I often moan about GP's that leave their patients, who are seriously ill, alone in their waiting rooms, or outside in the street haveing a cigarette. But until today I'd never been to a dentist (which might explain the state of my teeth *ho-ho*)

The patient was a 42 year old female who was 'shaking' on the dentist chair, I arrived and the patient was still in the chair, and was being given oxygen and reassurance from the dentist.

The patient had a long history of these episodes, and the dentist gave me a complete handover, including the social history of the patient, and while I was assessing the patient was still spending time reassuring her. The patient was not suffering from anything serious, but she agreed to go to the hospital for a quick check-up.

I must admit I was really impressed by this dentist for actually caring for their patient - and it is only as I sit writing this that I realise that I'm impressed at a healthcare professional that is actually doing their job.

Isn't that sad...

This didn't happen to me, but was overheard on the radio and related to me by someone who knows someone in Control (yes it's vague, but rest assured that it did actually happen).

A call came into Control that a young woman had a foot injury. It was prioritized and a there was no ambulance to immediately send, so it was put in the queue of low priority calls.

A short time later, a call came in asking where the ambulance was as the patient was actually a victim of a hanging.

An ambulance was immediately despatched and HEMS (Helicopter Medical Service) was also activated.

When the crew turned up, the patient wasn't hanging, but instead her foot had been run over by a pram. There was no obvious injury. The impression that has been given is that the caller lied to Control in order to get an ambulance quicker.

Actually, I know that they lied, but to say how I know this would potentially break confidentiality

And you wonder why I sometimes want to stab people in the eyes with a wooden stick...

I realise there is a difference between people who have no understanding of how serious their injury or illness is (and therefore get a higher priority than they would if a medical professional were examining them), but this is a pretty cynical attempt to get their pizza delivered trip to hospital quicker than someone who more genuinely requires an ambulance.

This act of bastardry could well have meant that someone who really needed an ambulance had to wait longer to get to hospital. This it turn potentially puts lives in danger. That is not counting how much it cost to activate the helicopter, or the cost if someone had been run over by the ambulance as it raced to the scene.

I know there are some folks from the police service who read this, so a quick question - Is it against the law to do this to the emergency services and if so would it be realistic to have the person charged? I understand you can be charged with "wasting police time", can this be translated to wasting any emergency services time? Once again, this shouldn't be directed to people who are just a bit dim, but towards those who are cynically manipulative of the system.

Or can we just take them round the corner and beat them up?

So there I was, pulling up to a job (male fitting in street), the ambulance was already there (having been dispatched from the same station as me, only two minutes earlier).

Then I heard a lound bang, and thought the bottom had dropped off the car - the crew on scene, and the police who were there all looked in my direction.

My front tyre had burst.

There I was stuck by the side of the road waiting for the tyre fitter to come and change my tyre. I may well have a spare tyre in the back of the car, but if I fit it, and it later falls off, then I'm to blame.

I returned to station to find a new wallpaper on the station computer...

"Brand new tyre required for Vauxhall Astra FRU, All enquiries to J2 station c/o Tom Reynolds".

I love my workmates...

Other jobs done today was a 70 year old male, found dead by his son at 7am. There was nothing that we could do except try and provide some support for his son. There have also been two people having seizures, I go to a lot of seizures on the car.

I also went to a woman who had returned from two months in India with a high temperature (and having not taken any anti-malaria medication). She had been there for the arranged marriage of her son, and was depressed because her son was not happy with the marriage. What can you say to her while you are waiting for the ambulance to turn up?

There was the usual "chest pain in a GP surgery", the GP was nowhere to be seen, and the patient (who was mainly suffering from difficulty in breathing) was laying nearly flat on an examination bed without any oxygen. So the noraml sort of GP job.

My last job (so far) was "Collapsed male, life status unconfirmed, caller cannot remain on scene", it was by one of our parks, so there was a high chance that is was a drunk. He was indeed drunk, and walked off when woken up.

Just another high pressure job in this dangerous city...

I get so many calls that are top priority because of "Difficulty in breathing" or "Altered breathing", and when I turn up there is nothing wrong with their breathing (except they are maybe crying, whimpering, or have a runny nose).

So I've just come from a chest pain job which was sent to me as "Normal breathing" - and when I turn up the patient is hyperventilating (breathing way too fast). The one time that someone really does have altered breathing and I'm the last to know...

I spent an hour calming her down and getting her breathing back to normal - I really should work on my hypnosis skills for relaxing people quickly.

One of the bugbears that each party is addressing for the upcoming election is the concept of HAI's or Hospital Acquired Infections. So far the politicians have been mainly concentrating on MRSA, but this is not the only thing that you can catch in hospital.

I've just come from a job where a 95 year old female, who had spent a week in hospital for a blood clot on the leg, was suffering from some difficulty in breathing.

The patient had been discharged from the local hospital yesterday, and during the night had developed laboured breathing, a cough and a feeling of tightness in the chest.

Upon examination it seemed that they pain wasn't related to any form of cardiac cause, the tightness was worse when she breathed in, she had a slight temperature, and coupled with the cough and no history of heart problems it seemed like a simple chest infection.

The patient and her daughter were happy with this provisional diagnosis, but were glad that she would be going to hospital for some more tests.

But then the daughter asked me where her mother could have caught her chest infection.

And I really didn't want to say "from the hospital".

I imagine that the ward from which the patient had been discharged had one or more people with a chest infection. Having worked in a hospital I know that a lot of patients, and their visitors don't cover their mouths when they cough, and it seems completely reasonable that this is where the patient caught this infection.

It is probably unrelated to nurse or doctor hygiene (as these sorts of infection are often airborne), but instead due to something as simple as someone not covering their mouth when coughing. It might not have been another patient - hospital wards see a lot of visitors, including small children who are constantly exposed to, and incubating infections.

It seems to me that a lot of hospital infections could be cut if patient visitors didn't treat the ward like some form of hotel, tracking their infections in and out of the community, and generally acting like the rules of hygiene don't apply to them. I'm a big fan of restricted visiting for the majority of cases - and is there really any reason for children to be dragged around a hospital at all hours of the day.

It used to drive me barmy when I was running a ward.

But medical staff do need to improve their hand washing.

Only a short post today as I’m answering all the emails and comments that I’ve recently got.  So if you’ve emailed me and don’t get a reply sometime today – then I probably didn’t get it.

As a ‘homage’ (Read: Total ripoff) of Memoirs of an Urban Vigilante a City of Heroes player who writes an exceptionally funny blog about the game, I present to you my new City of Heroes (UK, Union Server) character – “The Big White Taxi”.

So called because it is the self appointed nickname for the Ambulance Service.

A Big hello to B3ta, for what is probably the nicest write up I’ve ever read.

Thanks Rob, you are way too nice for someone putting together one of the sickest most interesting weekly mail-outs I know of.

 The first job of my last shift was to a “BBA, not breathing”, a ‘BBA’ is a ‘Born Before Arrival’, basically someone has given birth at home and the baby has arrived before the ambulance gets there.  The ‘not breathing’ means that…ummm…  the baby isn’t breathing.

It’s the sort of job I don’t like doing, dead children are no fun and have a habit of playing on my mind for a day or so. 

I got there quick, even though a bus wanted to play ‘chicken’ with me, and I was met by the father outside the house, and he didn’t look that upset – actually he didn’t look upset at all.

I moved as quickly as I can with all my kit into the house (at a fast stroll), and found a crying baby and a relieved looking midwife.

The delivery was planned to be at home, which is why the midwife was there  – but cord was around the babies neck, and the delivery kit that the midwife had was missing a few vital supplies (cord clamps if I remember right), the midwife had called us, and then after having a rummage down her bag, had found the claps and delivered the baby.

So, a false alarm – but a happy false alarm at that.

Rumours that I asked the father what the babies date of birth was so I could fill out my paperwork are malicious, and entirely true…

My shift ends at 6:30 in the morning, so I was very happy to be left alone from 11pm.

Except that at 6:20 I get a job (I ask them if they are joking – they aren’t).  The job is a chest pain on a bus, in a bus garage.

It is also so far out my normal area I have to study the map for some time before I can work out how to get there.

I turn up to find out that the ‘patient’ is an alcoholic who is asleep in one of the buses.  She denies any chest pain, injury or illness – and after some persuasion she leaves the bus under her own power and leaves the scene.

If I were being cynical, I would be thinking that the bus company, unable to actually touch her for fear of assault, has called for an ambulance purely so that someone else is responsible for getting her off the bus.

Previous experience would suggest that this is indeed the case.

Why would they say she had chest pain – perhaps they know that this gets the quickest response from us…

Oh well – it’s all overtime.

I've just got back from a stabbing which took place in one of our busier streets.
The patient had a single stab wound in the back - I was around the corner having dealt with an abdominal pain (nothing too serious), when Control phoned me up and asked me if I wouldn't mind having a look to see if I could lend a hand.

I turned up, and there was already a Paramedic on scene (he has asked me to call him a superparamedic here - I have kindly refused). He had already done most of the assessment and treatment, the patient had a single stab wound in his back, to the right of his spine. He was treated as if he had a sucking chest wound, and was quickly transported to hospital.

During transit he developed a cough, and when the dressing to his stab wound was removed, it looked like his pleural membrane (the bag around the lung) had herniated (poked through the hole) which might explain the cough.

The patient was later transferred to another hospital because there was some concern that air had entered his spinal column.

I also had another patient with a potentially life threatening condition - an eight year old girl with a serious asthma attack. The child was calm and collected, although her breathing was seriously impaired. Her mother however was going to bits - she was running around crying, and screaming, and generally getting in the way. Luckily the patients gran had her head screwed on right, and I could get a history from her.

I started the required treatment, and the ambulance quickly turned up and took her to hospital. But I think I'd spent more time dealing with the mother than the child...

I'm kind of prosaic about our regular callers, they have chronic conditions (normally brought on by drinking), but they are normally easy to deal with and if you keep friendly with them, they are seldom trouble.

Until they start being incontinent on the back of your ambulance. But that is a subject for another day.

What I do dislike is the regulars who feel the need to lie to our calltakers.

Take regular patient number one - she calls for an ambulance, claiming that she has had a fit - when I turn up (I get mobilised for fitting patients a lot), she tells us that she hasn't had a fit, but her legs hurt, so can we take her to the hospital. Repeat this once or twice a day, and you wonder why some of us won't be too upset when we eventually find her dead in the gutter.

Tonight I went to regular patient number two - he is an alcoholic, who tonight told our Control that he had been assaulted 20 minutes earlier, and had had a seizure as a result of this assault.

I get sent the job, and speed three miles to get to the patient, only to find him drunk, he hadn't been assaulted, and there was no evidence that he had been fitting.

It isn't the actual going to the patient that bothers me, as I mentioned earlier, it's an easy job. What does annoy me is that I rush to these calls - putting myself and other road users at risk, only to find the patient not undergoing a life-threatening event. I get very cynical about these jobs.

I've tried telling them that if they call for an ambulance and say they have a painful leg, then they will still get an ambulance, but that they won't be putting other peoples lives at risk whether by my (lack of) driving skills, or by taking an ambulance away from someone who urgently needs an ambulance at that time.

But still they insist on calling for an ambulance with phantom illnesses.


I did do something else beside attend to our regulars - there was an 89 year old lady, living on her own, who had been having a panic attack for the last hour. This was around 3:30am, and a bit of hand holding (literally in this case), a drink of water, and a nice chat soon calmed her down. I left the ambulance crew to make her a cup of tea, as she didn't want to go to hospital.

The patient felt really guilty about calling for an ambulance - but I don't mind going to people who are scared or worried. It might not be the lifesaving hero work that most folk think we do - but for that patient, it can be just as important.

And for us... just as satisfying.