Five jobs last night, none of which were particularly interesting - and none of which involved alcohol. I love Murphy's law for making these shifts particularly pleasant...

I offer this further bit of information with no bias, nor any particular message - but the Newham registry office has released the most popular names for babies in the area. For boys, the most popular name is Mohamed, while for girls, the most popular name is Fatima. As an aside, there are a lot of people who have the exceptionally original name of "Mohamed Mohamed", to which I always ask which is the first name, and which is their second name...

Three jobs that warrant a mention - the first was a 39 year old male with a racing heart-beat. We got to him and discovered that he was in SVT, so we "blued" him into hospital where four doctors were waiting to treat him. His heartbeat returned to normal after they treated him with Adenosine. Why four doctors? Well I suspect it is because, like dealing with hypoglycemic patients, you can make an immediate difference in someones condition - and the patient normally comes away impressed. Dealing with SVT's were my favourite type of job when I worked in hospital.

Another vaguely interesting job was to a 16 year old female who had fallen from a garden fence after arguing with her sister. Fairly minor injuries - but a friendly, appreciative family. The memorable thing is that they live on an estate that is spread out over a wide area (the sort of place that is a nightmare to navigate, because the house numbering scheme seems like it was designed by a madman). Roaming the streets was a gang of feral teenage girls who, to be fair, did help us find the address - but I wonder at the parents who let their young children run around at half ten at night.

Finally we had a job for a kid who lives at "The Residential Home For Children With Behavioural Difficulties", which is where feral children end up - and where they are allowed to stay up past 11pm watching music television, complain about the allergic reaction that their nicotine patch is giving them, and boss around the 'carers' who are supposed to be providing an example to live by, but are instead (I suspect) just looking forward to their next paycheck.

Bring back National Service I say...

This is why I'm not a manager - I am working seven days this week - and seven days next week...

I did manage to pick up two people who were drunk last night - one had a nosebleed, while the other was a 17 year old who had been fighting with 'friends' in the park at midnight, and had gotten kicked in the ribs. Lungs were both alright, although the way he was behaving you would have thought that he was about to drop dead.

Stand out job of the night was getting a 22 Stone, immobile woman, who was dizzy and vomited whenever her head moved, down some stairs and into hospital. This could have been a complete nightmare of a job, but is wasn't, if only because both the patient and her daughter were very pleasant people (and it helped that they had a stair-lift in the patient's home). It went a bit worse because the hospital was exceptionally busy, and we kept being pushed from pillar to post while they searched for a bed for her. It took us nearly two hours to do this one job.

We also went to a five year old who had a swollen top lip - probably because of a minor allergic reaction, not a real emergency (she'd had it for over an hour, and it wasn't getting any worse). What made the job memorable is that the rather large family, wanted to go to the Royal London hospital, and not the closest (by about 2 miles) hospital at Newham. I might have taken them to the Royal London if they hadn't been so rude about Newham... (by policy, we are supposed to take people to the nearest hospital, and can only take people to other hospitals "at our discretion") I took the mother, daughter and sister (who apologised for the behaviour of her brother) to Newham and within 20 seconds of arriving, were met by the rest of the family, who had driven up in two cars full of people. There was one patient and nine relatives (I counted nine, it might have gotten even more) most of which were 'angry young men'. They spent the next two hours dominating the Paediatric waiting area, and I was reminded of the Toronto hospital which only allows one 'support person'.

I apologised to the nurse at the hospital - but it's not my fault they all turned up...

So far the count is 10 Sober jobs, to 2 Drunk jobs.

As predicted, none of my patients were worse the wear for alcohol - I expect this trend to continue for the next five days.

I thought I was working seven days, but that is actually next week - I'm only working five days this week, plus a visit to the Old Bailey on Monday - my day off.

We did however have a delivery driver, who was allegedly robbed by having CS gas sprayed in his face. The police present asked me very politely if I wouldn't park my ambulance on their crime scene - I obliged because they were bigger than me. The patient didn't want to go to hospital, and after letting his eyes dry out we left him in the care of the police present. Medical tip, don't wet your eyes if you have been sprayed with CS gas, it will only make things worse - instead face into the wind and let your eyes dry out that way.

We also went to a five year old who was apparently having an asthma attack - when we got there the child was asleep and had nothing more severe than a runny nose. I had to put on my teaching hat because the mother didn't understood what asthma is, so I had to explain the difference between that and a runny nose.

We had a 73 year old lady who collapsed in a GP surgery and when the GP measured her blood pressure as 90/40 (rather low), he thought it would be a good idea to sit her in a chair, rather than lay her down. Luckily for him, she didn't faint again...

Our last job of the shift was to a 91 year old man, who had become unable to stand - the carers who helped his elderly wife look after him didn't know what to do, and refused to call out the GP despite the wifes request. The wife called the GP herself. The GP visited, took the patients blood pressure and told them that they should call an ambulance to get the patient into bed, and then they would arrange a hospital admission in the morning. As the GP is a locum doctor, I doubt that this would happen at all. This is disgraceful - the GP should have referred the patient at that time, rather than pass the patient onto the day doctor. As it was, we thought that it would be best to take him into hospital that night (which is what he wanted), so that they could try and find out why he was unable to walk.

Last week we went to a 70 year old female who had chronic leg ulcers and terrible eczema, her husband had called us because the district nurse, who is supposed to dress these types of wounds, hadn't visited in the last 10 weeks. The patient had have what appeared to be a stroke in the last two days, but the husband who called us "didn't want to bother anyone"... I was glad that we could take the patient into hospital, because it seems that this is the only way should could receive the care that she required.

I told the handover nurse about the lack of community care, and she has promised to do something about it - it's one of the few things that I miss from nursing - being able to shout at useless 'professional carers' over the phone. The situations that people find themselves in, where their final resort is to call for an ambulance, make me extremely angry, yet there is little I can do in this job to change that situation.

On Sunday we remembered those who fought in the various wars, and yet the best that we can do for the elders who lived through those times is to treat them like a problem and pass them on to someone else. Is it really so difficult to provide care for these people who have worked their whole life?

The cat is indeed, out of the bag. Ambulance personnel across the Complex know that I blog, they worked out my nom-de-plume (the only 'falsehood' on this site) mainly because of a picture or two of myself I have on the site. So far the response has been along the lines of "You want to take that picture down, you look like you've just escaped from the Day Hospital", and someone wrote a vaguely negative comment in my last post, to which a tonne of very nice people leapt to my defence.

I figured it would happen at some point - a few people knew about it a while ago, but kept it their little secret, so I have been prepared for this day. I've actually been prepared for it since I started posting about my ambulance work, so very little, if anything will change on this site.

I've added a little "these views are mine alone, not those of the LAS" to the intro over on the right of the page - it's always been implicit, but I thought it wouldn't hurt to make it explicit.

I've always maintained confidentiality, both of patients and of staff, trusts don't normally get that privilege because they need to be held accountable for the things they do. I've deleted one post that could have possibly identified a member of staff - it wasn't an important post, but I thought that it came too close to crossing the line that I have set myself.

I'm convinced that this blog shows the LAS, and the NHS in a generally good light - I do tend to fixate on the negative side of things, so I may try to be a bit more upbeat in the future in order to provide a bit of balance. This promise may be unlikely to be kept...

I don't think that "Da Firm" is going to try and make me stop blogging, if only because they tolerate the "Big White Taxi Service" website and forum, and I believe that there is some subtle use of that site and forum to understand exactly what the road-crews think of various issues. I have at least one very smart person who has volunteered to defend my blogging should management try to stop me. Although if they did try to stop me, I'd blog about it, and I think it would greatly increase my page hits...

I'm going to keep writing under the name Tom Reynolds, I'm kind of used to it, and people know me by that name anyway. Tom is my middle name and I prefer it to my actual forename. And my mum will hate me for saying that...

I fully expect to be called a wanker by some people in the service - but I would imagine that those would be the people who haven't actually read this site, and were just hearing rumours about it. That and I am fairly thick-skinned. My crew-mate knows about the site, although I don't think that he has read it himself, but he is supportive of my writing. I'll soon let you know if I get called into the office though...

For the next seven days, I am working shifts from 16:00 to midnight, and as an exercise I shall be keeping a tally of people who's illness or injury is caused by alcohol. On these shifts it is often half our calls that are related in some way to drink, and by publicly keeping count, I fully expect the universe to toy with me and make sure that none of my patients are drunk - so that I look like an idiot.

But I doubt it.

It looks like the first case of 'granny dumping' of the season. Every year, around this time, families will do their best to get their elderly relatives admitted to hospital. I've personally see quite a few cases of it. It isn't helped that, because no-one wants to get sued for sending someone home who isn't suitable to be discharged, people are sometimes admitted for 'social reasons'. This ties up hospital beds in acute wards because the patient has nowhere else to go.

It is a sad state of affairs - and in this case I would want to see the family prosecuted, if only because I think Oldchurch is an awful hospital...

I'm back at work, and it's 4am on a grotty Thursday morning. Our Control contacted us and told us that we had a job to go to, while she was telling us this the dispatcher kept apologising, so I knew it was going to be a rubbish job. We got a Category 'A' call to a man who is "Not alert, severe respiratory distress, unable to talk properly, intoxicated". So we race around to the bus garage that the call came from, to find three, very well looking people standing around talking.
Apparently our patient (who is as fit as a fiddle, and not even that drunk) managed to fall asleep at the bus station while waiting for his nightbus, and another man became concerned and called for an ambulance. Luckily for the caller, I was driving - and so I didn't ask him why the hell he told our control that the patient had severe difficulty in breathing, or why he thought that calling an ambulance was a good idea. The patient didn't want to go to hospital, and wondered if we could give him a lift home (his home is about six miles away) and when we said we couldn't take him home, the patient decided to wait for his bus , much to the surprise of the caller.

Once more, a bystander/good samaritan is confused and frightened by someone who is asleep - and that they believe that this warrants an ambulance, and then when we turn up they try to tell us that the person 'needs to be in hospital'. I would be mortified if anyone called an ambulance for me whenever I fell asleep on the train/bus/tube.

Can I also ask that if you phone an ambulance because you are having a baby - can you at least wait the 11 minutes it takes us to traipse across our area to reach you, before making your own way to hospital. This is especially true if it is five o'clock in the morning. Either wait for us, or make you own way to hospital without waking my crewmate up from his sleep on the sofa.

A week can be a long time, especially if you are working a week of late shifts starting at 6pm and finishing around 3am the next day starts to wear on your sanity a bit - and I have the scientific proof...

Take a look at last Tuesdays post, a jokey little post, followed on Wednesday by another rather upbeat posting. On Thursday (after only one shift), I'm moaning about the type of people who are calling me out for minor illness (and a moan about Christmas). Then on Friday I moan about being sent into dangerous situations, and I tell you that I want to hurt people if they annoy me. On Saturday I can't even be bothered to write a full post, and just tell you about even more stuff being stolen from the LAS.

Sunday, I can't be bothered to post at all.

And finally on Monday I have an excessively whiny post about, strangely enough, whiny people.

In 'real life', I had my 'decamp' interview yesterday, after a scant four hours sleep. It turns out that when I get moved from my current flat (nice flat, just surrounded by scrotes, drunks and drug addicts) I shall almost certainly end up with a much smaller property. If I were a teenager I'd post up some angsty bit of poetry - so be thankful I'm too old for that sort of stuff.

Today, I'm bleedin' knackered, and I feel like I need a revitalising break. This is rather good timing as I fly out to Canada tomorrow. Hopefully, when I get back I won't be quite so eager to stab people in their eyes with my pen because they live in a nicer flat than me, and quite obviously don't deserve it.

During this little break, I shall be doing my best to check my email , and I may even manage an update or two while I am away. But I wouldn't hold your breath, for I may just find myself very drunk and laying in a Toronto gutter. If you are in Toronto between then and Tuesday you can always phone me on +00447903257650

Back sometime on Tuesday...

Halloween is a funny time of year over here in Blighty. We celebrate it, but not in the same way that Americans do - we tend to show a scary movie (or Planet of the Apes), on telly, we have some drunken parties where women dress up like naughty witches, and men like Harry Potter, we even have a few kids running around setting fire to stuff (trick without the option of treat) and we also have stabbings and whiny people.

Last night, after talking to a few crews, I can report that our time was spent rushing between people who had very little wrong with them, but who insisted on rolling around on the floor, crying at the drop of a hat, and refusing to talk to the ambulance crews who just wanted to find out why they were acting like a dying swan. Seriously - if you, or someone else calls an ambulance, when the crew ask you a few questions in order to form a diagnosis, answer them. Rolling around on a bed trying your best to look like you have been stabbed up the arse with a hot poker is no way to behave when you have had a chest infection for the past week. Yes, you may have had the same "excruciating" abdominal pain for three days, but pretending you can't walk (when you are obviously not laying in pools of your own waste, and therefofe must had been visiting the toilet), and having put on make-up for the trip to the hospital, is not going to endear you to the ambulance crew, neither will you refusing to take the painkiller that we are trying to give you.

It doesn't help that they all lived in really nice areas, in really nice flats/houses, with no urine in the lifts, and must get paid much more than I do - while I (for the moment) live in a complete rat-hole, where people urinate in the corridors and burn their own flats to get moved somewhere else. I think it is safe to mention "Reynolds Law Of The Ability To Handle Pain", where the more expensive the house that I pick someone up from, the more whining I get from the patient, and the less sympathy I feel toward said patient.

Between attending to these people who would probably need three days bed-rest for a broken fingernail, we had a steady stream of stabbing/beating/serious RTAs. I went to a 19 year old whom someone had decided to "make stabby" on. He had been stabbed in the head, the chest and the abdomen. Luckily for him they were all fairly shallow wounds, but not wanting to poke down wound tracks in a grocers shop at night, we blued him into the local hospital anyway.

This seemed to be the pattern for the other crews on the complex, there was an RTA where the driver had a hole the size of a fist in the back of his leg, plus an open fracture of his Tib and Fib (lower leg-bones), there was a drunk bloke who looked like Quasimodo after being beaten, a couple more minor beatings, another stabbing, and a little old woman who was pouring blood from her back passage. All interspersed with the sort of people who you wanted to clump around the back of the head and tell them to buck up their ideas, and get over it.

So I suppose that in our own way, we do celebrate Halloween - by moaning and by trying to kill each other...