Quite simply superb writing from Inspector Gadget.

This is the worst kind of drama for us. It’s the kind where we have arrived before the other emergency services, specifically, before the paramedics. The officers from the response team are trying to save lives and calm the shattered pleas from relatives who were in the car behind and saw it all.

It's one of the ways I can tell if someone has been seriously hurt at a police incident, the coppers look worried.

I'm trying to stretch out my blogposts, I have a couple of jobs to write about but with my knee I'm not too sure how long I'll be off work - I'm writing this in the 'trauma clinic' waiting room, wondering what the doctor will say about my knee.

We were at the Royal London hospital, I was working with someone who is fairly new to the job. I like working with new people, they tend to not have any 'bad habits' and I can sound like the voice of experience. My crewmate was one of those steady guys, he'd been out of training school for some time and I could rely on him not to do anything daft on scene, or on the back of the ambulance.

As I mentioned, we were at the Royal London hospital having taken in the latest 'difficulty in breathing' that was, in reality, a runny nose. The whole shift had been like this, 'nothing' jobs that were simple walk-on, walk-off affairs.

"Attention all cars, attention all cars - ambulance required for a Bus vs Lorry RTA in Barking".

I was driving, my crewmate was the one looking after patients, he looked a bit excited.

"Might be a good job", he said.

"No mate", I replied, "We'll turn up and it'll be a fender bender".

So we offered up for the job, although it was miles away, and sped off.

During the drive there I could hear another crew getting sent to the same location, then the location of the accident changed - luckily I had planned this into my route to the scene, so we came across the accident first.

The bus has driven, at slow speed, into a JCB digger. The bus window was broken but there wasn't any other damage and as my crewmate jumped out he was just as quickly waved off - there were no injuries. We called Control and told them to cancel the other ambulance.

"Told you it would be nothing", I said to my crewmate, "It's against the laws of the Universe for me to get an interesting job...".

I got called to see the doctor halfway through writing this, essentially he is playing 'wait and see' and I have a repeat appointment in four weeks, which is fine by me as I don't want people cutting into my knee unless it's really necessary. I've been signed off work for two weeks which means one of two things - (a) I get loads of writing-type work done, or more likely (b) I get bored out of my skull. I have however learned why people who have canes on TV are always grumpy - it just flows naturally.

I’m thankful that Christmas is over, and as I sit here nursing a sore knee, I think back on some of the jobs that I went to over the holiday period…

Our patient was in his mid forties, he had called us from his mobile phone to tell us that he had suffered a fit.  While I’m used to people calling us if someone has a fit in front of them, the patient themselves phoning us is unusual (and normally means that they haven’t had a fit at all).

We found him sitting on the floor, beside a bus stop.  It was one of the really cold days and so it came as no surprise to me that he felt like a block of ice.  Our ambulance is warmer than an A&E department so I decided to sit and chat with him a bit so that he could warm up.

He told me that he was an alcoholic and that he hadn’t eaten or slept for the past three days.  A look into his eyes and I could see that it wasn’t just alcohol that was his problem.  I questioned him further and he admitted to taking ‘speed’.  If he was taking speed then I wasn’t surprised that he hadn’t slept for the past three days.

I checked him over to see if the cause of his seizure was anything we could treat.  All his vital signs were normal although we couldn’t check his temperature as our electronic thermometers stop working if it gets too cold.

His home address was on the other side of London, so I asked him why he was on ‘my patch’.

“It’s my daughter you see”, he told me, “She’s in foster care around here, but I want to see her for Christmas.  I even bought her a present.”.

I looked around in vain for something that may be a Christmas present for a little girl.

“I sold it, so I could get some cider”.

He’d been sleeping rough and in hostels after losing his daughter to social services, he’d been drinking so much that he had started to have alcoholic seizures.  Instead of eating properly he had been drinking cheap strong cider and taking amphetamines.  Then he had bought his daughter a Christmas present and sold it for a few cans of cider.  If I left him where he was there was a good chance that, without a decent meal inside him, he’d freeze to death.

So I did the only thing that I could do – I took him to hospital.

Then I had to put it out of my mind and do my next job.

Paramedics in Kent dealt with more than 350 calls in six hours from midnight on New Year's Eve - the equivalent of an average day for the emergency teams.
Kent's ambulance service said the calls were mainly drink-related incidents and road accidents.
On an average day, Kent crews deal with about 400 calls.

BBC News

I'm guessing that they have a lot less staff in Kent, as London deals with around ten times that call rate every day (3,500-4,000 calls a day), it just goes to show how different various ambulance services are. Anyone in the LAS care to tell me what the CAD numbers got up to last night and tonight?

(Spotted in the new section in the sidebar of this blog - the results of searching for 'ambulance' on BBC News)

You are going to love this...

I'm at work, it's 7am and I'm checking the ambulance to make sure that all the kit is there and that it is placed where I can find it. As it is 7am and I'm not a morning person I drop the electronic thermometer, part of which falls under the trolleybed. I get down on hands and knees to retrieve it...

...and hear a pop in my right knee.

Lots and lots of excruciating pain follows.

So I collapse onto the floor and scream a bit.

One of my stationmates hears me and comes to investigate, "What the bloody hell* are you doing down there?".

He goes and gets some help. Help to stand there, point and laugh at me. He includes some trainees in the mockery. I think he is getting his revenge because I keep calling him tubby.

I get given some entonox, a painkilling gas better known as 'laughing gas'. For some people this gas does nothing, for me - three puffs in - I'm giggling like a schoolgirl and can feel hardly anything. That which I do feel doesn't seem that important. I laugh a lot, use my good leg to get onto the ambulance trolley, and have some more entonox.

Mobile phone photographs are taken.

The trainees take my blood pressure, pulse and the like. I refuse to take my clothes off as I am a *bad* patient. I am also, as the young people say, 'off my head' on the entonox. It's good stuff, and to think they give us huge bottles of it to play with.

At the hospital, inbetween giggles, I am assessed by my favourite nurse (who, sadly, is escaping that A&E department soon) and I get seen by an Emergency Nurse Practitioner. I know Dr Crippen moans a lot about ENPs and the like, but the one who sees me is a good one - a full exam, a justification for an x-ray and good clinical skills.

The x-ray shows an effusion and maybe some ligament damage. I may get an MRI scan in the near future.

My duty station officer arrives, his first words? "If I'd known it was you I wouldn't have bothered coming, I thought it was one of the trainees".

He is, of course, joking.

So I'm hobbling around on crutches, with painkillers should I need them and an appointment to see the knee surgeon in a little while.

A big thanks to everyone involved, from my stationmates to the folks at the hospital, the care was excellent.

I have a few computery type things to do, but then I'm going to be at a bit of a lose end. I'm pondering learning a computer language, something that I can use in Xcode to knock up a Mac app. I'll search for a book on the Mac API in a bit, I just need to find a good one. It'll give me a chance to write some stuff for Mental Kipple, but I'll have to ration the eight or nine post ideas I have here. No work equals no inspiration.

*He may have used words stronger than 'bloody hell'.

Too damn tired to do anything except sit in a corner and breath quietly to myself, am barely able to string a sentence together - so here is a link to what Ben Hammersley is up to at the moment. I wish I could take photos like this instead of just dealing with the people.

(Favourite trick of the moment when called to an 'unconscious' drunk? Shine a torch in their face and shout 'Go towards the light!' Wakes them up without me having to touch them).

"Patient is suspended"

We rushed to the scene and the FRU arrived seconds before us. The patient, an elderly man, was laying on the floor. He wasn't breathing, he didn't have a pulse and he looked dead.

"He's dead, isn't he?", asked his wife. I could tell by the look on her face that she knew he was dead.

I could only tell her the truth, "He isn't breathing at them moment and his heart isn't beating. We are doing everything that we can for him, but you should expect the worst".

She nodded, she'd seen the colour of him and seemed resigned to his death.

My crewmate put the defib pads to his chest - he was in 'VF', a rhythm that we shock. So we shocked him and did some CPR, all according to our training. Then we shocked him again, gave him some drugs, breathed for him, shocked him again and eventually (and surprisingly) got a pulse back.

We all looked at each other - this sort of thing doesn't happen to us. Normally our dead patients stay dead.

We packaged him up for hospital, three times his pulse stopped but after a couple of minutes of chest compressions he'd get it back. Surely this wouldn't last, eventually he would die.

His wife seemed confused, but happy. Perhaps he wouldn't die after all.

We rushed him to the hospital, I think he lost his pulse twice more, each time we got it back. By the time we reached the hospital he was chewing on the breathing tube.

The hospital worked on him for a long time - still he didn't die. They tried everything, they even gave him a drug that costs more than £600 in the hopes that it would help stabilise him. They did everything, they thought that he may have had a chance as well.

His wife had hope. The last we heard was that he was transferred to another hospital where there was an intensive care bed. I'm guessing that I'll never learn what happened to him in the end.

I wonder if it was for the best that we saved him. My guess would be that, even if he does make a recovery, he will have some form of brain damage - he went without CPR for too long. The alternative is that he never leaves hospital. I wonder if his wife will continue to hope until he fades away in ITU.

From her acceptance that he was dead, to a probably vain hope that she would get him back, I wonder if it was cruel that our resuscitation was 'successful'. At the time we have no chance to make such decisions, we do what we do and get on with it. It's later, as you see the family around the patient, the monitoring machinery showing life but the patient making no movement, only then do you wonder if it is right.

I can't remember many of the people who die despite my best efforts (the cynical would suggest it's the sheer numbers I see that make it hard to remember). But this one will stay with me for some time.