Size Matters….

December 7, 2006

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Suits you sir!

 On my third night shift….9 jobs so far and two hours of the shift left!

My Hi-Vis jacket (which I need when attending RTCs, building sites, industrial units and when its dark!) is falling apart. This is due to the normal wear & tear experienced by ambulance crews up and down the country…climbing through wrecked cars, reaching through broken windows/doors to gain entry, numerous washes to get rid of blood/vomit/mud/spit/shit, patients grabbing hold of you etc.).

With each new batch of uniform I always order the same size as previous believing that clothing firms use the same measuring devices. Not so! If I order a new Hi-Vis jacket in a medium it will come back saying medium but will really be an extra large! I,ve always maintained that our uniforms should be measured properly rather than “off the shelf”.

The only time this ever happened was years ago when the service got rid of the blue/white shirts with black clip-on ties, dark blue trousers and NATO woolly pulleys in favour of the then new “squad suits”. The new “Greens”. A couple of tailors (or so we were led to believe) came to HQ and everyone, over two days, turned up to be properly measured.

Weeks later we all received a box with our new “Green” kit. And hardly anything fitted! After a hell of a lot of returned kit, sometimes three or four times, it was revealed that the “tailors” were actually “ex. funeral directors”. And they were only used to measuring people laid down!

We are yet again in the process of changing our uniform! They must get it right this time but by the state of the Hi-Vis measurements I,m not holding my breath! The consensus of opinion is that we will be going for the National Green colour with gold markings. Please dont let anyone in management choose “day-glo” orange or “sky blue”!


Always Learning…

December 6, 2006

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Second night shift has been okay (ish) so far. I,m writing this at 6a.m. Its amazing what caffeine tablets and plenty of Red Bull can do!! If we get a late job I,ll punch someone!! But in a “conducive to patient care” kind of way!!

I,ve had time to catch up on some CPD stuff. (Continuing Professional Development). All the Paramedics in my service have been given nice new folders with all the advice and backup needed to start our portfolios.

I,ve been looking at a few things on the web. First time I,ve seen the ASA magazine. (Ambulance Service Association). Some good articles and links all in one place. So I,m now up to speed now on the Bradley Report on the future of U.K. Ambulance services. Also read up on the new 2007/08 JRCALC guidelines. (Joint Royal Colleges Ambulance Liasion Committee – our rules/reg/protocols for using drugs, treatments etc). Looked at a case study on Paediatric Entrapment in a RTC, and an article on the MIRG (Maritime Incident Response Group – to deal with off shore jobs on ships etc) something which I,m hoping to join.

Went to an RTC early on in the shift. Called to a two vehicle RTC with reports of one person trapped. We arrived on scene to find both cars on the grass central reservation. I made my way over to the most obviously damaged car where I could see the female driver sitting in the front. She was conscious and complaining of chest pain. I had noticed that the side impact airbag had deployed ( T bone crash).

Fortunately she was not trapped, so after a collar had been fitted we extricated her from the car using the longboard with the help of the fire brigade. Securely strapped and headblocked as a precaution we made a more thorough exam in the back of the ambulance. Apart from the chest pain, which was due more than likely to the seatbelt, she was uninjured.

She was taken to the A/E for a check up. The interesting part of the job was remembering what had been said at a training day on “Scene Safety and Patient Extrication” recently. Never put yourself between the patient and the steering wheel if the airbag has not deployed. I asked the fire brigade commander if they had a special device/cover that fits over the steering wheel to prevent it accidently going off. He said no they did,nt and he thought we would have one. (we dont even have a pillow on our vehicle so getting one of these pieces of kit is fantasy!).

About time we took RTC safety more seriously. When an airbag goes off it can push you, or a piece of equipment, straight into the patient. Not a good thing!

The chap below should have had an airbag in his jacket!

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Behind Locked Doors…

December 5, 2006

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 Well I,m back on nights again!! I,m slowly turning into a nocturnal beast especially tonight with it being a full moon! I,ve noticed more and more hair growing out of my ears and nose!!

Anyway its been a busy start to the shift, kicking off 5 minutes into checking the vehicle. First job was to a 14 year old girl who had taken a whole lot of tablets. She was giving it loads at her parents house and was not taking any notice of us.

That is until we pointed out the effects of taking the said tablets i.e. rotting the stomach lining, liver failure and a very slow and agonising death! She soon listened to us and changed her mind and came to hospital. She really believed that she would be alright in the morning!

She was one of 6 children and mum was expecting her 7th. shortly. I think mum and dad were finding it hard to cope with their eldest growing up and flexing her wings! They seemed like a decent enough family and I hope things work out for them.

Our next call was to a 39 year old female cardiac arrest. We arrived to be met by 3 police cars and the RRV! We were all too late unfortunately as she had passed away some time ago. She had not been seen for a few days and the police had to force entry using a jemmy’

The next job was to a woman with a nose bleed! With two cars on the drive! And with no loss of motor function! (for her legs or her cars). A quick check up and the form was signed with advice given.

After we cleared the last job we were tasked to do a transfer from A/E to another outlying hospital. During our journey to A/E we were stood down from the transfer and given an emergency….about fifty metres from where we were. No time for Blues & Twos, only enough time to press mobile and attend on the data terminal at  the same time.

The lady who had called us was stood outside the address still on her mobile as we walked upto her. She was impressed at our speed! I said that our new vehicles used different fuel developed by NASA and it was helping us enormously.

Anyway she had called us to help her aunt who had collapsed on the hallway floor behind her frontdoor. We could see her through the letter box at the far end of the hallway and she was face down and not moving much. She was 91 years old, quite deaf and virtually blind.

The door was locked but we could just make out the shape of a key in the lock through the frosted glass. So out came the old Maglite (big metal torch also known as a “pop group” when used for self defence i.e. “Take That!”). I managed to break the window nearest to the lock and carefully put my arm in and retrieved the key. When I tryed the key in the door it was,nt locked!

Ooops! I thought! (not really, I thought oh f*%$ing b%$$%*ks!). But to my relief I realised the occupant had locked the door with the Yale and a bolt and a safety chain! So after some careful rooting around we managed to undo all the locks, bolts and chains and gain entry. Fortunately the lady on the floor was uninjured and after we had got her comfortable in her chair the relatives took care of her.

Did a couple of chest pains too. Its amazing that years ago I would look upon a chest pains job as exciting but now I find them so run of the mill! Back at base now writing this and drinking tea and eating cakes!! Nice!


Sad Day….

December 4, 2006

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It is with great sadness that I heard today that two firefighters were killed at an explosion/fire in Sussex. Several of their colleagues are in hospital, two in a serious condition.

It brings it home at times like this that the job firefighters do, and ourselves, has inherant dangers but we still turn up for work and do our stuff. My sympathies and my heart goes out to the families of those killed and wish a quick recovery for those injured.


Doctor Who?….or Doctor Where?….

December 3, 2006

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Well the three day shifts I did lived upto (or down to) expectations, we were late off each day which, added to being late off on all my previous night shifts, has left me completely and utterly knacked!! And guess what? I,m back on nights tomorrow for 4 x 12 hour shifts!! Really looking forward to those…not!!

One of the things that amazes me within the medical profession is why dont Doctors stay on scene with their poorly patients and wait for us to arrive? We were sent to an 83 year old male who was unconscious and breathing, suffering recently from a UTI (urinary tract infection).

We arrived at the address (within 8 minutes so the great God ORCON will be pleased) and found the patient in bed and in a very serious state. His breathing was laboured and his blood pressure was in his boots (very low). Oxygen was given, he was monitored, cannulated and a call put into the A/E for resus to be put on standby.

All the while we were doing this and getting the patient ready for rapid transportation to the hospital, the staff at the Nursing Home told us that the G.P. had left 5 minutes prior to our arrival. Why? He could have assisted us in getting a more detailed history of his patient, the least he could have done seeing as he left without giving us any initial observations to go on. This patient was “proper poorly”.

The times that we are told “…doctor is on scene.” and we arrive to find that they have gone beggars belief. When a doctor has stayed on scene I have found them (in the majority of cases), to be very helpful and they are usually surprised as to how much we can do. I still believe that most of them think we are just ambulance drivers and thats all!

With this gentleman there was some confusion in the history and we kept being told that he had a UTI. It was written in his care plan and the antibiotics had been noted down. On listening to the patients chest with the old stethoscope it was obvious that he had a severe chest infection and URTI (upper respiratory tract infection.) A simple mistake in putting down his condition in his care plan when using abbreviations had occured.

We went on Blues & Twos to the A/E where the team were waiting. Turns out he had right sided pneumonia.


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