Sometimes a day can just drag along. Today due to rather unusual circumstances , the day really dragged. Here is the time-line of today

10:00 Turn up for work, brew a cup of tea
10:01 First job of the day, taking someone from Newham hospital to Barts.
10:02 Cut finger on my locker door, try to stop bleeding, look for plaster.
10:23 Give up search for a plaster - there are none on the station - leave for Newham hospital.
10:26 Arrive at Newham hospital, ask for plaster, they also don't have a plaster so I now have a huge dressing on my finger.
10:28 Meet with patient, pleasant woman - meet nurse who will be accompanying patient, barely understand nurse due to her inability to speak English.
10:30 Get patient's notes and read them, they make more sense.
10:32 Ask Nurse in charge why this patient (who is having cardiac monitoring and a blood transfusion) is going to an outpatient department. Get told that the patient 'just is'.
10:54 After packaging the patient on a stretcher, loading them on the back of the ambulance, we set of for Barts hospital.
10:55 Nurse escort tells me that she gets travel sick.
10:55:20secs Give nurse a vomit bag.
11:37 Arrive at Barts hospital
11:38 Enter Outpatients department, Reception seem rather surprised to see patient on stretcher appear in front of them.
11:40 Problem is referred to the sister in charge, she also looks befuddled.
12:00 We wait while sister in charge phones around the hospital trying to work out why this patient is in her outpatient department.
12:30 Still waiting...We let Control know why we are waiting - there is no stretcher/bed to put the patient on.
13:00 Still waiting
13:30 Still waiting - we let Control know that we still have the patient on out stretcher while they work out what they are going to do with our patient.
14:00 Still waiting
14:30 Still waiting - we let Control know that we haven't gone to sleep, we are told by sister in charge that patient will be admitted soon.
14:45 We place patient on an examination bed so that we can go back to answering emergency calls, patient will hopefully be in a hospital bed soon. We leave the nurse escort with the patient.
14:48 We are finally available for another job.
14:49 We realise we have nearly no fuel, and no fuel card to pay for fuel. We decide to return to station to borrow a fuel card off an unused ambulance
15:20 We arrive back on station to look for fuel card (and have a cup of tea).
15:30 We leave to get fuel. Take infusion pump back to hospital - the ward seem surprised that the patient has been admitted to Barts.
15:48 We have fuel, we are now ready for another job.
16:00 We get a call, out of area, Maternataxi
16:09 Arrive at Maternataxi, contractions (genuinely) every two minutes, previous baby born in 3 hours, drive rather quickly toward her booked hospital
16:12 Patient's waters break - start swimming in back of ambulance.
16:20 Arrive at hospital
16:24 Throw patient at midwife, run back to ambulance.
16:30 Tell control that we need to return to station to mop out the back of the ambulance.
17:20 Get back to station, mop out.
17:45 Crew to relieve us are already on station, await ambulance to dry out
18:00 Leave for home.
18:37 Get home, collapse into sofa, start writing this post.

-Fin-

This is how you get to work an eight hour shift, yet only do two jobs...

In unrelated news, I had a rather nice time at the London Blogger Meetup, people there included 'Stroppycow', Andrew and Mark, all of which blog for different reasons. After only two pints of John Smiths, I managed to get on a train travelling in the wrong direction... The next meetup will be merged with that of the Funjunkie Christmas meetup, which I am rather looking forward to...

Tonight I'm being sent across London to work at Camden ambulance station. For a grand total of four hours...

Last night was also fairly easy, with one laughable job. I'd just like to say, before telling you about this call, that I have nothing against people who are pregnant, pregnancy is fine, women are fine, it's just...well...sometimes it makes me cringe that the normal processes of pregnancy lead to us being called out as an emergency vehicle.

The patient was a 30 year old female who is 8 weeks pregnant. She has been suffering from normal 'morning sickness', so she went to the GP on Monday, then to the A&E walk in centre on Thursday where they prescribed her a medicine to stop her vomiting. Last night she wanted us called because while the medication was working, but she still felt nauseous - and couldn't actually vomit.

So she her husband called us as a 999 emergency call, and asked to be taken to a hospital out of our area because "she had a bad experience at Newham hospital". She couldn't speak any English, and the husband didn't have the worlds best grasp of the language either - so I suppose that it may just have been that the patient didn't understand what was happening to her, perhaps she needed a translator service so that the information she was being given wasn't translated by her husband who, to be honest, wasn't the brightest bulb in the box. Or perhaps this young pair were just rather stupid...

What makes things worse is that they had a much nicer flat than me.

Tonight, for some reason the traffic in the area was bleedin' awful (note the technical turn of phrase) - it took me 35 minutes to get out of the street from my flats, and my normal 15 minutes commute turned into 2 hours. It was like this across the whole of the area, which unsurprisingly has a big knock-on effect for the ambulance service.

Imagine, everyone coming in to work is stuck in traffic (and talking to our resource centre there apparently wasn't a single ambulance which wasn't affected by someone being late) - this obviously manages to reduce the number of ambulances on the road.

I would imagine the same is true for other essential workers, police, firefighters, nurses and more.

So the next time you are in a traffic queue, and you feel like cutting in front of someone because your journey home is more important than anything else, consider this - they may just be the person who will be cutting you out of the wreckage of your car later when you decide to drive down the wrong side of the road again.

The actual shift was quite pleasant - we did a handful of jobs one of which was a drunk! One of our regular callers had fallen over in the street after having a little too much of the funny juice.

Our last job was the only job of note. We got called to a 33 year old male who had 'difficulty in breathing'. When we got to the patient it transpired that he had was 'feeling funny'. Could this be because of a lowered blood sugar, a head injury or the patient being septic? Could it be an undiagnosed mental illness, an aura preceding an epileptic fit or a brain tumour? Or, more realistically, could it even have been because he had been smoking marijuana all evening? As I was driving I never got the chance to point out that this was the entire point of smoking the stuff, but we took him to hospital as it managed to finish our shift off nicely. You can see the Mensa members we find ourselves meeting on this job...

Still no drunks - but, the weekend starts today and my shift ends at 2am...

I'm going to describe a job I went to last night.

The patient is female and 30 years old. She is married and is attempting to get pregnant. She is currently only taking fertility treatment, and having unprotected sex - she is normally fit and healthy and has no allergies. Her normal menstrual period is regular, however her period is over two weeks late this time around. She has been having nausea and vomiting for the past three days. She has no abdominal pain, and is not tender or guarding. She has no pain or increased frequency of passing urine. All vital signs are within normal limits.

So - given this information...

a) What do you think is 'wrong' with her?

b) Does she need a trip to hospital in an ambulance?

c) Why do you think she hasn't done a pregnancy test?

Five jobs last night, none of which were particularly interesting - and none of which involved alcohol. I love Murphy's law for making these shifts particularly pleasant...

I offer this further bit of information with no bias, nor any particular message - but the Newham registry office has released the most popular names for babies in the area. For boys, the most popular name is Mohamed, while for girls, the most popular name is Fatima. As an aside, there are a lot of people who have the exceptionally original name of "Mohamed Mohamed", to which I always ask which is the first name, and which is their second name...

Three jobs that warrant a mention - the first was a 39 year old male with a racing heart-beat. We got to him and discovered that he was in SVT, so we "blued" him into hospital where four doctors were waiting to treat him. His heartbeat returned to normal after they treated him with Adenosine. Why four doctors? Well I suspect it is because, like dealing with hypoglycemic patients, you can make an immediate difference in someones condition - and the patient normally comes away impressed. Dealing with SVT's were my favourite type of job when I worked in hospital.

Another vaguely interesting job was to a 16 year old female who had fallen from a garden fence after arguing with her sister. Fairly minor injuries - but a friendly, appreciative family. The memorable thing is that they live on an estate that is spread out over a wide area (the sort of place that is a nightmare to navigate, because the house numbering scheme seems like it was designed by a madman). Roaming the streets was a gang of feral teenage girls who, to be fair, did help us find the address - but I wonder at the parents who let their young children run around at half ten at night.

Finally we had a job for a kid who lives at "The Residential Home For Children With Behavioural Difficulties", which is where feral children end up - and where they are allowed to stay up past 11pm watching music television, complain about the allergic reaction that their nicotine patch is giving them, and boss around the 'carers' who are supposed to be providing an example to live by, but are instead (I suspect) just looking forward to their next paycheck.

Bring back National Service I say...

This is why I'm not a manager - I am working seven days this week - and seven days next week...

I did manage to pick up two people who were drunk last night - one had a nosebleed, while the other was a 17 year old who had been fighting with 'friends' in the park at midnight, and had gotten kicked in the ribs. Lungs were both alright, although the way he was behaving you would have thought that he was about to drop dead.

Stand out job of the night was getting a 22 Stone, immobile woman, who was dizzy and vomited whenever her head moved, down some stairs and into hospital. This could have been a complete nightmare of a job, but is wasn't, if only because both the patient and her daughter were very pleasant people (and it helped that they had a stair-lift in the patient's home). It went a bit worse because the hospital was exceptionally busy, and we kept being pushed from pillar to post while they searched for a bed for her. It took us nearly two hours to do this one job.

We also went to a five year old who had a swollen top lip - probably because of a minor allergic reaction, not a real emergency (she'd had it for over an hour, and it wasn't getting any worse). What made the job memorable is that the rather large family, wanted to go to the Royal London hospital, and not the closest (by about 2 miles) hospital at Newham. I might have taken them to the Royal London if they hadn't been so rude about Newham... (by policy, we are supposed to take people to the nearest hospital, and can only take people to other hospitals "at our discretion") I took the mother, daughter and sister (who apologised for the behaviour of her brother) to Newham and within 20 seconds of arriving, were met by the rest of the family, who had driven up in two cars full of people. There was one patient and nine relatives (I counted nine, it might have gotten even more) most of which were 'angry young men'. They spent the next two hours dominating the Paediatric waiting area, and I was reminded of the Toronto hospital which only allows one 'support person'.

I apologised to the nurse at the hospital - but it's not my fault they all turned up...

So far the count is 10 Sober jobs, to 2 Drunk jobs.

As predicted, none of my patients were worse the wear for alcohol - I expect this trend to continue for the next five days.

I thought I was working seven days, but that is actually next week - I'm only working five days this week, plus a visit to the Old Bailey on Monday - my day off.

We did however have a delivery driver, who was allegedly robbed by having CS gas sprayed in his face. The police present asked me very politely if I wouldn't park my ambulance on their crime scene - I obliged because they were bigger than me. The patient didn't want to go to hospital, and after letting his eyes dry out we left him in the care of the police present. Medical tip, don't wet your eyes if you have been sprayed with CS gas, it will only make things worse - instead face into the wind and let your eyes dry out that way.

We also went to a five year old who was apparently having an asthma attack - when we got there the child was asleep and had nothing more severe than a runny nose. I had to put on my teaching hat because the mother didn't understood what asthma is, so I had to explain the difference between that and a runny nose.

We had a 73 year old lady who collapsed in a GP surgery and when the GP measured her blood pressure as 90/40 (rather low), he thought it would be a good idea to sit her in a chair, rather than lay her down. Luckily for him, she didn't faint again...

Our last job of the shift was to a 91 year old man, who had become unable to stand - the carers who helped his elderly wife look after him didn't know what to do, and refused to call out the GP despite the wifes request. The wife called the GP herself. The GP visited, took the patients blood pressure and told them that they should call an ambulance to get the patient into bed, and then they would arrange a hospital admission in the morning. As the GP is a locum doctor, I doubt that this would happen at all. This is disgraceful - the GP should have referred the patient at that time, rather than pass the patient onto the day doctor. As it was, we thought that it would be best to take him into hospital that night (which is what he wanted), so that they could try and find out why he was unable to walk.

Last week we went to a 70 year old female who had chronic leg ulcers and terrible eczema, her husband had called us because the district nurse, who is supposed to dress these types of wounds, hadn't visited in the last 10 weeks. The patient had have what appeared to be a stroke in the last two days, but the husband who called us "didn't want to bother anyone"... I was glad that we could take the patient into hospital, because it seems that this is the only way should could receive the care that she required.

I told the handover nurse about the lack of community care, and she has promised to do something about it - it's one of the few things that I miss from nursing - being able to shout at useless 'professional carers' over the phone. The situations that people find themselves in, where their final resort is to call for an ambulance, make me extremely angry, yet there is little I can do in this job to change that situation.

On Sunday we remembered those who fought in the various wars, and yet the best that we can do for the elders who lived through those times is to treat them like a problem and pass them on to someone else. Is it really so difficult to provide care for these people who have worked their whole life?