Narcan do…!!!

April 30, 2009


I recently attended a call to a ‘male unconscious, life status questionable?’  The location was close to the centre of Big City alongside a public footpath. On arriving scene we were shown to where two Police officers were standing near to some bushes. ‘He’s in there!‘ One of the officers pointed to the nearest large bush which hid from public view a ‘smackheads den’.

We carefully climbed through the bushes trying to avoid the discarded syringes that were lying around everywhere until we found our call. The male was on his back, eyes closed, skin looking a very pale colour with just a hint of dusky blue starting to appear around the mouth. It was easy to see that his resps were down…really down! He was breathing at about 4 times a minute (normal rate should be 16 – 20 for a young adult at rest).

His pupils were more pinpoint than a big bag of pin pointy things on national pin point day! It was safe to assume that he had ‘gone over’ or had o/d on heroin. I grabbed hold of his shoulders and give him a good ‘ragging’ which elicited a slight response. One of the amazing things about reversing a heroin overdose is the simplicity of certain techniques. We sometimes attend addicts who have overdosed and are soaking wet through their friends dumping them in the bath or shower.

Grabbing an overdose by the shoulders and pulling them upright throws the head back quite forcefully (obviously we would not do this if trauma was suspected). This has an effect on the baroceptors and nerves within the neck and sends a message to the respiratory centre in the brain to kick in again. This sometimes does not work and we go to plan B. Of which all will become clear.

Our patient managed to struggle to his feet with our help. As he did so I could see the needles he had been lying on and other debris such as the plastic shopping bags that had once held stolen items used to pay for their hit. Various empty cans of extra strength lager lay about. This was about four feet from the public footpath were kids played up and down on their bikes. Our patient was still under the influence but breathing properly although he kept drifting off.  

We were approximately a hundred metres from our truck. ‘Come on then matey, sit on our little chair…’  Our patient sat down on the floor instead, his head dropped onto his chest and his arms hung by his side. This is a common response to heroin overdose and usually does not present much of a problem…usually. Sometimes they can go back over and go into respiratory arrest. If we are there then we can sort it out. If they are on their own…there is every chance that they will have a very long sleep…forever!

‘Right, I’m off back to the truck to get the NARCAN’  (Powerful opioid antagonist that reverses overdoses and respiratory depression if administered at the right time). As soon as I had finished saying the sentence our patient sparked up and was on his feet like a shot. ‘NARCAN…no way! I don’t  want no NARCAN!’  Through half closed eyes and on unsteady feet he made his way off down the footpath. He made it about ten feet away when he stopped, dropped his head and started to buckle at the knees.

‘Look fella! I’ll give you a loading shot of NARCAN and then we can decide what to do with you!’ I said to him as I shook him awake again. ‘NARCAN…don’t want that stuff…do you know how much I paid for my hit?’And with that he was off again on his travels. For another ten feet. He stopped again…started to buckle at the knees again.  Turning to my crew mate I mention again about going back to the truck and getting the NARCAN. ‘No way I said…I’m off…don’t want NARCAN!’  Off he went again staggering down the footpath…for another ten feet!

This time I just say the word out loud ‘NARCAN’ It has the desired effect, he re-sparks up and walks away. Every ten feet or so he stops…and I shout out ‘NARCAN!’  This goes on for almost a hundred metres until he disappears around the corner. I have never known NARCAN to be so effective before, without even having to give it! I wish all our meds were that effective!  No doubt our paths will cross again and maybe we wont be able to help next time. (We double checked before leaving scene that he had not collapsed around the corner-a ‘friend’ came and took care of him.)   


Dead Mans Click…Completing the Circuit!!!

April 19, 2009


Slowly…silently…under the cover of darkness two dark figures approached the back of the house from the rear garden. Situated between two other properties the garden was unkempt, overgrown and strewn with discarded items of furniture. A piss stained mattress nestled against a door-less fridge. Various bits of wood, once part of a cabinet, lay scattered about a charred extinct bonfire. With carefully placed footsteps the figures arrived at the back wall of the two story house. Crouching, the nearest figure took out a small rolled up pouch from a large jacket pocket.

Taking out a small hand drill one of the the figures places the point of the drill bit into the upper right hand corner of the lower door panel. With a rapid twist of the handle the drill pierces the door panel. A narrow lenght of tube slightly smaller than the width of the drill bit is introduced quickly into the hole. Pushing on the end of the tube releases a fan of metal plates on the inside of the door. Pulling sharply back the plates spread against the inner door panel and with one concentrated tug the figure yanks out the panel. The noise is momentarily harsh, but quick. the figures are through the space where the panel once was.

Speed is now the order of the night. Both figures quickly dart through the kitchen door and into the hallway heading for the front room where their target is. Knowing full well that the noise from the back door panel will have alerted their quarry both figures burst into the living room bowling over the target as he was getting up to investigate.  A black gloved hand grabs the stunned target by the throat and drives him back onto the floor. Squeezing tightly around the Adams apple and pushing back hard the air is expelled from the back of his throat and no screams of protest come forth.

‘Still’…’Be very still’  The throat grabbing figure utters through the black cloth of his balaclava. Dezza, the occupant of the house, strained to release the grip from around his throat. It only got tighter and as his peripheral vision started to darken he struck out at his tormentor. Both fists were expertly caught by the second figure in black. Dezzas hands were dragged above his head and knelt on. Using strips of pre torn black masking tape on their sleeves the two figures expertly bound Dezzas wrists, legs and covered his mouth.  His designer trainers and Adidas socks were taken off.

‘Open your eyes Dezza…open them and see the last two people on this earth you will ever see!’ Dezzas eyes remained screwed shut. A swift dig to the solar plexus drove what breath was left from Dezzas lungs and out through his nostrils. His eyes opened wide in pain and terror. ‘Not nice is it Dezza…being on the receiving end?’ Both figures stared down at their prey through black balaclavas, only their eyes showing.  ‘Its time we had a talk…it wont take long…and then we’ll leave you…’

The room was suddenly plunged in darkness as the smaller figure in black turned the lights off. At the same time the light switch was smashed to expose the wiring. A sudden noise of trickling came from the area of the light switch. From a small water bottle the contents had been poured onto the laminate flooring. ‘Its done…need to get his fingers now!’ In the dim light a bottle was produced containing a silver liquid. Each one of Dezzas finger tips was dipped in the liquid which dried to a plasticine consistency.

‘We’ve been told a lot about you fella! Seems you’ve been a busy lad. From what we’ve been told you like smacking old ladies about, you don’t mind flogging drugs to school kids, you get paid a fair whack from local shopkeepers to stay away from them and you’re pretty handy with a baseball bat from behind.’ The grip around Dezzas throat returned. ‘I should just rip your throat out now…but I’m in a good mood…so be warned and leave the town, in fact leave the country fella!’  The menace in the voice of the black clad figure rang clearly around the dark room.

Tearing off the masking tape from Dezzas mouth produced a sharp intake of breath. ‘Don’t even think about calling out!’ the second figure whispers into his ear in an unmistakable female voice. ‘Or you will lose your voice box along with your bollocks!’  To impress the seriousness of the threat a boot was stamped down hard onto Dezzas groin. ‘Do yourself a favour and leave..or we’ll be back…but we might not be as friendly!’

The smaller figure in black moved to the hallway and opened the small cupboard beneath the stairs. Locating the gas pipe it was quickly loosened to release the distinctive odour into the house. A imperceptible hiss followed the figure back into the room. Moving back quickly and silently the smaller figure lands a heavy blow with her boot to Dezzas head. ‘Its done…!’ Both figures rise, leaving Dezza stunned. His bindings now undone he struggles to take in what has happened, what is happening!

Both black clad figures are through the back door and across the garden disappearing into the night.     

Dezza, now on his feet and shaking the blurriness from his head, makes his way across the room to the light switch. He does not notice the water on the floor as he reaches for the switch. As his right hand fingers,coated in mercury, touch the bare wires all Dezza sees is a blinding blue flash followed by a deafening explosion! His body is taken apart as the gas explosion disassembles the house.

‘Good job Dani!’  The figures in black are watching the night sky lit up by the fire. It was Dani’s first live mission and things had gone well. SWAB Team 6 melted into the night once again.


Health & Safety Gone Mad…!!!

April 19, 2009
'You've called us for what...!!!
‘You’ve called us for what…!!!

This must be spreading…

I was called recently to an address where the wife of an enthusiastic DIYer was unhappy at how her husband was using his circular saw! She thought he might have an accident! We really need to start charging people for these ridiculous calls instead of letting it became the norm.

The full story of the BBC over reacting to Health & Safety rules is found here…‘you couldn’t make it up!’

Ambulance…the Final Frontier…!!!

April 8, 2009


I came across this rather interesting article recently and thought it might amuse you.

Interesting ideas but bear in mind these are ‘concept’ vehicles which generate thinking in terms of artistic, engineering performance rather than practicality.

One thing that has not changed in my twenty years in the service…the crap suspension. Some years ago I recall a council paying out nearly a million pounds to develop  a ‘detector’ vehicle which would scan for bumps in the road surface. this would lead to road improvements before they got worse. To save money they could have asked any ambulance service in the country to lend them a vehicle. Our ambulances are guaranteed to find any minor bump the size of a matchstick and turn it into a speedbump!

Another misguided element to this report is the belief that we should be responding at light speed to emergencies. At the moment we are flying to absolute crap…and its getting worse! Imagine a state of the art vehicle rammed with high tech gear and highly trained Paramedics/Technicians belting it to an emergency (as with call connect we have to respond to every call as if it is life threatening before the controller has even elicited what is wong with the patient!) and rocking up at the address for a nosebleed/cut finger/cold as in sniffles/lonely/wanting the curtains drawn etc etc etc etc etc and even more etc.

I do like the idea of the ejector seat though…but it would depend entirely on control getting the right address!!!

For those unfortunate enough to have travelled in an ambulance do you have any recomendations?

Cat Shit One…Apocalypse Meow…!!!

April 2, 2009

Thought you might like this for a little light hearted change…!

I will be following these guys in the future to see how it pans out! And maybe SWAB Team 6 will learn some new stuff…!

Selfishness and/or Ignorance…!?!?!?

April 1, 2009


This report on a woman blocking in an Ambulance on an emergency call prompted me to relate some of the things I have personally had to endure. The gentleman in the report died of a heart attack whilst his neighbour blocked the ambulance in. She was fined £5oo!

In my job most of the time people do get out of our way and will make reasonable efforts to help us. But, and this is getting worse, more and more seem to be in their own little world where everybody else is not to be considered. I have to contend with idiots who will not pull over to let us past when on ‘Blues & Twos’ and with drunks who get in the way of us treating  patients who havebeen assaulted.

A Good Public Information Film

(Although I cant understand why the Paramedic is being treated by a Fireman and then put into a fire engine?)

I had the not so nice experience of being shouted at and sworn at by a taxi driver to get my ambulance out of the way whilst I and my crew mate were doing CPR on a patient in a house! Only when the taxi driver actually walked in to the house to continue his verbal attack on us did he realise what we were doing…and he still then walked off muttering and grumbling!!! 

We are now covered by the  ‘Emergency Workers Obstruction Act 2006’  which gives us some protection but until people start getting prosecuted and it gets made public we are still going to see an increase in this sort of behaviour. As I said earlier most of the time people are good…but it is noticeable that more and more are becoming less tolerant towards us. Is that as a result of the culture we are now living in? This country is becoming increasingly more and more angry and frustrated. This leads to more assaults on us…and sooner, rather than later, one of us will be killed!

But that will be okay…just so long as the taxi driver gets to his next job, or the woman gets to walk her dogs, or the car being driven by the businessman is not delayed, or the customer can get his newspaper whilst we continue CPR on the floor of the newsagents, or the middle aged man can reach over us and get his tin of beans off the shelf in the supermarket whilst again we are doing CPR on a patient!!!

Another Good Public Information film (we don’t see enough of them)

We need more patience from people but that has to be thrust into some peoples faces…just to make them take notice! By that I mean we need more prosecutions and more education. Just to reinforce the selfishness and ignorance of some people that we come across…I was actively resuscitating a baby in my arms trying to get past the crowd of people in the A/E department but was hindered by a couple who were complaining of having to wait so long to see a doctor! They could see me struggling to get past them whilst performing mouth to mouth and nose on the baby! Luckily another member of the public dragged them out of the way!

I would like to hear your thoughts and suggestions on how to deal with this and if you have come across this culture of selfishness yourself?