Who Needs Help The Most….?

January 28, 2007

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Nights yet again? Marvellous! Very busy as usual with last night, Saturday, being busiest so far on my run of three.

Most jobs were of a medical nature and easily sorted out with referrals to G.P.s or a quick trip down to A/E for X ray exclusion of fractures. The latter part of the shift seems to fill up with the drink related jobs around 2 in the morning.

I,ll just run by quickly on 2 jobs that stand out for me which reflect the different ends of the spectrum in this profession of ours:

Called to a 99 year old lady who had fallen at home. She lives on her own, is fiercely independent but is very grateful for our assistance in helping her back onto her bed. This lady is becoming increasingly prone to falls and as such she is getting an invite to the next Ambulance staff night out as I think most crews have been to her. 

 We picked her up and sorted out her room where she lives her life, happy and content with her lot. But this time she was in tears and said that perhaps this was the time for her to move into a home. We could see that it was a monumental effort for this proud woman to come to this conclusion that yes, she has done well to survive this long with minimal help, but now it was time to let others look after her. A very nice lady who will, I hope, find a nice home to help her thrive once again.  

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Arriving at an address for a “haemorrhage…possibly dangerous body area” as we got out of the truck two police cars pulled up behind us. They asked us what address we were going to and we replied “number 123456, This Street”.It was the same address they were going to for reports of a “domestic” after a nights heavy drinking. (Thats a big surprise).

Any way I let the police lead on and knock on the door which was answered by a male in his twenties who said “please help my girlfriend“. We all marched in to find her on the floor covered in blood after putting her arm through a window. (She had done this accidentlly whilst trying to stop her boyfriend from breaking in after they had an argument).

I knew that this was bad….I had just got my new Hi-Viz jacket after waiting months for it to replace my old, battered, torn, faded, ripped one. As soon as I approached the female to ask about her wounds, like a moth attracted to a bright light, she grabbed my sleeves! I now had a yellow jacket with red arms!

We assessed her cuts and dressed her arms saying she needed a trip down to A/E for some stitches and to check for any underlying damage. After what seemed like a lifetime we got her onto the truck. Her boyfriend wanted to come with her, and since he had calmed down we said ok.

That calmness lasted about 1.5 seconds as he launched into “…you f##king slut…” 1.5 seconds later and I launched him out of the back of the truck. He was upset and proceeded to lay down under the back of the truck so we could not reverse and would have to run him over if we did,nt let him back in!

No way was this going to happen, I had washed off the truck earlier and did not want bits of him stuck to our nice shiny vehicle! Eventually we pushed him out of the way and took the female to A/E who shortly after arrival discharged herself and caught a taxi back to her boyfriend who she “loved”.What was the point? 


Day Off…….?

January 24, 2007

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Time for a Day Off I think…!!!

First day off in seven days! Started my Minor Injuries course at the local University last week, two days of admin and course overview and strategy. Although the second day was better with practical applications including examination and auscultation (listening with a stethoscope) of chest injuries.

Then I was straight back to work at the weekend on days. Nothing really out of the ordinary, normal run of the mill chest pains, falls, medical ailments. Did have two very severe “hyperventilating” jobs which took some sorting out but eventually all ended well. (Usually it is quite straight forward to sort out this type of job.)

Had the classic “male collapsed,unconscious”after he had been caught shoplifting. Arrived on scene and I could see that the male was pretending to be unco. (Certain things you learn in the job that you dont get taught in training school.) I tried the obvious pinch test, shouting in his ear and then proceeded to put the largest O/P airway into his mouth and throat. This confirmed my suspicions that he was feigning unconsciousness as he gagged it back out. (You still need to go through the process of assessing the patients level of consciousness and response to painful stimuli even if you know they are faking it!).

He still would not co-operate so we had no choice but to put him on the truck. A Police officer accompanied us to the A/E. There we rolled him onto a trolley where the Police officer handcuffed him to the rail just in case. I handed over to the nurse who tried to get him to wake up to no avail. Everybody knew that he was faking it!

Later on during the shift I asked the nurse if they had found out who the shoplifter was (he had no ID on him when we brought him in). She explained that he had remained totally still and unresponsive until the Police officer took the cuffs off where upon he leapt off the trolley and ran full pelt out of A/E down the road, over a fence, across the train tracks, into someones back garden and climbed up onto someones roof!!! Miraculous recovery!!!

Every day was busy, and the jobs seemed to blur into one and another! Very tired from getting up early in the mornings and was late off a couple of times due to late jobs coming in! Will be nice to have a long lay in!

Spent most of today, my day off, catching up on my “reflective practice” and sorting out course work. Tomorrow the gym! Nights at the weekend!…….cant wait!

Found this SWAB team video…..have a look.


Red Mist……

January 17, 2007

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Red Mist….Clouds the Judgement

We,ve all been to those jobs where someone kicks off, giving it loads with the verbals, arguing the toss, getting in our faces. And we,ve all, I hope, managed to check the “red mist”descending over our eyes before we say or do something that will probaly lose us our jobs.

Sometimes a firm voice or a witty retort to the loudmouth will be enough to calm the situation. I know that in the back of our minds we just want to punch their ******** lights out and stamp all over their necks!Dont we? But, professionals as we are, we take the abuse in the course of our duties and crack on. The yearning to “…hear the sickening, cracking, splintering of bone as Doc Martin/Magnum boot connects with the skull” must be put on the back burner while we sort the patient out.   

So long as these feelings are kept in check then everything is okay. But what about those times that we have had to subdue someone for our own, and the patients, safety. How far can we go? And someone somewhere must have put a sly dig into a loudmouth?

So long as we do the best for the patient and remain courteous and polite we should have no problems. It is a statement of our times that we are under camera surveillance most of the day/night. Estimates point to our been captured on CCTV/cameras on average 300 times a day!

Spare a thought for the Firefighter in Oregon, USA who did not check the red mist. They were called to a man complaining of a headache. He was in the foyer of an apartment block. One of the other residents took exception to the crew attending the patient and gobbed off time and again to the Firefighter Lieutenant who eventually lost it. I think personally the crew lost it and restrained the loudmouth unnecessarily but without causing any harm. What happened next was the turning point in the Lieutenants career. Click here.

The CCTV images are exceptional high quality, so be aware……check the red mist!


Third Watch…..

January 16, 2007

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Third Watch

I,m not one to usually sit at home and watch work related stuff but last year my attention had been drawn to a brilliant series from across the pond. Titled “Third Watch” (1500 hrs – 2300 hrs shift) it follows the day to day lives of the New York Paramedics, Police Officers and Firefighters of the 55rd precinct.

I first came across this whilst off work having snapped my Achilles tendon. It was on Channel 4 in the afternoons and soon became my highlight of televisual feasting. The only problem was that the episodes were sometimes aired out of sync. So I was very pleased to receive the DVD box-set from Mrs. Magic at Christmas.

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Its a bit like Casualty only better as it concentrates more on the Paramedic side rather than the hospital setting. The series shows all the interactions between the separate agencies and with the members of the public. It really does make The Bill look like the old Z Cars of yesteryear. Each episode builds on the preceding events and you watch the characters change their views, attitudes and lives due to the experiences they all encounter. There is a sense of realism in every episode and the set pieces are impressive just as the fires/explosions in Londons Burning were.  

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What I enjoyed about the first series (there have been 6) was the portrayal of the “newbies”, the new larkers, the fresh out of training school Paramedics, Police and Firefighters. It was interesting to see how they fared in their new positions and I could relate to a lot of what they went through. If you get the chance have a look at this series as I think its the “mutts nuts!” 

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New Yorks Finest…


Whats Your Poison….?

January 16, 2007

Everything in moderation….except Guinness.

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A woman in California has died recently from excessive intake of water.


Saturday Nights Alright For Fighting……

January 14, 2007

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I am writing this for the second time. I was almost finished and was in the process of adding a pic when……it all crashed! And the automatic save did not automatically save! So I have returned from having a nice cup of tea and a sit down!

Last nights foray into the Big City Centre started off slowly but built up to a crescendo by 0400hrs. I had checked the Foxtrot Oscar RRV for all the equipment it should carry. Defib/monitor, drugs bag, trauma bag, resus O2 bag, entonox etc. I then picked up the Police officer from the main Police station in the city. “K” was to be my crewmate for the shift from 2000hrs. till 0400hrs. It was “K”s first full shift on the Foxtrot Oscar vehicle. It is becoming more and more popular with the Police and the waiting list to go on it is growing week by week.

Our first job was to a man lying in the street. On arrival scene we were met by a Police Inspector and a PC who had come across this man whilst on foot patrol. It was quite obvious that he was NFA (no fixed abode) and was sleeping rough. He had propped himself up against an air vent which was pushing out warm air from the residential building down this side street. The Inspector had contacted Police comms to ask for our attendance as he was not sure if this man was injured. This is the beauty of working the Foxtrot Oscar system, the Police can ask for us direct and the Ambulance comms can also ask for us where a Police presence is required.

I asked the gent on the floor if he was okay? He said that he had bought some new boots and they had given him blisters…and he wanted to go to A/E! Knowing full well that some people living on the street have contracted “trench foot” due to the practice of wrapping their feet in plastic bags, I asked him to remove his footwear and socks…..hindsight is a wonderful thing! Yep…sure enough, nasty looking blisters but not nasty enough to warrant a trip to A/E. The main problem for us now was that we were now being gassed by the noxious fumes emanating from his ends of his legs! His feet were black with grime and the smell of his cheese encrusted, sweat soaked, swamp gas, putrid skin was made worse by the warm air wafting from the air vent over him!!! Luckily the Inspector found him a place in a Hostel and he was taken there. 

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Another job was to a “pseudo-fitter” in a pub. She was young girl who pretends to fit and kicks off at everybody within hitting distance. Apparently she suffers from ADHD ( what used to be called being a nuisance or naughty). She was also well known to the Police as “K” recognised her straight away. Mum turned up and eventually calmed her down and took her home. Police comms were still reading out her ASBO conditions 10 minutes later as we headed back into the City Centre! 

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Most of the rest of the shifts jobs were assault related (due to drink obviously). One was to a young lad with a split nose and lip and redesigned shirt. He had smacked a bouncer (sorry door supervisor operative) and was then surprised to get smacked back…but harder! Other assaults involved broken noses of various shapes and sizes and bumps, bruises, cuts, grazes, nicks and a fair bit of spillage of “claret”. Most fights were due to misunderstandings….ie, misunderstanding that the lads you have just gobbed off to are much more sober than you and therefore can land better punches than you! 

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All in all, we attended 15 incidents and managed to deal with 13 without having to tie up an ambulance. This also works for the police as they can get someone quickly on scene to check out an injured person before arresting them rather than having to send an officer with them to the hospital. There are plans for the scheme to be expanded.    


Foxtrot Oscar 1…

January 13, 2007

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Just fine tuning my uniform for tonights shift on Foxtrot Oscar 1, our combined Paramedic/Police response car.

My boots are getting a good polishing to bring up a lovely sheen on the toecaps so as to provide a good target for anyone who wishes to vomit on them! My Hi-Viz jacket is getting a good checking over…zips: okay, epaulettes: okay, reflective markings: okay, two sleeves: okay. Hope they are still there at the end of the shift!

Will let you know how it goes with the Big City public and what they got up to. I do love a Saturday night shift!


I Hate Night Shifts…!!!!!!!!!

January 12, 2007

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Our vehicle data terminal exploding due to over use…!

Nearly finished my last set of four nights! Less than half an hour to go!

I am creased! I am knackered beyond belief! I am exhausted! I am twitching!

12 jobs in one shift! So far! On a night shift on a Thursday!

What is wrong with everybody? Has control been ringing people up to ask them if they want an ambulance because I,m on duty?

When I first started on A/E many moons ago, if you did three jobs on a night shift then you was said to have been busy. Now it is getting ridiculous! 

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My Sanctury Soon…..


Alone in the Crowd…

January 11, 2007

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We were called to a Cat A red call “Severe Respiratory Distress”for a gentleman in his late 60s. Arriving on scene I waited for my colleague to get the O2 resus bag off the truck and then I locked up. Our address was in the centre of Big City in a renovated block of Victorian tenement buildings originally built as a barracks in the middle of the 19th. C.

It was blowing a gale and the temperature had dropped a few degrees since yesterday making the air almost freeze on our breath. After what seemed like an age we gained entry through the controlled access main doors. Our patient resided on the ground floor almost next to the entrance. A party was going on next door with sounds of laughter and music coming from within.

On entering the gentlemans flat we were first confronted by the stale smell of alcohol and the familiar aroma of self neglect. The gentleman was sat on the edge of his bed and breathing very fast trying to take in air and talk to us at the same time. After a few words of encouragement we managed to slow his respirations down. No need for the O2.

It was plainly evident that he was a alcoholic as littered all around us were empty bottles of whiskey and other sources of alcohol dependence. (I dont think he was collecting them to put “ships in a bottle.”)He was emaciated and looked worse for wear. My colleague asked him questions about how he felt, had he any pains, did he suffer from anything, what meds did he take etc. He had no family left. 

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I asked him…”does your heating not work?” to which he replied that it did but he was afraid of the fuel bill! It was more cold in his flat than outside! We located the thermostat and turned his heating on. (Better to be warm and dead than cold and dead.) A quick look around and we could see that he was not coping and needed help. All the while he was telling my colleague about what he was going through. He seemed like a once proud man who had been taken over by alcohol.

His obs were acceptable…O2 sats 95%, B.P. 142/90, pulse 100, resps 24 per minute and his blood sugars were 6.5.He seemed to be anxious and shaking saying he had been like this for 11 days since stopping drinking the whiskey. Alcohol withdrawal can manifest itself in many ways…one way in which we were soon to discover.

Up until now he had been orientated and articulate in his responses and offered rational explanations for his predicament. He was obviously a social case and did not need to go to A/E. I noted the state of his bedroom…like a scene from Miss Havishams house in Great expectations, only this time the cobwebs were replaced by dried blood on the walls and wardrobes! This was due to the many falls he had recently whilst under the influence. 

We attempted to contact the “Falls Team”who would be able to assess our patient and put in place a package of care. That was the theory…unfortunately we had rung outside of the allotted hours of their response. I did not want to leave an answer phone message which may or may not be picked up the next day! The next option was to arrange for a out of hours GP Doctor to call that night and hopefully arrange a direct admission to an elderly ward. (it sometimes works!) I passed on all the relevant details to the call handler and awaited for the Doctor to ring back…and waited……and waited……….and waited………..and waited!

Our patient seemed happy enough with the arrangements we were trying to put in place for him. (On reflection it would have been easier to have chucked him on the truck and dump him in A/E but that would not have been fair on anyone). Whilst chatting to our gentleman he turned around and called for “Maureen” to back him up on his answers to our questions!

“Who are you talking to Albert?” We knew that there was no one else in the flat. “I,m talking to Maureen, shes marvellous…” he said looking towards the back of his bedroom. I thought about this and asked him if he had “Life-Line” installed* saying that it was a brilliant system for people on their own. He agreed with a nod of his head.

Suddenly he piped up…”I cant sleep at night either!” Due to the coldness of his flat I was not surprised! He continued “…they come in the middle of the night and wake me up, making all kinds of noises!” I asked who it is that wakes him up?  “Its his friends!” pointing to no-one at the other end of his bedroom. “He had about twenty people behind the wardrobe and on top of it….all of them having sex!” He then went on to explain in puzzlement that “I dont understand it….those wardrobes are flush against the wall!”

My colleague and I looked at each other, then looked at Albert. He was now becoming more and more animated and his breathing was coming in short gasps as he let fly into a tirade of abuse at his “friend”. We decided that perhaps the out of hours GP was now not an option. After calming Albert down we told him that it would be better for him to get a good nights sleep at the A/E. I re-contacted the GP and stood him down, not that I think he was in a hurry to attend anyway! 

We carried Albert out and past his neighbours with the party just starting to get into full flow.  We settled him comfortably on the truck and took him the 2 miles down the road to A/E. Handing over to the nurse I quickly explained our actions on scene and that we had brought him in as a last resort. She was not happy. But then she had not spent the last hour and a half in a filthy flat trying to get this once proud man the care that he desperately needs. 

I,m just glad that we did not leave him waiting for the GP to attend as I,m sure he might have fallen again or even have had another visit from his “friends”or he may even have started up on the whiskey again. It just never ceases to amaze me that when people like Albert need help the most, the appropriate agencies only work day light hours Monday to Friday. Everything falls back onto A/E.

I hope Albert got some sleep! 

* Life-Line…an alarm system linked to a regional control centre that can be contacted by pulling a cord or pressing a button.  


Strike a Light…!!!

January 11, 2007

Oxygen and Fire are a dangerous mix…thank God for stupid people!

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Daftest job of the day…called to a not too elderly woman on 24 hour oxygen at home. She was sat in her armchair with her oxygen mask on set at 2 litres to help with her chronic respiratory condition.

The lady thought it would be a good idea to have a cigarette…whilst still on the oxygen!

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Result…one explosion leading to facial burns and burns to the two fingers holding what was left of the cigarette!

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She wont be doing that again…! She survived albeit with a new tan!

 


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