I really need to sort out the template of this page so that when a post doesn't have a title it doesn't write "Untitled" in big letters at the top of the post.

What happened today - the full story...

I got a call to a house on an estate in Bow to a 60 year old female diabetic with 'low blood sugar'. No problem I thought, I got there quickly and was happy to see that the flat was on the ground floor. I thought that I won't need my cardiac monitor/defibrillator so I went to leave it in the car, but that was when I heard someone wail. I've written about this wail before, it's the sort of thing you hear when someone is dead...

I grabbed the defibrillator and ran into the house. I was led to a bedroom where I found a very unwell looking Bangladeshi woman, the first thing I did was to check her pulse, as on first impressions, she looked dead. She had a pulse, which pleased me a lot...

Oxygen was given and I checked her blood sugar level, and it was 2.2, which is dangerously low. We have an injection that will raise a patients blood sugar. So I gave that, and within ten minutes she was coming around, the ambulance crew then gave her some sugar and the last I saw of her was her walking out to the ambulance.

What a bunch of heroes...

So, I then wanted to turn the car around to leave the estate, so I drove into a parking space that is guarded by a pole that is folded up when the space is empty. As I went to reverse out of the space I heard a horrible grinding noise and the engine cut out. There was then a strong smell of petrol - So I thought something may have gone wrong with the car.

This pole had lept up catching against the underside of the car, and I later found out that it had torn the fuel line. I think it has some valve in the fuel tank that stops it emptying the whole tank, which is rather handy, or I'd have been swimming my way out.

I was then low-loaded away to Waterloo, because the car is originally one of theirs, when I filled out a ream of paperwork, and stroked the station cat. I then had a Station officer from Newham pick me up to take me back to my station (I caught him singing "Life in a Northern Town" by the Dream Academy, and the "Just One Cornetto" songs on the way back)

When I got back to West Ham the fitters had a spare car, but they wanted to make sure it was safe to drive (they had just gotten it back from a service or something). But then a couple of ambulances turned up which were broken, and they didn't have a chance to check it out - so I sat on station, had a cup of tea and finished reading my book (and very good it is too).

It is a source of amusement, when driving into work that you find the Rapid Response Unit you are going to be working on speeding past you on the way to a call. What it means is that there is definitely time for a cup of tea before the night shift gets back for me to take over - this means a slightly more relaxed, yet awake, EMT will be serving the people of Newham today.

It also means that I can read some blogs, write this post, catch up on some work bulletins and generally start feeling a bit more humaan.

I'm also happy for the bloke working the nightshift, he likes to get back to station late - as it's a bit more overtime.

Throughout the day, in an attempt to be as geeky as possible, I shall be telling you exactly how far I have travelled and the average speed that I drive at to get to jobs (answer:as fast as possible, but you may be surprised at how slow that speed actually is).

Today I was sent on a course to learn “Conflict Management”.  As part of their responsibility under health and safety legislation ‘Da Firm’ has decided that we all need to be trained in personal safety.

I was quite happy, as it is an eight hour day, and I was taken off a twelve hour shift in order to attend this course.  I have been to four of these courses in the last 10 years or so, so I wasn’t expecting any surprises.

The actual location of the course was in ‘Partnership house’ which is a Christian building opposite Central Control at Waterloo.  It was bloody freezing there as well, and the coffee they supplied was completely undrinkable…

…Luckily I had a can of Red Bull in my bag.

The course was run by a free-lancer for Maybo, he was ex-army, and ex-police, and a very good tutor – although I was a bit surprised when one of the first things that he said was that “This course is copyright Maybo”, it just seemed like a strange thing to say.

As expected, it was the usual mix of talking about how to assess and defuse potentially hazardous situations, coupled with some physical skills of how to escape from people trying to grab you.  When I first did a course like this, many, many years ago the skills were all rather more ‘hard’ and involved pushing people away – this current course was a lot more ‘soft’, which is more useful because the people who tend to grab us are ‘little old ladies’, so punching them in the face is vaguely discouraged.

Quite a fun little day, and I learnt a few new tricks that’ll come in handy when I’m wrestling people to the ground…

Tomorrow, I shall be trying to blog every hour in some strange attempt to mix “Extreme Blogging” with the episodic format of Television’s “24”.  This will either be fun, or really tedious.  There will even be pictures.

Sometimes patients can be awkward buggers, all their signs and symptoms point to one thing, and it is only a bit later, with a bit more investigation that you find out what is actually wrong with them.

Today was a case in point, I got called to a 40 year old male who had been suffering from chest pain for the past two hours.  I turned up and started my examination of him.  He had fallen down the stairs the day before, his chest was painful when I pushed on it, and he had no symptoms leading me to believe that the problem was anything to do with his heart.  I immediately thought that the pain was muscular in nature, rather than a more serious cardiac problem.

The only thing was that his pulse felt ‘funny’, a strange little ‘thrumming’ sensation that was a little like a double heartbeat.  So I thought that if I hooked him up to my cardiac monitor I’d have a better idea what was going on – but the leads on the monitor weren’t working, so I would have to wait until the ambulance turned up.

It was a little embarrassing because the patient and his wife were both doctors (probably working in research)  Both were happy with their treatment and the ambulance soon turned up.  The patient was connected to their monitor and we found out that he was in SVT which is a rythmn problem with the heart, causing it to beat too quickly.

So the actual ‘Chest Pain’ was probably related to the fall, being either a bruise or a muscle strain.  While the patient’s real problem was hidden from a cursory examination.  It is only because we have the capability to electrically examine the heart that the patient was sped into hospital rather than taken in normally.

I’m wondering if the fall somehow caused the arrythmia, it’s probably not outside the realms of possibility.

Knowing what the patients problem was also meant that the ambulance crew didn’t look embarrassed after handing the patient over to the nurses at the hospital.

Tomorrow I have a special learning day – learning how to ‘maintain personal safety’, how to defuse aggressive situations and how to escape from grapples and the like…

Then on Wednesday, I have a plan for something a little bit special – that will either be fun, or really tedious.

I've just come from a job where the ambulance crew who responded called me 'Mr Blog' - they wondered if I'd write about the job we were at.

18 year old male, normally fit and healthy, with a dry cough for one day. Location? 400 yards from the hospital.

Erm...and that's it - Cue a phone call to 999, one RRU, one ambulance and all the work/paperwork that any attendance to A&E requires.

Before that I went to a patient who gave their complaint as 'Chest pain', and sat there talking to me, rubbing their ample belly, which had been hurting them for the past week. I'm sure some people think their chest is the two inches around their belly-button.

I've mentioned before how some addresses are 'flagged' as dangerous, when a crew goes to an address and gets punched, kicked, spat at or otherwise abused they return to station, fill in a form and that address is then flagged.

We will still go to these addresses, but the police will normally be called first, we then wait around the corner until the police turn up and we go to the patient together.

The police have a similar system, but it's much wider in scope, and we don't have access to it because we are an 'essential' and not an 'emergency' service.

When an address shows up as 'flagged' the crew are informed that they should wait for the police to turn up...

...So why then, did I turn up to a flagged address, have a chat with the patient, and then, a couple of minutes later, I opened the door to the police and the ambulance crew? Could it possibly be because no-one told me it was a flagged address?

I heard the crew being told that the address was flagged, and that they shouldn't approach, but as I didn't know what call they were going on I couldn't have known that it also should have applied to me. The FRU desk which handles my jobs should have told me about the address and given me the same advice, but that didn't happen.

At the end of the day, I was alright (the patient is well known to me, if only because he is a neighbour of mine) - but when I called the FRU desk to ask why I wasn't told about the dangerous address the best answer I got was a 'Sorry about that- are you alright?'.

I know it gets busy up in Control (especially last night - everyone was busy), I also know that communication between the Sector desks (who control the ambulances in the area) and the FRU desk (who coordinate the RRU's across the whole of London) is often not brilliant - but this is the sort of thing that could lead to really bad things happening...

...bad things happening to me.

One of my regular readers is someone from an Ambulance Control, she left the following in my comments section about why we on the road tend not to see too many hoax calls.

We do get a fair number of hoax calls in control. Most of them can be spotted a mile off, however, and consist of someone under the age of 16 requesting police, fire and ambulance for some unfeasible event. They usually hang up when you read them back the address they are calling from, or, if they are in a call box (which they usually are) tell them to "look up at the 'security camera' in the box so I can see your face" or "the doors of the phone box will now lock automatically - the police are on their way to catch you for making NAUGHTY HOAX CALLS". Obviously, you have to be 100% sure that it is a hoax before you do this, otherwise someone will die and then you will get the sack.

I also spend a fair deal of time when working on the dispatch desks calling back suspected hoaxes from call boxes until a member of the public answers and confirms there are no dying individuals lying around that we ought to be attending to.

One or two do slip through the net, though. There was an almighty ruckus when some really "funny" people decided to tell us that someone had fallen down the stairs and then given birth to her sixth baby on the spot. A whole fleet of ambulances and midwives turned up to find a bunch of sniggering teenagers on the doorstep and no sign of any woman or baby. They didn't even have the sense to give a false address. One of the midwives rang up and shouted at me for half an hour.

So, thanks to the folks up in Control around the country for dealing with the obvious hoax calls

I think this will make up for the moan I'm going to post about Control in a little while.

I could hardly believe it, the first job of my shift was to the 45+ Stone patient who was my last job on my last shift.

It only took 45 minutes to get him out of his flat this time, which just goes to prove that practice does indeed make perfect.

I promised answers to some of the questions asked in my comments area, so here goes...

Do you deal with a lot of hoax calls personally?

In my own personal experience, I have found that hoax calls tend to be fairly rare these days. The youths these days tend not to make hoax calls - instead they set objects on fire and wait for the Fire Service to turn up. Just a few nights ago, the target of these pyromaniacs was my block of flats. One of our crews was on the way to a job, and as they passed my flats saw flames leaping out of a window. One of the refuse chutes had been set on fire, along with a couple of waste bins.

So, no. We don't get many hoax calls, we just get people causing trouble.

When people are having epileptic fits, is there any medicine you can give them

Paramedics carry Diazepam in rectal and intravenous forms, which can be used to bring people out of fits. Unfortunately EMTs are not permitted to carry or administer these drugs - in my eyes I think it would make a lot of sense for us to carry these drugs, as seizures can be a life-threatening condition.

Do you have to do any paperwork after a job

Yes, I do, I have to fill in a 'Patient Report Form', which contains the patient's details, what is wrong with them, their 'vital signs', the times that I get to the job, and finish the job, how far I have travelled and space to 'code out' the patients problem.
I also have a 'Running' form, where I fill in the times to the job (again), the miles I've done (again), Where I went to (again) and the serial number of the patient report form.
Then there is a special RRU form, where I fill in the times (yet again), the mileage (yet again), where the job was (yet again) and do some maths to work out if I got to the job in less than eight minutes.
Luckily I don't have to fill in HIPAA forms or anything like that - but it does seem that most of the time I'm filling in paperwork rather than actually seeing patients.

What do you give for a heart attack

In London we give Asprin, which reduces the mortality of a heart attack by 25%, and GTN (nitroglycerine) which 'opens up' blood vessels, hopefully allowing more blood to got to the heart so that the damage done by the heart attack is minimised. In some parts of the country ambulance paramedics can give anti-thrombolytic drugs. These 'clot busters' break up the blood clot causing the heart attack - but because of the risks of serious side effects and the nearness of hospitals we don't yet have these drugs in London.

You didn't like 'Constantine', what was the last film you liked?

I went to see 'Robots' last night and thoroughly enjoyed it. Laughed out loud at the fart jokes, the Britney Spears pastiche and the ever funny Robin Williams. There are lots of interesting films coming out in the next couple of months, so I'm considering getting a Season ticket.


I think that's all the questions, many apologies if I've missed yours. If you want to ask me anything then please do feel free to leave a comment, or drop me an email.