It's getting so you have to tie things down now...

Yesterday a "Decontamination POD" truck was stolen, this is an unmarked truck that we use to carry around chemical incident equipment. The current word is that this truck was carrying a load of atropine - which is the treatment for nerve agents.

If people were to start injecting this into themselves, they could get serious (as in fatal) effects.

I leave it as an exercise for the reader to decide if this is a good, or a bad thing...

I've just gotten on station for the start of my shift, only to find out that some scrote had broken into the station last night and nicked the video recorder and DVD player.

I mean, it's not like we are ever on station long enough to use them, but it's the principle of the matter.

These are the sort of people who we serve, these are the sort of people we are polite, professional and caring towards - and this is how we are repaid...

Now I'm on my favourite shift, picking up drunks on a Friday night. All I can say is if they know what is good for them, they had better not annoy me...

I know that the ambulance service is being used as a substitute GP service these days, but it really takes the biscuit sometimes. Take, for example, the job I was sent on last night. It came down to our ambulance as "Patient wants to kill his doctor".

I immediately called up Control on the radio and asked if we were being sent because they couldn't find the patient's GP? Although I was half joking, I wondered what good we could do for the patient.

Control got back to us, and let us know that they were indeed sending the police, and that we should wait until they turn up. However, when we arrived at the address we knew who the patient was - so we cancelled the police and sorted out the patients problem.

I mention this if only because, when I got back on station and read the local newspaper, I found a story about a coroners investigation into the death of a 55 year old female who had taken a fatal overdose of blood pressure medication. When Control asked if she was violent, they were told that yes, the patient was violent. The police were called and the crew waited at a rendezvous point for half an hour until the police turned up. By then it was too late, and the patient died.

Once more, the paper blames the ambulance crew, it doesn't blame the psychiatric services who discharged her a few weeks earlier after a failed suicide attempt. Nor does it blame the person who made the phone call that said that the patient was violent. Violence from the drunks, druggies and criminals doesn't worry me - the job that worries me, is the little old lady, who has become confused and is sitting in her living room with her husband's service revolver, or her favourite kitchen knife, desperate to stop the strange men in green from stealing her away in the night.

Instead, it blames the crew who, quite rightly, waited for the police. If one of the crew had been stabbed to death, it might be a more sympathetic headline. We are expected to go into people's houses, where we have been told that the patient is violent, where we could get assaulted or even killed - but as soon as we start thinking about our own safety, we are the ones to blame for anything that goes wrong with that patient.

As normal the ambulance service has investigated, but in a show of support for it's road staff, has stated that the policy of waiting for the police at a rendezvous point is the correct thing to do.

We aren't cowards, but we also aren't stupid/paid enough to wander into dangerous situations.

I came across this story on the BBC news website,

A Cambridge University student dialled 999 for an ambulance as she needed some painkillers, according to paramedics.
The 19-year-old student was said to have run out of her pain relief tablets which she needed for period pains.

East Anglian Ambulance Service said an emergency crew was called to the student's flat on Saturday afternoon.

The spokesman added: "It should be obvious to anyone that if you want some paracetamol, an emergency ambulance is not the place to get it from. For someone who is supposed to be intelligent you would think would have more common sense than to dial 999 for some pain relief".

The call came through at about 1640 BST from King's Parade, Cambridge, and sparked a full blue-light response from the ambulance service.

I was curious as to how this counts as national news, when it happens to us all the time. My first thoughts when I looked at the story was "So what?", but then I realised that although Ambulance Trusts keep trying media campaigns to cut down on inappropriate calls, most folks are still surprised by the reasons why we are called out.

This call is the sort of thing I get called to once or twice a day, multiply that by the 10 ambulances we have in our complex during the day and you get at least 10-20 "inappropriate calls".

Every day...

I was writing this post at work, so let me tell you about the calls that interrupted my writing,

1) Small child with a minor cut to the head, lives 200 yards from the A&E department.
2) Woman with painful teeth - for the past week.
3) Hoax call, a child phoned up from the Mosque and told us that someone had been stabbed.
4) A drunk who had fallen asleep on the bus, we woke him up and he wandered off on his own accord.
5) The one 'proper' job - an alcoholic who had a fit (related to his alcoholism).

Still, I suppose that it meant that I had an easy seven hour shift (the first of seven such shifts, so I'll be lucky if they are all like this one)

"I hope that table is strong..."

The stand-out job of yesterday was an epileptic man who had a fit and had hurt his neck. Normally this isn't a problem, but in this case it was a lot of hard work.

The patient weighed 18st, and had fallen face-down in a very narrow hallway, not only did he have epilepsy, but he also had a history of spinal cord injuries, and had a shunt inserted in his neck.. Because of his potential for a serious neck injury we couldn't just sit him up and walk him out - instead we would have to immobilise his neck and find some way to carry him out.

The narrowness of the hallway, and his positioning in it made it difficult to get past him - and where we would normally roll someone onto a scoop stretcher, in this case it was impossible. I hate having to step over a patient, it makes them feel really uncomfortable - but in this case we had no other option.

So we called for another crew to come and help us (did I mention that this job was outside our normal cover area?). After much scratching of heads and throwing out of suggestions we decided on a course of action.

We managed to slide a spinal board under him, then manhandle this (with the help of some of his friends) onto the kitchen table, which was thankfully very solid. We then strapped another board onto his back, essentially sandwiching him between the two boards before rolling him over, removing the first board, and securing him tightly. We now had the patient 'packaged' in a more normal manner.

We then had to lift him out of the house, by manhandling him over the banister of the stairs, out into the street, and finally onto our stretcher.

Did I mention that he kept going unconscious as he suffered one after another minor fit?

Or that he is allergic to the drug that we use to bring people out of fits?

Or that he warned us that sometimes, when he has fits he can get very agitated and violent, and that it would be a good idea if we tied his hands down?

At the hospital, I joked that I would never work with this crewmate again, because his presence was obviously a jinx. But we were just glad that we managed to get the patient out of the house without (a) paralysing him, and (b) without dropping him on his head.

One of the jobs that I both enjoy and hate is for a "collapse behind locked doors" - this is when a (normally elderly) patient hasn't answered the front door or the telephone, and is presumed to be in some trouble. What we often get is someone who has died during the night. Although I hate having people die, the one good thing about this type of job is that I get to use my size 12 boots to kick down a door.

There is a skill to kicking down a door - and I was taught by the best, a policeman. The police also have a huge ram that they can use when their boots aren't enough. These are very heavy, but also very fun to use

We got called to a house where the daughter could see her elderly mother laying on the floor - shouting through the door and banging on windows didn't get any response, so we assumed the worst. The daughter was (understandably) crying, so I had an attempt at kicking the door down.

Unfortunately for me, the woman had been burgled earlier in the year, and so had two locks, and a bolt holding the door shut - so it took a couple of minutes of prolonged (and eventually painful) kicking to get the door open. I managed to wake up all the neighbours, and it's always fun to be the centre of attention...

Finally the door gave up and we gained access, we were greeted by the elderly woman sitting on the floor smiling at us earlier in the morning she had fallen and couldn't get up. When we had tried banging on her windows she had been asleep, and it was only the repeated bashing of my foot against her door that had caused her to wake up.

This was a good job in a number of ways; the lady was happy and healthy - and just needed a hand to get up off of the floor, I got to kick in a door and get away with not causing any serious damage, and finally we looked like heroes to the two daughters of our patient - there were smiles all round and we left the job feeling that we had really been of some use today.

In an update to the great and wonderful new I.T. programme that is being implemented in our local hospital, I have an example into how the providers think...

...They are going to install a palm scanner on the door so the staff can book in and out. Of course, biometrics work wonderfully, and this is an obviously essential system to help patient care. Sarcastic? Moi?

During today's shift I had to pick a patient up at a local Nursing Home, and very nearly became one of those "Under Investigation". The GP had visited this patient, an 88 year old male with Dementia and Parkinson's disease, who had not been eating and drinking. The GP had left the patient in the care of the nursing home, and had arranged a 'non-urgent' ambulance.

A 'Non-Urgent' ambulance is the sort of job where you take a wheelchair bound patient into hospital for his out-patient eye check. There are no blue lights and sirens involved here...

My crewmate and I turned up to take this patient into the nearest hospital and found him in a collapsed state, extremely dehydrated and with a very faint pulse. I asked the staff what the patient was normally like and they looked at each other and shrugged. It seemed that no-one on that floor had any information about the patient, even though he was a long term patient. The staff didn't know his previous medical history, or even what regular medications he took. So I asked for the letter that would be accompanying the patient to the hospital, which is written by the GP. On it the GP had written the patients Blood Pressure as 100/60, which is a bit low - when I checked the blood pressure it was 80/60, a much more worrying result.

We transported him into hospital, where even the medical students, who have recently descended on A&E like over-enthusiastic teddy-bears, spotted that this man was seriously ill. I left the patient, and the escorting nurse in the tender mercies of the triage nurse and a trio of medical students who all agreed that he 'needed access'.

"Needs access" is a shorthand way of saying that the patient needs an intravenous cannulae so that drugs and, more importantly in this case, fluids can be given. In this case, although they were right, I suspect that their main motive may have been to get cannulation practise on an uncomplaining patient.

Perhaps if we had been a bit busier today, and the patient had died, I too would be 'under investigation' for not reaching the patient quickly enough - even though he was supposedly receiving care from a doctor and nursing staff...

Imagine, if you will, getting sent to a job where a 15 year old boy is threatening suicide. You turn up at the address and discover that it is a care home. Meeting with one of his carers she hands you a list of the boy's medications and it reads like a 'Who's who' of psychiatric drugs. You talk to the boy, and he seems calm, collected and very polite. He explains that he wants to jump out of a window and kill himself, and agrees that he would like to go to hospital. You take him into the paediatric department of a local hospital. As this does not feel like the normal "Teenager wants to kill themselves" you have a chat with the children's nurse and you ask them to let you know what happens to the patient. You leave, and continue with your shift. The next day you ask the children's nurse about the patient and she tells you - "The boy wanted to die because he wants to have sex with, and kill small children - and that he knows that it is wrong".

I hate paedophiles as much as any other member of society - but in front of me that day, I saw a victim.