Yesterday, while sitting on Standby (a concept I'll explain later in the week), I was reading the paper, listening to a bit of music when I heard a job go out on the radio that chilled my blood.

"Three children, suspended".

It turned out to be a fire at a house, well out of my area, where there were actually five casualties - going from what I overheard on the radio, an RRU was sent along with five ambulances and a doctor in a a car. Watching local news a little later it turns out that the three children are all in "critical, but stable" condition.

There is always a bit of radio chatter - and you listen to it with half an ear, if only because you are curious about what other people are getting up to - but the thought of three children being dead (and perhaps being the first person on the scene) soon brings what is going on over the radio into sharp focus.

Yesterday, I had ten jobs - and Control had a nasty habit of letting me roam untouched around the area for an hour, but as soon as I wanted to return to use the toilet, they would have me bouncing from job to job.

The first couple of jobs were in nursing homes, the usual story of patients who 'weren't eating', or 'have a cough' - patients, who, when I turned up, would not so much be knocking on death's door, but were instead halfway down death's hallway, hanging up their coat.*

Then came a couple of 'standard' chest pain patients, people with angina who, for whatever reason, were having cardiac chest pain. While this is a medical emergency, it's a medical emergency we are all very well practiced at and is one of our regular jobs.

As the day went on, the calls I went to got slightly more silly, the patient with diarrhea that I got given as a 'Chest Pain' (thus warranting a RRU response), another patient who had chest pain after vomiting for the past two days (obviously just an upset stomach and heartburn from the vomiting), and a man who had dark black stool and was worried that his bleeding ulcer had returned (even though he had just been put on iron tablets - the side effect of which is...you guessed it, black stools).

To be fair this last patient was very nice, very polite, and just hadn't been told that this could be a side effect of his new medication - once more the ambulance service was picking up the slack from the family doctors.

I did have a 'fire' call - someone who had been in the flat above a pan fire - everyone was unhurt, the Helicopter ambulance was cancelled before they managed to take off - and I was left feeling very glad that I didn't have to deal with - "Three children, suspended".

*Nicked from Alan Moore

As I mentioned I my last post, today I am without my mobile phone. It feels very strange.

I am so used to being able to get touch with people, and because my phone is a smartphone, I can pick up my emails while on the move. When using it's Bluetooth connection, I can connect my Pocket PC to the Internet pretty much anywhere. I can phone people up or text them, and should I find something interesting, I can take a picture of it. I can even update my blog using it.

But that little pouch on my belt is empty - and I feel disconnected.

We often have problems with mobile phones in the ambulance service - we often find ourselves trying to talk to a patient, while they are more intent on talking to their friend/mum/cousin/dealer on the phone.

I've had to pull people out of the way of incoming traffic because they are so focused on photographing the damage to their car with their mobile phone, that they neglect to realise that they are standing in the middle of a busy dual carriageway.

I've been trying to resuscitate dead patients when their mobile phone has rung - I look at the screen and see that the person trying to call them is "MUM".

I've been in the middle of what can best be described as a 'public order situation', and while trying to deal with the injured (and prevent any more injuries), half the crowd are on the phone telling their 'posse' to get to that location as quickly as they can.

I've even had a patient and a relative fistfighting in the back of my ambulance over an overheard phone call, made while the patient was pretending to be unconscious.

But I still miss my mobile.

I went out today - and saw an alcoholic, a COPD, a couple of heart failures, a handful of kids with chest infections and at least three anosias.

"But", I hear you shout, "yesterday you told us you would be working on Sunday, today is Saturday - so how could you see these patients?". The answer is fairly simple - I just went shopping.

The problem with being surrounded by patients for twelve hours a day (first as a nurse, then to a lesser extent as an EMT), is that your eye is automatically drawn toward people with obvious symptoms. It's not just your eye - a trained ear can hear the cough of a child with a chest infection, or the puff and wheeze of a chronic bronchitis.

I suspect doctors have the same problem, the constant inspection of clubbing in the fingers, the subliminal inspection of the eyes, and the unconscious appraisal of someone's gait.

In some part, it's because you are trained to look for what is wrong with people - but equally, there is that desire not to be around the person who is most likely to have a heart attack in front of you. At least when you aren't on duty. This is why, when the 80 year old female with ankles the size of tree trunks, and blue lips decides to hit the pavement, there won't be a medical professional to be seen for miles.

It's not that we are lazy, or that we have no heart for our fellow man when we aren't getting paid for it - just that without any of our 'kit', there is very little we can do to look busy, or effective. Without equipment, the options are CPR (if their heart has stopped), the recovery position (if they are unconscious) or a "there, there", with a bit of hand holding if it is a grazed knee.

Of course, the first thing to do is to call for an ambulance.

(The anosia patients are those teenage girls who think that the best way to attract a slack-jawed mate is to empty half a bottle of cheap perfume over their heads - do they not know what they smell like?)

In completely unrelated stuff: The "Hitchhikers Guide To The Galaxy" Internet only trailer is a thing of pure joy. And my mobile phone has taken one too many dives onto the unforgiving concrete - and so I will be getting a replacement (same model - gotta love phone insurance) tomorrow.

This is the second promised post for the day.

I've been asked to appear on tomorrows the BBC Five Live morning programme, presented by Victoria Derbyshire. Essentially it is for the same sort of thing that I went on radio Scotland for - to talk about being an 'unofficial employee blogger'.

My 'bit' will be on around 10AM.

Also appearing on the programme will be Richard Allen, a Liberal Democrat MP and Spokesman on Information Technology. He is also a visiting lecturer at the Oxford Internet Institute. I've read some of his blog, and it seems that, for a politician, he has his head screwed on correctly. I'm hoping he will be in the same studio as me, so I can have a chat to him afterwards.

I suspect that I'll be able to break out the old notes that I made - except that this time I'll do my best to remember what it is I actually do for a living.

I'll also try to mention "Free Mojtaba and Arash Day" which is tomorrow, and kind of puts the recent 'sackings due to blogging' incidents into context. There are thought to be at least 20 Iranian bloggers in prison at the moment.

I was hoping that the radio piece might be more about how mainstream media is starting to become frightened of the apparent power of the Blogosphere to hold what they publish to account. Given the recent resignation of Eason Jordan and the discovery by bloggers that 'Jeff Gannon', was a right wing stooge involved in gay Internet porn. Not that there is a problem with gay porn, just that the American right-wing are rather upset at homosexuality.

But it seems that this won't be the topic of discussion, which isn't a problem as if there is one thing I can talk about it's about bogging as an employee. It it based, if you couldn't guess on the recent Waterstones firing, (Who has since got a better job, possibly due to his blogging) and people like'Dooce' and Queen of the Sky.

Still no offers from daytime telly though...

UPDATE: The producer of the show saw this and emailied me to explain why the piece wasn't about how blogging affects mainstream media. Good reasons as well, although he did seem surprised that I blogged this within half an hour of talking on the phone to him.

This will be the first of two posts today, the later one will follow when I have more details on an upcoming project. Meanwhile this one is being written at insomnia o'clock.

I was supposed to be at work on Saturday, and I'm supposed to be on night shifts this week, but I'm afraid that I won't be able to do them - you see I am an injured little EMT for the moment.

But please, no need for sympathy, because it was all my own fault.

A couple of days ago, when I was working night-shifts, I got called to what would later turn out to be a homeless heroin user, who had pain in - guess it - his injection site. I mentioned this job in passing on last Tuesday's post. What I didn't tell you was that - while my ninja breaking and entering skills were useful in gaining access to the patient, I needed to replace the padlock. So I leaned over the gate, and it was either this, or the pair of scissors that I have in my shirt pocket but one of my ribs got broken.

So it's been painful - but I've broken ribs before (my famous 'diving on a bandage' experience, plus my 'wind up a drunk until he hits you' moment). So I'm pretty used to what happens - I get pain, I ignore pain, it gets better.

Unfortunately, on Friday I helped a crew carry a lump heavy patient down a couple of flights of stairs (not the patients fault, he wasn't fat so much, but instead just 'extra-large'). Well it appears that I put a bit too much strain on the rib - and it's now more painful than when I originally broke it. Now - this shouldn't be a problem on the RRU, as you seldom have to lift patients, but unfortunately the bags that you have to carry into the patient's homes are heavy. I don't know how much they weigh (perhaps that will be a project for a later date), but I think it will delay my healing.

Pain I can deal with (I just wince a bit, but act manly and ignore it, or dose myself up on painkillers), but doing stuff that will slow the healing process is not a wise thing to do. So I'm taking some time off sick. It's not something I enjoy doing, if only because I get bored at home, but in the long run I think it'll be the best thing for me to do.

I expect I'll get a phone call from work in the morning to ask what is wrong with me, and I'll tell them. Then I suppose they will ask if I filled out an 'adverse incident' form, which I didn't as it was my own silly fault. Then they might offer counselling - but they normally wait until you return to work for that.

It's a bad time to go sick, as we are desperate to get our ORCON times up to standard (ORCON is the percentage of emergency calls we get to within eight minutes - I may just have mentioned it previously...) So I am feeling a bit guilty, but if I have real troubles in just putting my seatbelt on, then I think I need a little time to recuperate.

The real shame is that I am going to be missing some night shifts - which are the ones I really enjoy.

Yesterday I had very little to do - the RRU tends to be a bit quiet during day shifts, as there are more ambulances to go around. This is a good thing, although you do need to be happy with your own company.

My shift starts at 06:30, so around 7am I left the station for a bit of a drive around, and spent 40 minutes parked outside Stratford bus garage in order to provide 'standby cover'.

Nothing - not a peep from anyone injured or ill.

I actually didn't see a patient until gone 11am, which was a 'Purple +', an elderly lady who had died sometime ago and had been discovered by her son. He was the sort of son who visited or phoned his mother everyday - so when she didn't answer the phone that morning he had rushed round to find her dead.

He was obviously upset, so I looked after him while the ambulance crew (who had gotten there just seconds before me) arranged the police/GP, and spoke to the son's wife - who can best be described as 'a rock'.

As soon as I became available I got sent to a 20 year old female who had collapsed at the other side of town - once more I was beaten by the ambulance by mere seconds, and the woman turned out to have had a simple faint brought on by not having a decent breakfast.

I then got sent from that job to an 80 year old collapse (typical, nothing for hours and then three jobs on the bounce), I managed to beat the ambulance to that job. The woman had been generally unwell for sometime with a chest infection, and I suspect that it had gotten a bit too much for her.

But like all women *cough*, she wouldn't do as I told her - and insisted on talking on the phone before the ambulance could take her away. I wanted to rule out a cardiac cause for her collapse, but she really wanted to do things her own way. She didn't end up in the resuscitation room, so I suspect my diagnosis may have been right.

I then had a bit of a pause before being sent to an 'unconscious' child - who, when I walked into the room, was sitting up looking very happy. He had been having a high temperature for the past 3 days...

The final job of the day was to a known epileptic who had had a fit at the bus station - not that this slowed down the commuters any - a couple of times while dealing with her, my response bag got kicked. It was a bit strange as, although I didn't recognise her face I was able to guess her surname.

So either I 'knew' her subconsciously from a previous visit, or my psychic powers are getting stronger.

At the end of the day - an easy shift, and one that I suspect will be typical of my new role.

At the moment, one of the more important stories in London is the visit by the IOC to see if London should hold the 2012 Olympics. Stratford will be the main site, which places it firmly in my 'turf'.

So the streets are alive with the banners, decorated buses and trains and the public debate in order to persuade the public to get behind the Olympic bid.

Which is why our ambulances have been stickered with this...



I'd like London to win the bid - besides being a bit of a giggle, it'd be nice to provide emergency cover for thousands of tourists, athletes and to have the whole 'terrorist' thing to worry about (because I doubt that the 'War on Terror' would be won by then).

That, and it'd be something to tell the non-existent grandchildren.

A little while ago it seemed that every other shift I would be working with HEMS. Either RTAs, people falling through their ceilings or babies getting scalded.

The Doctor on HEMS at the time was a very nice Doctor, and after one job which we transported to the Royal London by road - she offered us the opportunity to visit the HEMS flightdeck.

While I was up there, I took this jerky smartphone video of the helicopter and the surrounding view.

I don't often get the chance to take videos or pictures of the jobs I go on (it often doesn't seem right, and I'm normally a bit busy) but in this case it seemed like the right thing to do. As you can see, the view is lovely - and were it not so overcast I imagine that on a quiet day you could get quite a suntan up there.

(If you are quick, you can just see the back of my old crewmates head as he disappears behind the helicopter).

So far the calls that I have gone to on the RRU have been the normal run-of-the-mill things that I go to when I'm working on an ambulance. I've had a couple of Diarrhoea & Vomiting (but then recently everyone has had at least a couple of Diarrhoea & Vomiting). I've had people who get confused between their abdomen and their chest - so I've been going to people with constipation who have described their pain as 'Chest pain', thus making it a high priority call. I've also been going to all manner of illness typified by 'difficulty in breathing', in which there is no difficulty at all, more like a blocked nose.

Add to this the normal 'hot children', and you can see I've been on fairly familiar ground.

There have been one or two jobs of interest - one was a gentleman who was having an Anterior Myocardial Infarction (heart attack) while he was sitting in front of me. Thankfully the ambulance was pretty close behind me, so I had just enough time to get a history and start giving some oxygen before they turned up. They did a 12 lead ECG on the back of the ambulance and this confirmed the MI.

I went to a job the night before last that was a nightmare in an organisational way, still at least it wasn't a medical emergency.

I got sent to 124 Berry Road (not the real address) for a 'Severe difficulty in breathing', but when I turned up there was another RRU outside the address knocking on the door. I checked with the other RRU, and he was having trouble getting anyone to open the door - but didn't need my help, so I started to head back to the station.

Then I got a call on the phone that the patient had given the wrong address, and was in fact at number 128, so I headed back to make sure the other RRU knew.

As I pulled up outside the new address a woman came out of number 130, and beckoned me inside - thinking that there was still a communication failure I entered, and looked for the other RRU.

Except he wasn't there - he was in number 128 with his patient, and I had stumbled across a completely different case. This patient had stomach pains and diarrhoea.

Eventually everyone who needed an ambulance got one - but it just goes to show how confusing it is when neighbours call ambulances independently of each other at 3am in the morning.

Neither of the patients actually warranted an ambulance, but neither drove, and they didn't think to call a minicab

I've also been climbing over 7ft gates to get to heroin users who had painful injection sites.

I love my job.

I now have three days off before beginning a set of four day shifts (06:30 ? 18:30). I shall be spending part of it in "World of Warcraft".

European servers, 'Earthen Ring' Realm, with a character rather imaginatively called 'Reynolds'.