When I'm at a 'job'. I don't panic, it's part of my job description to keep control of a situation and to stop other people from running around screaming like a headless chickens. Sometimes I will have to be forceful, or act quickly, but I never panic.

I got a job, '14 month child, floppy and lifeless'.

"Fuck", I thought.

It was in a part of my patch I'm not very familiar with, new buildings on the isle of dogs. The address was given as 'Flat 1, Rose house, Starling road'.

This is obviously not the address I was given, I do respect patient confidentiality after all

I rushed to Starling road, a new estate, loads of buildings, none of which seemed to be marked.

"Fuck", I thought.

If a child is floppy or lifeless, then the chances are it is either very ill, or is dead.

I sped up and down the road. I spotted some of the names of the flats in tiny writing, on little blue plaques many of them pointing away from the road. My pulse started to rise. It had taken me four minutes to reach the area, but how much longer would it take me to locate the potentially very sick child?

I found 'Lilac House', 'Lily House' and 'Tulip House', but I couldn't find 'Rose House'.

Now I was starting to panic. Was I being stupid? Had I driven past it? Was the baby dead, and if it was, was it because I couldn't find the fucking house?

I could feel the sweat soaking my back, without being able to get to the patient there was nothing I could do. I cursed the council, the builders, the architects, everyone who had thought that putting pretty, but bloody useless signs on the buildings was a good idea.

I got Control to ring the parents back, the mother came out to meet me. 'Rose House' was behind another block of flats, behind a road barrier. The name plaque had text around an inch high, pointing away from the road.

Luckily the baby only had a runny nose.

I hated it though, the utter feeling of helplessness that comes with being unable to find a patient, the sweating, the raised pulse and the vaguely sick feeling in the bottom of the stomach as you race up and down a street in the dark trying to find the right location.

Please. If any architects, builders, council planners or sign writers read this, make the signs bigger. Make them so I can read them at night. Make them so that if it is your relative that is critically ill, I can find them before it's too late.



Only 3,960 jobs today...

4,200 calls last night compared to our more normal 3,600. Yes, we were busy, and in a surprising turn-about almost all of my jobs were genuine, 'I need an ambulance' type affairs.Between midnight and six am we had 1,000 calls.At least I have things to write about for the next 10 or twelve days...

It's the busiest night of the year for us, as evryone goes out and gets drunk at their work Christmas party. I don't know what's going on at the moment, but it's barely 21:00 and already we are at 3,500+ calls.

We normally do 3,500 calls in a day, so how many more will we squeeze in over the next three hours?

My first job was to and alcoholic having had a fit. A common symptom of being an alcoholic is having fits, I'd say that of the two types of fits that we go to, I tend to see more alcoholic fits, that epileptic fits. I don't have any numbers to prove it, but it just seems right in my experience.

This job was typical. I had to step over the detritus on the carpet, the packets of tobacco, the trainers, the half eaten takeaway container. I saw my patient sitting on a chair, being sick. He was vomiting directly onto the living room floor, his wife didn't see fit to put a bucket under the stream of vomit.

Lovely.

Like a lot of our regular alcoholic customers, he was topless, while his tracksuit bottoms were stained with...well I wouldn't like to guess, but they were stained with something. Homemade tattoos covered his chest, arms and hands, and inbetween bouts of vomiting he would continue making a roll-up cigarette.

"Can I turn the living room light on?", I asked the wife.

"Don't work", she said back to me in a voice that I guessed had been arguing with her husband just before I'd arrived.

I guessed this because she then started arguing with him again.

While the living room had a nice stereo, a reasonable televison (satellite included) and a gaming console, they didn't have a lightbulb.

He didn't want to go to hospital, but I always think of the potential headlines in the paper the next day "Ambulance leave patient to die", so the crew and I persuaded him to go to hospital for a 'check up'.

You know why? No one ever lost their job by taking a patient to hospital.

"I don't want to waste their time", he mumbled, "I'm just an alcoholic".

"It's alright mate", I'd reply, "We look after everyone, even alcoholics".

“Warning : Assailant may still be on scene, wait for police” had apparently flashed up on my computer screen.  Unfortunately it had done so silently, so the first I saw it I was pulling up outside the house.  Luckily, I was pulling up to the house which had the police car outside it.

I entered a house that was full of four generations of Bangladeshi people who were mainly shouting at each other and the two beleaguered police officers.  Quite rightly so I thought, as I looked at the fifteen your old boy i had been called to treat.  He had been hit around the head with a metal bar.  Thankfully his injuries were fairly minor, although there was a possibility that he had broken his elbow.

Unfortunately this was one of those nights where ambulances were a bit thin on the ground, so I was waiting for sometime.  At least this meant I was able to get the reasoning behind what had been happening.

There were two families, one with a daughter, the other had a son (my patient).  He had apparently offered her a place to sleep after she had been in an argument with her family.  This had then turned into a feud that had dragged on via school bullying.  The police had just told everyone present that they would be going around the other family’s house to arrest people when the father of this family turned up.

To say there was a lot of shouting would be an understatement.  There was also a procession of stern young men into the garden for a bit of a war council, mobile phones clamped to ears as they called in reinforcements.  The atmosphere was getting a trifle warm for my liking.

Luckily the police were able to calm the situation down somewhat, a bit tricky when the father was shouting about how he was going to burn the other family’s house down if they didn’t do anything.  Meanwhile large numbers of youths were appearing and disappearing into the night.  I thought that there was a real chance for things to turn nasty.

“Sir”, said one of the policemen, “I don’t wish to insult, or cause offence, but normally with this kind of trouble it is one cultural group against another, but in this case both parties are Bangladeshi.  Could you explain that to me?”

One of the calmer young men replied, “That’s how it used to be, now everyone is fighting everyone else, and race don’t matter”.

By now I had the real impression of angry villagers with pitchforks and flaming torches gathering, thankfully I was rescued by both police backup and an ambulance to take the injured party away to hospital.

“Control”, I called up on my radio, “Just to make you aware, if there is any assaults in this part of my patch, don’t let crews go in without police escort, because it might kick of big time”.

“Roger that EC50, I’ll make a note”.

I don’t think that there was any trouble that night, but it is a little hard to lynch someone if you’ve been arrested…

While we deal with a lot of crap jobs on a day to day basis, but when we are really needed I think we do a bloody good job.

One of the people injured in the London bombings is getting married this weekend.

The thing that gets me is this quote.

“As well as losing both feet in the bombing, Ms Hicks lost 75 per cent of her blood and her heart stopped twice on the way to the hospital.”

That means that an ambulance crew successfully resuscitated her twice, long enough to get her to hospital and that because of that unnamed crew, she is now alive and getting married.  It’s stories like that which makes me happy to do the work that I do, that sometimes we can make a difference.

(Via: Going Underground)

Did you know that the Meteorological Office offers ‘health forecasts’?  We got a memo from them (via our office) about a predicted increase in paediatric respiratory infections.

No kidding!  For two days all I attended were patients with chest infections.

Then on Friday all but two of my thirteen calls were faints, or epileptic fits.  I’m left wondering if it is something in the weather that caused that little spike.

Oh, I also attended three schools on Friday (one epileptic and two fainters), while normally I wouldn’t see that many schools in on month.

A strange day.

I’ve checked with my sources, and the story is true.

At Poplar ambulance station there is no room to park.  The station itself is tiny, barely bigger than a portacabin.  There is a big metal fence and electric gate around it.  There is minimal parking.

So the ambulances park out on the street – if they didn’t then every emergency call would be delayed by minutes as the crews wait for the gate to open and then maneuver the ambulances out.  This would be very bad for the patients (and more importantly, extremely bad for our ORCON times).

There is nowhere else to park.

So…a couple of days ago the ambulances all got parking tickets.

Apparently there is a man who lives in one of the nearby tower blocks who keeps complaining because his daughter nearly had an accident pulling out of the turning.

So a nice man from the council (or a parking warden) came around and put tickets on the ambulances.  In his defence he did try to not ticket them by telling the crews to drive around the block…

The ambulance crews find this all very amusing.

(We are, by our driving exemptions allowed to park where we like as long as it’s not ‘dangerous’, we are guessing that this man has complained so much the council has been spurred into action).

It was as if my prayers had been answered, a GP who today managed to balance the poor skills of yesterdays doctor.

I was sent to a 74 year old male with difficulty in breathing and chest pain. My computer display told me that the GP was going to remain with the patient.

I got there and was met by an apologetic GP who thought that the patient just had a chest infection, but while she was talking to him, the patient developed a possibly heart related pain. She had tried treating him herself, but thought that the best thing was for him to have some further tests in hospital.

My assessment and treatment of the patient went without a hitch, and I agreed that although I also thought the pain was as a consequence of his chest infection, it would be best for the patient to be assessed in the local A&E department.

As was the case yesterday the ambulance was 40+ minutes in arriving, so I had a bit of a chat with the GP (who was rather pretty...) and the patient (not so pretty). As there was nothing else the doctor could do with this patient, I let her leave the house to see her other patients.

A nice job, made easier by another health care professional.

Just how it should be.

I’ve had some good comments from the Morphine post, it’s very interesting to hear about the different dosages and protocols that various ambulance organisations use.

This post is one that I’ve been thinking about writing for at least a year, but I’ve always been a bit shy of writing it because it touches on possible racism.  Just remember, I hate everyone, not just one type of person.

Sickle Cell disease is a horrible illness, it results in massive pain, and due to the blood cells ‘clumping’ it can cause stroke, blindness, kidney failure, heart attacks and numerous other complications.  The pain these patients feel is unbelievable.

The thing is, most of these patients are black.

Here is the problem that I have.  There are a number of sufferers who are banned from certain emergency departments, there have been legal orders that say a patient should not got to a specific A&E when they get a crisis.  It’s normally because the patient has caused trouble while waiting to be treated, I was an A&E nurse in North London for long enough to realise that some Sickle Cell Disease patients aren’t saints, but…

In my personal experience, Sickle Cell Disease patients are the only patients who get banned from departments.  Drunks can be much more violent, yet they never seem to get banned.  ‘Frequent flyers’, patients who attend every day, use up more time and resources than those with Sickle Cell Disease, yet they never seem to get banned.  I’ve also personally witnessed nurses being hit, yet the patient still receives treatment, and isn’t banned.

Why I understand that Sickle Cell Disease patients can be demanding, they are in a huge amount of pain.  Some of them are indeed opioid addicts, but my thought on the matter is that it isn’t hurting me to give them painkillers, and that the stresses of withdrawal can cause a sickling crisis.  But it does seem that Sickle Cell Patients are being discriminated against.

This affects the ambulance service in the following way – we might pick up a patient 200 yards from the local hospital, he has chest pain, and is in a lot of general all-over pain.  If he is banned from that local hospital, we might have to travel miles to get him to a hospital that will accept him.  If he has a heart attack or stroke on the back of the ambulance, is it our fault for bypassing a nearby hospital?

These patients often have a ‘treatment protocol’ at their hospital – this states the type of pain relief that they get, and who should be contacted to continue their treatment.  These patients are often concerned that if they are not taken to their specialist centre (always miles away…) then the hospital that we do take them to won’t have their treatment protocol.

Also, will we be called more because we are now carrying morphine, and will maybe give it to patients, when their personalised treatment protocol states that they shouldn’t have morphine at all?

 In my opinion, Sickle Cell Disease patients are treated poorly in A&E departments, and I don’t think that it can be just that they are ‘demanding’ for their pain relief, or that they are personally ‘annoying’.  While a lot of these patients can be annoying, I think it’s only because they are treated poorly to start with.

Disclaimer: I used to work in an A&E department with a huge patient population of Sickle Cell Disease patients.

And don’t forget, it’s World Aids Day today.