary loss of concentration.

Dispensing with the block of wood he proceeded to push another plank towards the saw. As the saws teeth chewed up the plank he gingerly and deftly moved his fingers along the ever decreasing wood. Turning to his young charges, still pushing the plank through, he announced “I dont want anyone doing this!”

And with that the final few inches of plank sailed through the circular saws teeth…closely followed by his fingers! Blood spattered across the machine and he withdrew his hand looking at where the ends of his four fingers used to be!

The kids in his class were mightily impressed and thought initially that he had used some special effects props to demonstrate this lesson. Their opinion soon changed quickly. As quickly as the the colour of the teachers skin changed to a very pale white and beads of sweat ran down his forehead.

When I arrived on scene I retrieved his fingers while my crewmate dressed his hand. Putting the four digits in a bag and placing in a small container of ice, we shot off to the hospital putting in a pre-alert call. Unfortunately the fingers were too badly damaged to be reattached.

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Ooops!

One good thing came out of this…the kids in that class will never mess with a circular saw  


Ashes to Ashes…!!!

May 16, 2007

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Its dark, its wet and I,m cold! And I,m on nights…again! So hopefully it might not be busy. Most sensible people will stay in and watch the T.V. or read a book or just sleep. But if our last job is anything to go by, then perhaps it would be best if all our jobs were outdoors!

***cue BBC wibbly wobbly picture and strange atmospheric sound effects***

Having trekked halfway across the city we turn off the “Blues” as we pull up outside the address. Looking through the passenger window of the truck I can just make out the open front door through the raindrops that have collected on the glass. A light is on in the gloomy hallway and I can just about make out the shape of a person standing on the doorstep….waiting for us.

Diving quickly out of the vehicle and grabbing the resus bag we cross the wide grass verge, almost “Ninja like” trying to avoid the incessant rain we crouch vainly attempting to keep dry. It doesn’t work! We look like drowned rats! (So much for Ambulance Ninja School!)

“Hello!”… “did you call for an Ambulance?” The person on the doorstep nods and waves us into the house. It takes a couple of seconds to wipe the rain water from our eyes and faces, a couple more seconds for our eyes to get accustomed to the dim lighting ahead of us and more than a couple of seconds to see through the fog of cig smoke!

Walking into the living room was like walking through the doors on “Stars in Your Eyes” through all the smoke. Only on the other side there were no cameras or enthusiastic audience waiting to cheer us on. At the centre of the smoke storm was our patient sat upright in a leather chair. I quickly remembered what the job had flashed up on the vehicle data terminal…”Severe Respiratory Distress” Cat A code Red…

“Hello! Is it you we,ve come to see?” The reply from the chair is a splutter and a cough and something resembling a “Yes!”

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“Right, before we start can you put your cig out please so I can ask you a few questions?” The floor around the chair is covered in ash, all the ashtrays are full and the patients woolly jumper is starting its own collection of wildlife. I can see his eyes are bloodshot, the kind of red thats been diluted with alcohol and causes problems with focusing.

I get straight to the point…”How can we help? What is your main problem?” I know that he is having a little difficulty in breathing but this could be normal for him given the amount of ashtrays, rollup baccy and enough ash on him, the chair and the carpet to cover a small version of Pompei!

“I,ve got chest pain!”…”and I,m finding it hard to smoke!” Something tells me that we are not dealing with one of lifes great intellectuals! As the smoke drifts towards the open front door (thank God we left it open!) I begin to pick up the distinctive smell of stale alcohol. My nose directs me to the side of the chair where a large basket is full of empty Special Brew beer cans and on the other side a half empty/half full (depends on your outlook in life) bottle of whiskey. 

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“Do you suffer with anything to do with your heart? Have you had chest pains before? Are you on medication? Does the pain alter if you take a deep breath?”

I already have a good idea whats wrong as I listen to his chest wheezing and hear the phlegm rattling around the back of his upper airways. He is quite warm and clutches the left side of his chest directly below his armpit. At my feet I can see one, two, three, four different inhalers for asthma. They are almost covered by ash and the excess spillage of fag ends from one of the many ashtrays!

Making sure that nothing is going to jump off his jumper I place him on oxygen and soon he is breathing easier. A quick listen with the stethoscope to his chest indicates that he is probably suffering from a chest infection. We make the decision to take him in to A/E. He gestures to the old crone sat in the opposite armchair…”come on then lets go, make sure you bring my fags and baccy wont you?”  

Up until now I hav,nt paid much attention to the woman sat nearby. She seems old in her face, her posture, her clothes. A mass of tangled hair sits on top of her head. I don’t usually judge people by how they look but FFS she looks scary!!!

As we take our patient out the old crone turns off the fire, switches off the Sky satellite and unplugs the 42″ plasma telly. (I make a mental note to pack in my job, drink at least 10 cans of Special Brew and a bottle of whiskey a day, smoke at least 40-60 cigs a day then I too maybe able to get a 42″ plasma telly with Sky.)

Once we are on the truck and we are settled for the trip to A/E I ask more questions…and am astounded at the answer to his age. He is 39! He looks about 69! He then tells me his dad died from smoking and drinking too much! (No shit Sherlock!!!)

I think that perhaps he may be heading the same way…………..


“Taxi…!!!”

May 15, 2007

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One of my great irritations with my job is the abuse we get from people when it comes to Ambulance transport. And G.P.s need to take some of the blame.

There is an old fashioned term used within the medical profession since the discovery of the telephone…”off legs!” 

This term, on the face of it, should refer to someone who is unable to make use of their legs. Someone who is unable to propel themselves forward in a bi-ped manner. A person who, either through sickness, trauma or poor mobility in general, cannot walk.

Unfortunately “off legs!” can, and is, frequently applied to persons who can mobilise, who can walk, and who sometimes are fitter than the crew calling for them! 

“Off legs!” is usually mentioned to Ambulance control when a G.P. is arranging for a patient to be admitted to a hospital ward. Therefore the Ambulance dispatcher will assign a crew to the detail which is 99% of the time as an urgent. (Low priority detail not requiring “Blues & Twos”.)

Recently I seem to have been assigned to many such calls which takes away a crew and emergency vehicle. As I said earlier if the patient is truly “off legs!” then no problem. But when we are being used as taxi service then that grates.

Typical example…called to a lady “off legs!” numbness in both legs, unable to walk!

On arrival at the address we are greeted by the family who show us into the house where we find our patient…walking from room to room collecting her things to take into hospital with her! Her legs appear to be in fine working order, both facing the right way, moving in a coordinated manner, transferring her body through space by using equal footfall therefore enabling her to get from point A to point B in good time!

She has been waiting for us to take her to hospital for three and a half hours (remember these are urgent not emergency details). Her family have a car so I ask if they are following? Usually if they are I ask them to take the patient…just so long as I am satisfied that the patient will not need any kind of interventions or monitoring by us.

On this occasion the family said that they could not take her as they had to be at work in two hours time! They could have taken her at least two hours earlier but the G.P. insisted on calling us!

As an Ambulance service we should be looking at some kind of payment for these jobs either by the G.P. or the patients family for unneccessary transport. That might stem the tide of calls we receive to take people to hospital who could get there easily themselves.

It is some kind of law of physics that states that:

“…every person who is off legs will live in a house with at least two cars on the drive!”


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