Not only do we have young lads being stabbed in broad daylight (as blogged about earlier), but we are now having police targeted in drive-by shootings with automatic weapons. It's gotten so bad that the government is thinking about making the wearing of body armour compulsory outside the few places in London where this is already the case. This thought is also helped by the fact that the police officer shot was saved from more serious injury by her body armour.
The L.A.S has given us all body armour - which I have worn perhaps three times "in anger" but have worn on a couple of nightshifts just because it makes a nice body warmer. I can see our management making us wear our armour all the time, in one of those knee-jerk reactions that we all know and love from working for the N.H.S. It'd be a shame not only because they are heavy, uncomfortable and restrict your movement; but also because by trying to squeeze into it, I can see how much weight I've put on in the last few months.

Sorry folks, bit of a rant here...but I last slept 22 hours ago...

We got a call to a patient who was "Depressed - not moving", normally it's some teenager having a strop, but this time it was a little different. Basically the patient suffers from depression, was discharged from the local psychiatric unit three weeks ago and has recently had her dose of anti-depressants reduced. Yesterday she was crying all night, and tonight she was just sitting staring into space, refusing to make eye contact and not talking at all.
One of the things that we as an ambulance crew cannot do is physically remove someone to hospital if they don't want to go - that would be kidnapping and is frowned up by the law. This young girl wasn't going anywhere despite my best attempts to persuade her - she just wasn't communicating.
The solution would be simple - call the Community Psychiatric Nursing Team to come and assess her, and if needed arrange her compulsory removal to the psychiatric unit ( called a "Section" under the Mental Health Act). The problem? It was 11pm...
First off I phoned the psychiatric unit that she had received treatment under, after talking to two idiots who had trouble understanding plain English, I finally managed to get the number of the CPN team. Now the LAS is quite smart; when we want to arrange an outside agency we go through our control and all the telephone conversations are recorded...so if someone says they are going to attend they damn well better. I got onto Control, passed the details to them and waited for them to get back to us.

I'd just like to say that in eight years of medical experience I have never had a simple referral to a psychiatric service, they always seem to try shirking any form of work - by "forgetting" you or by being just plain obstructive. Maybe I'm just lucky and get the idiots every time.

Needless to say we waited...and waited...and waited...from 22:20 until 23:00 we waited; then at 23:02 Control got back to us. Apparently the CPN team all goes home at 23:00 and hadn't answered the phone until 23:00 on the dot. So they refused to visit the patient - the moral so far is if you are going to have a psychiatric breakdown in Newham - don't do it after 22:00.
So we switched to plan "B" which is to arrange the out-of-hours Social Worker to come and visit as they double as Psychiatric liaison. Again we went through Control and waited...and waited...and waited...Finally we heard back that the social worker would ring the family and would like to talk to me. (Outside agencies try this trick, as they know the patients phone isn't being recorded, and so can say whatever they want with any disagreement being my work against theirs) The social worker explained that she was very busy and so would prefer not to come to see the patient and have I tried the out-of-hours GP?
Back to Control I went and got them to try and contact the out-of-hours GP (A GP for those not in the UK is the patients "Family Doctor") Can you guess what we then did? We waited...and waited...and waited... Finally Control got back to us and informed us that the out-of-hours GP hadn't arrived for work yet and that when they did, they would have to see two other patients first.
All through this time the patients family were very understanding and were happy when I explained that the GP would call at some point in the night. All I could do was advise them to remove anything that the patient could use to hurt herself, and keep an eye on her - calling us back if they felt the need.

Total amount of time an Ambulance was tied up trying to get outside agencies to DO THEIR DAMN JOB - Two Hours and Nineteen Minutes. And not the worlds most satisfactory outcome.

As I mentioned to our Control - sometimes you feel very lonely out there on the mean streets of Newham.

Much fun and games last night, working out of Poplar. Not only did some German bloke graffiti on the back of one of the ambulances - but he also called the crew from a payphone and ran off, repeating it twice.
There are a lot of strange people out there...
MacMedic gives a rundown of what his shifts are like, so I thought I'd do the same, in honour of our brothers in foreign climes.

All these people called an ambulance by dialling "999".

(a) Fractured Wrist - Young lad at the Boat show.
(b) "Frequent Flyer" who has just been released from prison...We thought we'd got rid of him for good.
(c) 15 year old with a runny nose.
(d) Very minor R.T.A.
(e) Domestic Assault, with no actual injury, but police already on scene.
(f) "Facial Injury" which turned out to mean "Some bloke kicked my door".
(g) Assault with a cut hand, actually a decent injury with tendon involvement (which means surgery and physiotherapy).
(h) Varicose Vein that had burst, plenty of blood everywhere.
(i) 29 year old with chest pain, hyperventilating with very upset relatives.
(j) Overdose in a house filled with young men with short hair and tight t-shirts (ifyouknowwhatImean).
(k) R.T.A with a traffic light pole coming off the worse in a two car collision.
(l) 8 month pregnant "lady" who had fallen earlier that day.
and...
(m) A fitting 9 year old, only one of the parents spoke English, and so decided to stay at home and send the father who doesn't speak English with us, because "The hospital has interpreters..."

Now, out of these thirteen jobs, only five actually went to hospital...a prize if you can tell me (via the comments) which five went to hospital

Occasionally you get a job that makes you laugh, normally because the person who you are picking up is an idiot. We got called to a chip shop in one of the main roads in Newham, unfortunately there are about 20 chip shops on this road, but we managed to find it by looking for the shiny white police car parked outside. The call had been given as an "assault" which can mean anything from a slap on the face to a fatal stabbing.
In this instance it was a young lad, the spitting image of "Ali G", who was complaining that he had been hit on the nose, needless to say there wasn't a mark on him, and it turned out that he had been hit by his girlfriend. The police wanted to take statements, but he wasn't interested and when I tried to look at him he told me that I wasn't needed as "I'm St John's innit, and a security guard". This fella wouldn't scare a kid just out of Primary school, so I suspect he was telling a little bit of a lie. As he wasn't hurt and "refused aid" my crew-mate and I retreated to a safe distance to do our paperwork...
In the course of the night we found ourselves at the local hospital (dropping off some ill person or something) when who should walk in with another crew from my station, but our earlier "Ali G" lookalike. I asked him why he decided to call an ambulance when he'd already sent us packing, and it turned out that another woman had hit him...
...The prostitute he'd hired after his girlfriend had slapped him. Turns out she had hit him and then robbed him of his "bling", and he couldn't have put up much of a fight because he only had one scratch on him.

It's wallies like these we have to put up with...and call "sir"...

The 2001 Census has been used to show why I am so busy. According to National Statistic Online, Asians consider themselves to have the worst health with Bangladeshi men three times more likely to visit their GP than the "general population". Couple this with Newham having a 32.5% Asian population (compared to 4.6% nationwide); is it no wonder that we are run off our feet dealing with GP case-work. Couple this with the fact that Asians are 46-51% more likely to suffer from heart disease than the general population, and I can see why I never have time for a cup of tea on station.
Still, if I wanted a quiet life I'd work in Suffolk.

Although I often moan about the idiocy of other peoples driving when faced with a big white van with blue flashing lights on top; I am sometimes pleasantly surprised at the lengths some people will go to in order to get out of the way.  For example, yesterday we had people nearly grounding their cars on roundabouts and roadside verges, squeezing into parking spots I wouldn't be able to fit a mini cooper in and swearing at other drivers who wouldn't move out of the way.  I've had workmen stand in the middle of the road and stop traffic, lollypop ladies fence off crossings with their "lollypops" and van drivers who I have 'clipped' while squeezing past them wave me on and tell me, "don't worry about a little damage".

Yesterday we had all the above on one call (except hitting a van driver), it was like the Red sea parting before us.  It was a beautiful thing to behold; it left us in awe and wonder.

Shame we were going to two year old with a cough.

There are some people, who despite their personality, you dread working with; one of these people is Noddy (not his real name).  He is what is known in the trade as a "trauma magnet".  He's one of those people who will get the cardiac arrests, car crashes, shootings and stabbings; by contrast I am a "shit magnet", meaning I only seem to pick up people who don't need an ambulance.  Other than having to do some real work for a change I really enjoy working with him.

So I was working with him a little time ago and we got called to a suspended, basically this is someone who's heart isn't beating and they have stopped breathing.  It's one of those jobs that require us to work hard trying to save the punters life.  We got to the address and found relatives performing CPR on their gran.  You might have seen it on T.V as a "Cardiac Arrest".

(Let me correct a few ideas you might have about resuscitation.  First, it rarely works, "Casualty and E.R." have led people to believe that you often save people; I can count on the fingers of one hand the number of people who have survived an arrest and most of them arrested while I was watching them in hospital.  Secondly, it isn't pretty, when you arrest there is often vomit, faeces, urine and blood covering the patient and the area around them.  Finally, people never suspend where you can reach them, if there is an awkward hole, or they can find someway to collapse under a wardrobe they will do so).

This poor woman was covered in body fluids and was properly dead; there was no way we were going to save her.  One of our protocols says that we can recognise someone as beyond hope and not even commence a resuscitation attempt.  Unfortunately we couldn't do it this time as the relatives had been doing CPR (which is the right thing to do) and so we had to make an attempt.

Some crews would do a "Slow Blue" in such a case, but I'm not a big fan of such things, so Noddy and I got to work and tried to resus the patient for 30 minutes.  Our protocol goes on to say that if after attempting a resus for a specified time we can end it and recognise death; which is what we did.

However, in this time it seemed that the entire extended family had arrived and there were over 20 people in this little terrace house with much wailing and gnashing of teeth.  It's always hard to tell someone that their mother had died, but it has to be done, and if you can manage it well you can answer some of their questions and hopefully provide some healing for them.

The G.P was informed (as they get money for certifying deaths it's one of the things we can't do), as was the police (a formality in sudden deaths).  The family had called a priest and he was there before the police arrived, while the GP was going to "phone the family"; what he expected to be able to do over the phone confused me.  And we tided up and went on to another job.

Until two weeks later, when Noddy gets called to a chest pain.  He turns up and finds himself in the middle of a wake, surrounded by twenty familiar looking people.

Can you guess who the wake was for?

Funny old world.